Everton Cazzo1, Martinho Antonio Gestic2, Murillo Pimentel Utrini3, Felipe David Mendonça Chaim4, Elaine Cristina Cândido5, Luciana Bueno da Silveira Jarolavsky6, Ana Maria Neder de Almeida7, José Carlos Pareja8, Elinton Adami Chaim9. 1. MD, MSc, PhD. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. 2. MD, MSc. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. 3. MD. Assistant Lecturer, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-Unicamp), Campinas (SP), Brazil. 4. MD, MSc. Attending Physician, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. 5. BSc. Attending Nurse, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil. 6. BSc. Head Nurse, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil. 7. BSc. Attending Psychologist, Bariatric Surgery Outpatient Service, Hospital de Clínicas da Universidade Estadual de Campinas (HC-UNICAMP), Campinas (SP), Brazil. 8. MD, PhD. Associate Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil. 9. MD, MSc, PhD. Full Professor, Department of Surgery, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil.
Abstract
CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m2, associated with glucose intolerance. He underwent the Scopinaro procedure for biliopancreatic diversion, with uneventful postoperative evolution, and presented a 55% loss of excess weight one year after the surgery, with resolution of glucose intolerance, and without any manifestation of protein-calorie malnutrition. A 28-year-old male with Down syndrome, whose IQ was 68, was admitted with BMI of 41.5 kg/m2, associated with hypertension. He underwent Roux-en-Y gastric bypass, with uneventful postoperative evolution. He presented a 90% loss of excess weight one year after the surgery, with resolution of the hypertension. CONCLUSION: Bariatric surgery among individuals with intellectual impairment is a controversial topic. There is a tendency among these individuals to present significant weight loss and comorbidity control, but less than what is observed in the general obese population. The severity of the intellectual impairment may be taken into consideration in the decision-making process regarding the most appropriate surgical technique. Bariatric surgery is feasible and safe among these individuals, but further research is necessary to deepen these observations.
CONTEXT: Bariatric surgery has become the gold-standard treatment for refractory morbid obesity. Obesity is frequently associated with certain syndromes that include coexisting cognitive deficits. However, the outcomes from bariatric surgery in this group of individuals remain incompletely determined. CASE REPORT: A 25-year-old male with Prader-Willi syndrome, whose intelligence quotient (IQ) was 54, was admitted with a body mass index (BMI) of 55 kg/m2, associated with glucose intolerance. He underwent the Scopinaro procedure for biliopancreatic diversion, with uneventful postoperative evolution, and presented a 55% loss of excess weight one year after the surgery, with resolution of glucose intolerance, and without any manifestation of protein-calorie malnutrition. A 28-year-old male with Down syndrome, whose IQ was 68, was admitted with BMI of 41.5 kg/m2, associated with hypertension. He underwent Roux-en-Y gastric bypass, with uneventful postoperative evolution. He presented a 90% loss of excess weight one year after the surgery, with resolution of the hypertension. CONCLUSION: Bariatric surgery among individuals with intellectual impairment is a controversial topic. There is a tendency among these individuals to present significant weight loss and comorbidity control, but less than what is observed in the general obese population. The severity of the intellectual impairment may be taken into consideration in the decision-making process regarding the most appropriate surgical technique. Bariatric surgery is feasible and safe among these individuals, but further research is necessary to deepen these observations.
Authors: Mario Masrur; Roberto Bustos; Lisa Sanchez-Johnsen; Luis Gonzalez-Ciccarelli; Alberto Mangano; Raquel Gonzalez-Heredia; Ronak Patel; Kirstie K Danielson; Antonio Gangemi; Enrique Fernando Elli Journal: Obes Surg Date: 2020-03 Impact factor: 4.129
Authors: Niels Vos; Sabrina M Oussaada; Mellody I Cooiman; Lotte Kleinendorst; Kasper W Ter Horst; Eric J Hazebroek; Johannes A Romijn; Mireille J Serlie; Marcel M A M Mannens; Mieke M van Haelst Journal: Curr Diab Rep Date: 2020-07-30 Impact factor: 4.810