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  1. Article ; Online: Racial differences after bariatric surgery: 24-month follow-up of a randomized, controlled trial for postoperative loss-of-control eating.

    Ivezaj, Valentina / Dilip, Abhaya / Duffy, Andrew J / Grilo, Carlos M

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2023  Volume 20, Issue 3, Page(s) 261–266

    Abstract: Background: While some bariatric surgery outcomes vary by race/ethnicity, less is known about racial/ethnic differences in loss-of-control (LOC) eating and psychosocial outcomes post-surgery.: Objective: This prospective study examined and extended ... ...

    Abstract Background: While some bariatric surgery outcomes vary by race/ethnicity, less is known about racial/ethnic differences in loss-of-control (LOC) eating and psychosocial outcomes post-surgery.
    Objective: This prospective study examined and extended initial short-term findings regarding racial differences in post-bariatric surgery LOC eating and weight loss to longer-term outcomes through 24-month follow-ups.
    Setting: Academic medical center in the United States.
    Methods: Participants were 140 patients (46.4% non-White) in a 3-month randomized, controlled trial for LOC eating performed about 6 months after bariatric surgery. Participants were reassessed at 6, 12, 18, and 24 months after treatment ended (about 33 mo after surgery). Doctoral assessors administered the Eating Disorder Examination-Bariatric Surgery Version interview to assess LOC eating and eating-disorder psychopathology at 12- and 24-month follow-ups. The Beck Depression Inventory II was repeated, and measured weight was obtained at all follow-ups.
    Results: White patients had significantly greater percent excess weight loss at all follow-ups than non-White patients (p < .03). White patients reported significantly more LOC eating at 12- (p = .004) and 24-month (p = .024) follow-ups and significantly greater eating disorder psychopathology at 12-month follow-up (p < .028). Racial groups did not differ significantly in eating disorder psychopathology at 24-month follow-ups or in Beck Depression Inventory II depression scores at any follow-ups.
    Conclusions: Our findings suggest that among patients with LOC eating after bariatric surgery, non-White patients attain a lower percent excess weight loss than White patients but have comparable or better outcomes in LOC eating, associated eating disorder psychopathology, and depression over time.
    MeSH term(s) Humans ; Follow-Up Studies ; Prospective Studies ; Race Factors ; Feeding and Eating Disorders ; Weight Loss ; Bariatric Surgery/psychology ; Binge-Eating Disorder/psychology
    Language English
    Publishing date 2023-09-26
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2023.09.017
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    Zs.A 6572: Show issues Location:
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  2. Article ; Online: Outcomes of routine upper gastrointestinal series screening and surveillance after laparoscopic adjustable gastric banding.

    Friedman, Danielle T / Duffy, Andrew J

    Surgical endoscopy

    2019  Volume 34, Issue 5, Page(s) 2178–2183

    Abstract: Background: Esophageal dilatation and dysmotility are known complications of the laparoscopic adjustable gastric band (LAGB), but their incidence varies widely in the literature. There are no formal recommendations guiding surveillance for these ... ...

    Abstract Background: Esophageal dilatation and dysmotility are known complications of the laparoscopic adjustable gastric band (LAGB), but their incidence varies widely in the literature. There are no formal recommendations guiding surveillance for these potentially underdiagnosed pathologies. This study demonstrates the utility and outcomes of a yearly upper gastrointestinal series screening protocol to detect and manage esophageal dysfunction after LAGB.
    Methods: We reviewed charts for all patients presenting for an outpatient surgical encounter related to LAGB between January 1, 2015 and December 31, 2017. Exclusion criteria included failure to undergo UGIS 6 months or more after band placement, or having undergone band placement in combination with another bariatric procedure. Descriptive statistics were used to characterize demographics, imaging findings and surgical outcomes. All imaging classifications were based on final radiologist report. Means were compared using a Student's t test.
    Results: A total of 322 records were reviewed with 39 patients excluded; 31 without UGIS and 8 with concomitant gastric bypass. 85% were female with an average age of 50 years. 66.8% identified as white or Caucasian with 24.7% black/African-American. Greater than 75% of the cohort had at least 5-year follow-up interval. UGIS was performed for symptoms in 66.1% and for routine screening in 33.9%. Of asymptomatic patients, 47.9% demonstrated esophageal dilatation or dysmotility on UGIS, similar to 51.3% of symptomatic patients. 96.8% of all patients went on to band removal. Sixty-four patients had repeat UGIS an average of 8 months following band removal, of which 40.6% were persistently abnormal.
    Conclusions: The incidence of esophageal pathology was significantly higher than most reported series, as was the number of patients with persistently abnormal UGIS despite band removal. The data supports our policy of yearly UGIS for all post-LAGB patients, with strong recommendation for band removal if esophageal dilatation or dysmotility is found.
    MeSH term(s) Cohort Studies ; Female ; Gastric Bypass/methods ; Gastroplasty/methods ; Humans ; Laparoscopy/methods ; Male ; Mass Screening/methods ; Middle Aged ; Obesity, Morbid/surgery
    Language English
    Publishing date 2019-07-25
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-019-07005-4
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    Zs.A 2214: Show issues Location:
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  3. Article ; Online: Predictors of early weight loss in post-bariatric surgery patients receiving adjunctive behavioural treatments for loss-of-control eating.

