Orange, CA, United States
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Sczepaniak J.P.,Coastal Center for Obesity | Owens M.L.,Coastal Center for Obesity | Garner W.,John Sczepaniak Medical Enterprises | Dako F.,John Sczepaniak Medical Enterprises | And 2 more authors.
Journal of Obesity | Year: 2012

Factors postulated to predict weight loss after gastric bypass surgery, include race, age, gender, technique, height, and initial weight. This paper contained 1551 gastric bypass patients (85.9 female). Operations were performed by one surgeon (MLO) at community hospitals in Southern California from 1989 to 2008 with 314 being laparoscopic and 1237 open. We created the following equation: In[percent weight] = At2 - Bt, where t was the time after operation (days) and A and B are constants. Analysis was completed on R-software. The model fits with R 2 value 0.93 and gives patients a realistic mean target weight with a confidence interval of 95 for the first year. Conclusion. We created a curve predicting weight loss after surgery as a percentage of initial weight. Initial weight was the single most important predictor of weight loss after surgery. Other recorded variables accounted for less than 1 of variability. Unknown factors account for the remaining 6-7. © 2012 John P. Sczepaniak et al.


Sczepaniak J.P.,Health Enterprises | Sczepaniak J.P.,Saint Georges University | Owens M.L.,Coastal Center for Obesity | Shukla H.,Health Enterprises | And 3 more authors.
Obesity Surgery | Year: 2015

Background: Weight loss after bariatric surgery is commonly reported as either a percentage of initial body weight (%IBW) or 100 % minus %IBW which is a percentage of total weight loss (%TWL). These are basically equivalent expressions. Weight loss is also reported as %EWL or as a percentage of excess body mass index loss (%EBMIL). These last two expressions incorporate the concepts of ideal body weight and BMI = 25 as reference points. More straightforward but less commonly used is absolute weight loss. This study compares these various measures using the Bariatric Outcomes Longitudinal Database (BOLD).Methods: BOLD data, 2008–2011, was accessed for outcomes on 239,659 gastric bypass (GB) and sleeve gastrectomy (SG) patients with approval of the Surgical Review Corporation. The outcome data was converted into %TWL, %EWL, and %EBMIL. %EBMIL was varied by changing the reference BMI from 1 to 25 kg/m2. The post operation data was analyzed for both procedures. Variation coefficients (VC) were compared using different measurements on the same data pool. We assumed that the lesser the variation, the more reliable the measure is, and therefore, we made use of the VC to compare the different reporting methods.Results: There were 164,247 patients who remained after removal of errors and missing data. Demographics are as follows: 78.1 % female, 73.1 % white, 12.5 % black, 8.71 % Hispanic, 81.6 % GB, 18.4 % SG, mean age of 44.8 years, height of 167.0 cm, weight of 132.0 kg, and BMI of 47.1 kg/m2. GB patients had 26.8 %TWL at 6 months (VC = 21.5) and 34.2 %TWL at 12 months (VC = 27.0). %EWL was 54.7 at 6 months (VC = 27.3) and 69.4 at 12 months (VC = 30.9). Varying the reference BMI for %EBMIL showed the lowest VC to be 0–2 kg/m2 for GB up to 12 months post operation. SG patients had 24.0 %TWL at 6 months (VC = 25.4) and 29.5 at 12 months (VC = 30.5). %EWL was 50.0 % at 6 months (VC = 31.4) and 60.2 % at 12 months (VC = 34.5). Varying the reference BMI for %EBMIL showed that the lowest VC occurred when the reference weight was chosen as 0 kg/m2 for both GB and SG. %TWL or, equivalently, %IBW had the lowest variation coefficient and therefore is the more accurate measure of weight loss following bariatric surgery.Conclusions: For ease and accuracy of comparison, the percentage of initial body weight or percentage of total weight loss should be used for the expression of weight loss after surgery. © 2014, Springer Science+Business Media New York.


Kadeli D.K.,John Sczepaniak Medical Enterprises | Sczepaniak J.P.,John Sczepaniak Medical Enterprises | Sczepaniak J.P.,Coastal Center for Obesity | Kumar K.,John Sczepaniak Medical Enterprises | And 3 more authors.
Journal of Obesity | Year: 2012

Background. Many insurance companies require obese patients to lose weight prior to gastric bypass. From a previous study by the same authors, preoperative weight at surgery is strongly predictive of weight loss up to one year after surgery. This review aims to determine whether preoperative weight loss is also correlated with weight loss up to one year after surgery. Methods. Of the 186 results screened using PubMed, 12 studies were identified. A meta-analysis was performed to further classify studies (A class, B class, regression, and rejected). Results. Of all 12 studies, one met the criteria for A class, six were B class, four were regression, and one was rejected. Six studies supported our hypothesis, five were inconclusive, and no study refuted. Conclusions. Preoperative weight loss is additive to postsurgery weight loss as predicted from the weight at the time of surgery. © 2012 Deepak K. Kadeli et al.


PubMed | Coastal Center for Obesity
Type: | Journal: Journal of obesity | Year: 2012

Factors postulated to predict weight loss after gastric bypass surgery, include race, age, gender, technique, height, and initial weight. This paper contained 1551 gastric bypass patients (85.9% female). Operations were performed by one surgeon (MLO) at community hospitals in Southern California from 1989 to 2008 with 314 being laparoscopic and 1237 open. We created the following equation: In[percent weight] = At(2) - Bt, where t was the time after operation (days) and A and B are constants. Analysis was completed on R-software. The model fits with R(2) value 0.93 and gives patients a realistic mean target weight with a confidence interval of 95% for the first year. Conclusion. We created a curve predicting weight loss after surgery as a percentage of initial weight. Initial weight was the single most important predictor of weight loss after surgery. Other recorded variables accounted for less than 1% of variability. Unknown factors account for the remaining 6-7%.

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