Two years after the start of the COVID-19 pandemic, bariatric surgery patients showed an increase in the percentage of weight regain and a decrease in the percentage of excess weight loss, as well as changes in fasting blood glucose and glycosylated haemoglobin parameters, according to a study led by researchers from the University Hospital of the Federal University, Sergipe, Brazil.
The study’s researchers study sought to assess the impact of the COVID-19 pandemic on cardiometabolic risk markers and weight outcomes of post-bariatric patients who underwent bariatric surgery before the COVID-19 pandemic. All individuals who underwent surgery at the University Hospital of Sergipe between 2007 and 2017, and who attended the last face-to-face nutrition consultation at the outpatient clinic between December 2019 and March 2020 (before the suspension of face-to-face consultations due to the COVID-19 pandemic), were considered eligible for the study sample.
Data were collected at four different times during the study:
T0: January to March 2019, one year before the pandemic
T1: December 2019 to March 2020, pre-pandemic period
T2: January to March 2021, one year after the start of the pandemic
T3: January to March 2022, two years after the start of the pandemic
Before the pandemic, the post-bariatric follow-up plan consisted of nutritional appointments every three months and biochemical tests twice a year. After the pandemic began in March 2020, the face-to-face appointments and biochemical tests were discontinued until November 2020.
Sociodemographic and clinical data.
At T2, the patients answered a questionnaire regarding education (less than or equal to incomplete high school and greater than or equal to complete high school), ethnicity and gender (female and male), alcohol consumption and smoking status.
Information on date of birth, date of bariatric surgery and surgical technique (Roux-en-Y gastric bypass) was obtained from medical records. Time since surgery was determined in relation to T1.
Outcomes
In 2021 (T2), the sample consisted of 55 patients from whom data had been collected for the previous periods (T0 and T1). During the second pandemic year (T3), after some sample losses, 50 patients were evaluated.
The mean age of the study participants was 49.31±8.82 years and the majority were female (90.9%) and brown/black ethnicity (81.1%). Regarding comorbidities, 12.7% were diagnosed with T2DM, 12.7% with dyslipidaemia and 30.9% with hypertension.
Significant changes were observed in all anthropometric markers and in the glycaemic profile, with different fluctuations between the pandemic years. Between T0 and T1, there were no significant changes in any of the anthropometric variables assessed. However, between T1 and T2, there was an increase in all anthropometric parameters.
In the T3 period, despite the reduction in the percentage of weight gain to levels similar to those seen between T0 and T1, there were no changes in the percentage of excess weight loss and the postoperative weight regain rate, which remained at levels similar to those seen in T2. During this period, among the biochemical markers, there was an increase in fasting blood glucose and glycosylated haemoglobin levels.
The results show weight gain during the first pandemic year, increased fasting blood glucose and glycosylated haemoglobin. Therefore, potential risk factors for changes in these outcomes were examined: time since surgery, pre-pandemic anthropometric data, pre-pandemic weight regain rate, dietary habits, physical activity, biochemical data, blood pressure, diagnosis of DM2, dyslipidaemia and hypertension.
Uncontrolled eating and emotional eating were identified as factors related to weight gain, and that people who were physically active at T2 had a lower percentage of weight gain vs. those who were physically inactive. There was also an association between weight gain between T1 and T2 and an increase in systolic blood pressure at T2 and diastolic blood pressure at T3.
No associations were found between weight gain and the biochemical variables analysed in the study, nor were BMI and time since bariatric surgery represent risk factors for weight gain during the pandemic.
Regarding the physical activity, there was an increase in sedentary behaviour during the pandemic. At T1, 67.3% of individuals were categorized as physically active, of these 54.1% became sedentary at T2 (p<0.001).
There was a positive change in this behaviour at T3, where 24.2% of the patients who were physically inactive at T2 were classified as active (p=0.013). Despite this positive change, the evaluation of the total time after two years of pandemic (between T1 and T3) showed a change in behaviour from 34.3% of individuals who were physically active at T1 to sedentary at T3 (p=0.016).
“The main finding of this study was that COVID-19 pandemic negatively affected the long-term postoperative weight trajectory, as well as hemodynamic, biochemical, and lifestyle parameters in patients who had previously undergone bariatric surgery,” the authors concluded. “These results may contribute to better care strategies in the post-pandemic period and to the management of future similar stressful situations that may be experienced by populations with the same characteristics as the sample in this study.”
The findings were published in the paper, ‘Cardiometabolic risk factors of post-bariatric patients two years after COVID-19 pandemic onset: a longitudinal study’, published in Scientific Reports. To access this paper, please click here
コメント