    Smith, Caitlin E / Dilip, Abhaya / Ivezaj, Valentina / Duffy, Andrew J / Grilo, Carlos M

    Clinical obesity

    2023  Volume 13, Issue 4, Page(s) e12603

    Abstract: This study examined baseline patient characteristics as predictors of early weight loss, defined as any weight loss within the first month of treatment, among patients receiving adjunctive behavioural treatments for loss-of-control (LOC) eating about 6 ... ...

    Abstract This study examined baseline patient characteristics as predictors of early weight loss, defined as any weight loss within the first month of treatment, among patients receiving adjunctive behavioural treatments for loss-of-control (LOC) eating about 6 months after bariatric surgery. Participants were 126 patients in a treatment trial for LOC-eating (roughly 6 months postoperatively) categorized by early weight change following 1 month of treatment. Early weight-loss, defined as any weight loss following 1 month of treatment, and weight-gain, defined as any weight gain, groups were compared on sociodemographic and clinical variables assessed using a battery of reliably administered diagnostic and clinical interviews and established self-report measures, and on surgery-related variables (time since surgery, percent total [%TWL], and percent excess weight loss). Most patients (n = 99; 78.6%) lost weight after the first month of adjunctive treatments. Black patients (n = 24; 61.5%) were significantly less likely to achieve early weight loss compared to patients identifying as White (n = 60; 83%) or 'other' (n = 15; 100%) which was not predicted by any other sociodemographic variable. Severity of eating-disorder psychopathology, psychiatric comorbidity, and a broad range of psychosocial measures were not significantly predictive of early weight changes. Duration since surgery and percent weight loss from time of surgery to study enrolment 6-months post-surgery differed by early weight-loss and weight-gain groups. Findings suggest that among post-bariatric surgery patients receiving adjunctive behavioural treatments for LOC-eating, baseline patient characteristics, aside from race and surgery-related variables, do not predict early weight loss.
    MeSH term(s) Humans ; Bariatric Surgery/psychology ; Behavior Therapy ; Binge-Eating Disorder/psychology ; Comorbidity ; Feeding and Eating Disorders ; Obesity, Morbid/surgery ; Weight Loss
    Language English
    Publishing date 2023-05-31
    Publishing country England
    Document type Clinical Trial ; Journal Article
    ZDB-ID 2625816-X
    ISSN 1758-8111 ; 1758-8103
    ISSN (online) 1758-8111
    ISSN 1758-8103
    DOI 10.1111/cob.12603
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    Zs.A 6918: Show issues Location:
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  4. Article ; Online: 24-Month follow-up of randomized controlled trial of guided-self-help for loss-of-control eating after bariatric surgery.

    Grilo, Carlos M / Ivezaj, Valentina / Duffy, Andrew J / Gueorguieva, Ralitza

    The International journal of eating disorders

    2022  Volume 55, Issue 11, Page(s) 1521–1531

    Abstract: Background: Loss-of-control (LOC)-eating postoperatively predicts suboptimal longer-term outcomes following bariatric surgery. This study examined longer-term effects through 24-month follow-ups after completing treatments in a randomized controlled ... ...

