Estella Y Huang1, Ryan C Broderick2, Jonathan Z Li2, Joaquin L Serra2, Pranav Ahuja2, Samantha Wu2, Michael Genz2, Eduardo Grunvald3, David C Kunkel4, Bryan J Sandler2, Santiago Horgan2, Garth R Jacobsen2. 1. Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA. ehuang@health.ucsd.edu. 2. Division of Minimally Invasive Surgery, Center for the Future of Surgery, University of California San Diego, 9500 Gilman Drive, MET Building 845, La Jolla, CA, 92093-0740, USA. 3. Division of General Internal Medicine, UCSD Bariatric and Metabolic Institute, University of California San Diego, La Jolla, CA, USA. 4. Division of Gastroenterology, GI Motility & Physiology Program, University of California San Diego, La Jolla, CA, USA.
Abstract
BACKGROUND: The legalization of cannabis in several states has led to increased documented use in the population. Bariatric surgery patients are no exception with estimates of anywhere from 6 to 8%. Cannabis is known to be associated with increased appetite, mood disorders, hyperphagia, and rarely, hyperemesis, which can potentially affect post-surgical weight loss. We aim to study the differences in bariatric surgery outcomes between cannabis users and non-users. METHODS: A retrospective review identified patients undergoing bariatric surgery. Patients were divided into two groups, cannabis users (CU) and non-cannabis users (non-CU). Cannabis users (defined as using at least once weekly) and a group of non-users were called to obtain additional information. Primary outcome was weight loss. Secondary outcomes included incidence of post-operative nausea and vomiting (PONV), length of stay (LOS), readmission, and need for additional intervention. RESULTS: A cohort of 364 sleeve gastrectomy patients met inclusion criteria, 31 (8.5%) CU and 333 (91.5%) non-CU. There was no difference in EWL between CU and non-CU at 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, and 2 years. However, the CU group trended towards greater EWL at 3 years (52.9% vs. 38.1%, p = 0.094) and at 5 years (49.8% vs. 32.7%, p = 0.068). There were no significant differences between CU and non-CU with respect to either incidence or severity of PONV at one year after surgery or longer follow-up. CONCLUSION: Cannabis users did not experience inferior weight loss after bariatric surgery despite common assumptions that appetite stimulation can lead to suboptimal weight loss outcomes. Our findings add to other work challenging this dogma. Larger, long-term, multicenter studies are warranted.
BACKGROUND: The legalization of cannabis in several states has led to increased documented use in the population. Bariatric surgery patients are no exception with estimates of anywhere from 6 to 8%. Cannabis is known to be associated with increased appetite, mood disorders, hyperphagia, and rarely, hyperemesis, which can potentially affect post-surgical weight loss. We aim to study the differences in bariatric surgery outcomes between cannabis users and non-users. METHODS: A retrospective review identified patients undergoing bariatric surgery. Patients were divided into two groups, cannabis users (CU) and non-cannabis users (non-CU). Cannabis users (defined as using at least once weekly) and a group of non-users were called to obtain additional information. Primary outcome was weight loss. Secondary outcomes included incidence of post-operative nausea and vomiting (PONV), length of stay (LOS), readmission, and need for additional intervention. RESULTS: A cohort of 364 sleeve gastrectomy patients met inclusion criteria, 31 (8.5%) CU and 333 (91.5%) non-CU. There was no difference in EWL between CU and non-CU at 1 week, 1 month, 3 months, 6 months, 9 months, 1 year, and 2 years. However, the CU group trended towards greater EWL at 3 years (52.9% vs. 38.1%, p = 0.094) and at 5 years (49.8% vs. 32.7%, p = 0.068). There were no significant differences between CU and non-CU with respect to either incidence or severity of PONV at one year after surgery or longer follow-up. CONCLUSION: Cannabis users did not experience inferior weight loss after bariatric surgery despite common assumptions that appetite stimulation can lead to suboptimal weight loss outcomes. Our findings add to other work challenging this dogma. Larger, long-term, multicenter studies are warranted.
Authors: Rachel E Goetze; Matthew M Clark; Daniela B Rakocevic; Lisa A Howell; Terry D Schneekloth; Maria L Collazo-Clavell; Todd Kellogg; Karen M Graszer; Sarah A Kalsy; Karen B Grothe Journal: Surg Obes Relat Dis Date: 2020-12-16 Impact factor: 4.734
Authors: Frank L Bauer; William T Donahoo; Harris W Hollis; Adam G Tsai; Brian J Pottorf; Jason M Johnson; Lori J Silveira; Farah A Husain Journal: Perm J Date: 2018