    Abstract Background: Loss-of-control (LOC)-eating postoperatively predicts suboptimal longer-term outcomes following bariatric surgery. This study examined longer-term effects through 24-month follow-ups after completing treatments in a randomized controlled trial testing guided-self-help treatments (cognitive-behavioral therapy [gshCBT] and behavioral weight-loss [gshBWL]) and control (CON) delivered postoperatively for LOC-eating.
    Methods: 140 patients with LOC-eating 6 months after bariatric surgery were randomized (5:5:2 ratio) to 3-months of gshCBT (n = 56), gshBWL (n = 60), or CON (n = 24) delivered by trained allied-health clinicians. Independent assessments were performed throughout/after treatments and at 6-, 12-, 18-, and 24-month follow-ups; 83% of patients were assessed at 24-month follow-up.
    Results: Intention-to-treat analyses comparing the three groups (gshCBT vs. gshBWL vs. CON) in LOC-eating abstinence at posttreatment (30%, 27%, 38%), 12-month follow-up (34%, 32%, 42%), and 24-month follow-up (45%, 32%, 38%) revealed no significant differences. Mixed-models revealed significantly reduced LOC-eating frequency through posttreatment, no significant changes in LOC-eating frequency during follow-up, and no differences between the three groups. Weight reduced significantly, albeit modestly, through posttreatment but increased significantly and substantially during follow-ups, with no differences between groups.
    Conclusions: Overall, the 12-week scalable guided-self-help treatments did not differ from each other or control, were associated with significantly reduced frequency of LOC-eating and modest weight loss at posttreatment but were followed by significant weight gain during the 24-month follow-up. Weight gain was substantial and nearly universal whereas the frequency of LOC-eating did not change over time (i.e., LOC-eating reductions and abstinence rates were well maintained through 24-moth follow-ups). Patients with postoperative LOC-eating require more intensive adjunctive treatments.
    Public significance: Loss-of-control (LOC) eating postoperatively predicts poorer bariatric surgery outcomes and the longer-term effects of postoperative adjunctive postoperative interventions for LOC eating are unknown. In this 24-month follow-up of a controlled study of scalable guided-self-help treatments and a control condition, improvements in LOC-eating frequency, eating-disorder psychopathology, and depression during treatment were maintained well, with no differences between the three groups. Proportion of patients achieving abstinence from LOC-eating at the 24-month follow-up ranged from 38% to 45% across the three groups. In contrast, weight increased significantly during the 24-month follow-ups, with no differences between the three groups. Findings suggest LOC-eating following bariatric surgery might represent a "marker" for a subgroup of patients that are at risk for substantial weight gains over time. LOC eating following bariatric surgery is challenging to treat with low-intensity scalable treatments and may require more intensive specialist treatments.
    MeSH term(s) Humans ; Binge-Eating Disorder/complications ; Follow-Up Studies ; Bariatric Surgery ; Weight Loss ; Weight Gain ; Treatment Outcome
    Language English
    Publishing date 2022-08-24
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 603170-5
    ISSN 1098-108X ; 0276-3478
    ISSN (online) 1098-108X
    ISSN 0276-3478
    DOI 10.1002/eat.23804
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    Zs.A 1749: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article ; Online: Invited Commentary.

    Duffy, Andrew J / Friedman, Danielle T

    Journal of the American College of Surgeons

    2018  Volume 226, Issue 6, Page(s) 1069–1071

    MeSH term(s) Dental Porcelain ; Gallbladder Diseases ; Humans
    Chemical Substances Dental Porcelain (12001-21-7)
    Language English
    Publishing date 2018-05-25
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1181115-8
    ISSN 1879-1190 ; 1072-7515
    ISSN (online) 1879-1190
    ISSN 1072-7515
    DOI 10.1016/j.jamcollsurg.2018.03.011
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  6. Article ; Online: Randomized Controlled Trial of Treatments for Loss-of-Control Eating Following Bariatric Surgery.

    Grilo, Carlos M / Ivezaj, Valentina / Duffy, Andrew J / Gueorguieva, Ralitza

    Obesity (Silver Spring, Md.)

    2021  Volume 29, Issue 4, Page(s) 689–697

    Abstract: Objective: Loss-of-control (LOC) eating postoperatively is a consistent predictor of suboptimal longer-term bariatric surgery outcomes. This randomized controlled trial examined the effectiveness of two guided self-help treatments (cognitive behavioral ... ...

    Abstract Objective: Loss-of-control (LOC) eating postoperatively is a consistent predictor of suboptimal longer-term bariatric surgery outcomes. This randomized controlled trial examined the effectiveness of two guided self-help treatments (cognitive behavioral therapy [gshCBT] and behavioral weight loss [gshBWL]) compared with a control (CON) for reducing LOC eating and weight.
    Methods: A total of 140 patients with recurrent LOC eating approximately 6 months after bariatric surgery were randomly assigned (5:5:2 ratio) to one of three conditions: gshCBT (n  =  56), gshBWL (n  =  60), or CON (n  =  24). Three-month treatments were delivered by trained allied health clinicians to increase generalizability to bariatric surgery settings. Independent assessments were performed by doctoral research-clinicians using established interviews/measures; posttreatment outcomes were obtained for 89% of patients.
    Results: Mixed models revealed significant improvements for LOC eating frequency and weight loss but no significant differences between treatments; race neither predicted (main effect) nor moderated (interaction effect) treatment outcomes. Intent-to-treat categorical analyses of abstinence from LOC eating (30% for gshCBT, 27% for gshBWL, 38% for CON) and proportion attaining 5% weight loss (20%, 22%, 17%) revealed no significant differences between treatments; non-White participants had a higher proportion achieving LOC eating abstinence but a lower proportion attaining 5% weight loss compared with White participants.
    Conclusions: In this 12-week randomized controlled trial following bariatric surgery, significant LOC eating reductions and weight loss did not differ significantly between treatments. Race was associated with posttreatment categorical outcomes.
    MeSH term(s) Adolescent ; Adult ; Aged ; Bariatric Surgery/psychology ; Cognitive Behavioral Therapy/methods ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Treatment Outcome ; Weight Loss/physiology ; Young Adult
    Language English
    Publishing date 2021-03-10
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
    ZDB-ID 2230457-5
    ISSN 1930-739X ; 1071-7323 ; 1930-7381
    ISSN (online) 1930-739X
    ISSN 1071-7323 ; 1930-7381
    DOI 10.1002/oby.23124
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  7. Article: Information Technology-Enhanced Telehealth Consultations Reduce Preoperative Evaluation Center Visits in a Bariatric Surgery Population.

    Zafar, Jill E / Chan, Kathleen T / Ryder, Lori J / Duffy, Andrew J / Dai, Feng / Carr, Zyad J / Charchaflieh, Jean G

    Healthcare (Basel, Switzerland)

    2023  Volume 11, Issue 3

    Abstract: ... ...

    Abstract Background
    Language English
    Publishing date 2023-01-19
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2721009-1
    ISSN 2227-9032
    ISSN 2227-9032
    DOI 10.3390/healthcare11030309
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  8. Article ; Online: Structured Resident Training in Robotic Surgery: Recommendations of the Robotic Surgery Education Working Group.

    Porterfield, John R / Podolsky, Dina / Ballecer, Conrad / Coker, Alisa M / Kudsi, Omar Yusef / Duffy, Andrew J / Meara, Michael P / Novitsky, Yuri W

    Journal of surgical education

    2023  Volume 81, Issue 1, Page(s) 9–16

    Abstract: Objective: A universal resident robotic surgery training pathway that maximizes proficiency and safety has not been defined by a consensus of surgical educators or by surgical societies. The objective of the Robotic Surgery Education Working Group was ... ...

    Abstract Objective: A universal resident robotic surgery training pathway that maximizes proficiency and safety has not been defined by a consensus of surgical educators or by surgical societies. The objective of the Robotic Surgery Education Working Group was to develop a universal curriculum pathway and leverage digital tools to support resident education.
    Design: The two lead authors (JP and YN) contacted potential members of the Working Group. Members were selected based on their authorship of peer-review publications, their experience as minimally invasive and robotic surgeons, their reputations, and their ability to commit the time involved to work collaboratively and efficiently to reach consensus regarding best practices in robotic surgery education. The Group's approach was to reach 100% consensus to provide a transferable curriculum that could be applied to the vast majority of resident programs.
    Setting: Virtual and in-person meetings in the United States.
    Participants: Eight surgeons (2 females and 6 males) from five academic medical institutions (700-1541 beds) and three community teaching hospitals (231-607 beds) in geographically diverse locations comprised the Working Group. They represented highly specialized general surgeons and educators in their mid-to-late careers. All members were experienced minimally invasive surgeons and had national reputations as robotic surgery educators.
    Results: The surgeons initially developed and agreed upon questions for each member to consider and respond to individually via email. Responses were collated and consolidated to present on an anonymized basis to the Group during an in-person day-long meeting. The surgeons self-facilitated and honed the agreed upon responses of the Group into a 5-level Robotic Surgery Curriculum Pathway, which each member agreed was relevant and expressed their convictions and experience.
    Conclusions: The current needs for a universal robotic surgery training curriculum are validated objective and subjective measures of proficiency, access to simulation, and a digital platform that follows a resident from their first day of residency through training and their entire career. Refinement of current digital solutions and continued innovation guided by surgical educators is essential to build and maintain a scalable, multi-institutional supported curriculum.
    MeSH term(s) Male ; Female ; Humans ; United States ; Robotic Surgical Procedures/education ; Curriculum ; Internship and Residency ; Education, Medical, Graduate ; Surgeons/education ; Clinical Competence ; General Surgery/education
    Language English
    Publishing date 2023-10-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2023.09.006
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  9. Article ; Online: Examination of night eating and loss-of-control eating following bariatric surgery.

    Ivezaj, Valentina / Lawson, Jessica L / Lydecker, Janet A / Duffy, Andrew J / Grilo, Carlos M

    Eating and weight disorders : EWD

    2021  Volume 27, Issue 1, Page(s) 207–213

    Abstract: Purpose: Post-operative loss-of-control (LOC)-eating is a negative prognostic indicator for long-term outcomes following bariatric surgery. Emerging research suggests that night eating might also be associated with poorer post-operative outcomes. This ... ...

    Abstract Purpose: Post-operative loss-of-control (LOC)-eating is a negative prognostic indicator for long-term outcomes following bariatric surgery. Emerging research suggests that night eating might also be associated with poorer post-operative outcomes. This study examined the co-occurrence and clinical features of night eating in patients with LOC-eating following bariatric surgery.
    Methods: Participants were 131 adults who sought treatment for eating/weight concerns 6 months following sleeve gastrectomy. The Eating Disorder Examination (EDE) interview (Bariatric-Surgery-Version) assessed LOC-eating, regular night eating (at least weekly), and eating-disorder psychopathology. Participants completed the Night Eating Questionnaire (NEQ), Beck Depression Inventory (BDI-II), and the Pittsburgh Sleep Quality Index (PSQI).
    Results: Approximately, 15% met screening criteria for night-eating syndrome based on the NEQ. Greater NEQ scores were associated significantly with race, lower percent total weight loss (%TWL), and greater EDE, BDI-II, and PSQI scores. Similar results were observed when comparing groups with regular night eating (21.4%) versus without (78.6%); adjusting for race and %TWL revealed similar findings.
    Discussion: In post-bariatric patients with LOC-eating, 15% likely had night-eating syndrome and 21.4% engaged in regular night-eating behavior. The co-occurrence of LOC-eating and regular night eating following sleeve gastrectomy may represent a more severe subgroup with elevated psychopathology, poorer sleep and %TWL.
    Level of evidence: Level III, evidence obtained from well-designed cohort or case-control analytic studies.
    MeSH term(s) Adult ; Bariatric Surgery ; Feeding Behavior ; Feeding and Eating Disorders ; Gastrectomy/methods ; Humans ; Postoperative Period ; Weight Loss
    Language English
    Publishing date 2021-03-17
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2038625-4
    ISSN 1590-1262 ; 1124-4909
    ISSN (online) 1590-1262
    ISSN 1124-4909
    DOI 10.1007/s40519-021-01156-x
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  10. Article ; Online: Gallbladder Disorders: A Comprehensive Review.

    Lam, Robert / Zakko, Alan / Petrov, Jessica C / Kumar, Priyanka / Duffy, Andrew J / Muniraj, Thiruvengadam

    Disease-a-month : DM

    2021  Volume 67, Issue 7, Page(s) 101130

    Abstract: Gallbladder disorders encompass a wide breadth of diseases that vary in severity. We present a comprehensive review of literature for the clinical presentation, pathophysiology, diagnostic evaluation, and management of cholelithiasis-related disease, ... ...

    Abstract Gallbladder disorders encompass a wide breadth of diseases that vary in severity. We present a comprehensive review of literature for the clinical presentation, pathophysiology, diagnostic evaluation, and management of cholelithiasis-related disease, acute acalculous cholecystitis, functional gallbladder disorder, gallbladder polyps, gallbladder hydrops, porcelain gallbladder, and gallbladder cancer.
    MeSH term(s) Cholecystitis/diagnosis ; Cholecystitis/therapy ; Cholelithiasis/diagnosis ; Cholelithiasis/therapy ; Gallbladder/pathology ; Gallbladder Diseases/diagnosis ; Gallbladder Diseases/therapy ; Gallbladder Neoplasms/diagnosis ; Gallbladder Neoplasms/therapy ; Humans
    Language English
    Publishing date 2021-01-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 390545-7
    ISSN 1557-8194 ; 0011-5029
    ISSN (online) 1557-8194
    ISSN 0011-5029
    DOI 10.1016/j.disamonth.2021.101130
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