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Weight Loss and Timing of J Tube Removal in Biliopancreatic Diversion with Duodenal Switch Patients Who Report Physical or Sexual Abuse

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Abstract

Background

Bariatric surgery patients who report physical or sexual abuse form a sizeable cohort that stands out due to psychological comorbidity. Their possible vulnerability to suboptimal weight loss remains of interest. Their risk for malnutrition due to inadequate oral intake following surgery is underexplored.

Objectives

Study aims were to determine the effect of self-reported physical or sexual abuse in patients undergoing open biliopancreatic diversion with duodenal switch (BPD/DS) on (a) 3-year weight loss trajectories and (b) timing of feeding jejunostomy tube (J tube) removal. Delayed J tube removal served as an indicator for inadequate oral intake.

Methods

In this retrospective cohort study, the sample (N = 189) consisted of all patients who underwent primary BPD/DS by the same surgeon during 2009 and 2010 at a Midwestern health system. All patients had a J tube placed during surgery. Longitudinal mixed models were used for testing differences in weight loss trajectories by abuse status.

Results

There were no significant differences in weight loss trajectories by abuse status. The abused group had the J tube in place a mean of 61.9 days (SD = 39.5) compared to 44.8 days (SD = 32.8) for the not abused group, a significant difference.

Conclusions

Our use of the best available statistical methods lends validity to previous findings that suggest physical or sexual abuse does not affect weight loss after bariatric surgery. Increased likelihood of persistent inadequate oral intake in the abused group suggests the need for early multidisciplinary interventions that include mental health and nutrition experts.

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Acknowledgements

The authors would like to thank clinic managers Christine Heavey and Lorrie Dohn for their assistance with this project.

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Authors and Affiliations

  1. College of Nursing, South Dakota State University, Wagner Hall 204, Brookings, SD, 57007, USA

    Polly A. Hulme

  2. College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA

    Kevin A. Kupzyk

  3. Department of Surgery, Creighton University, 10506 Burt Circle, Omaha, NE, 68144, USA

    Gary J. Anthone

  4. Bristol-Myers Squibb, 507 29th Circle, Fremont, NE, 68025, USA

    Kimberly A. Capron

  5. Nebraska Medicine, 987400 Nebraska Medical Center, Omaha, NE, 68198-7400, USA

    Thang Nguyen

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  1. Polly A. Hulme
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Correspondence to Polly A. Hulme.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

For this retrospective study, informed consent was not obtained from participants. Please see the Statement of Human and Animal Rights section for more information.

Ethics Statement

This original manuscript has not been submitted elsewhere. The manuscript has not been published previously, in part or in full. Each of the authors contributed to maintaining the integrity of the study and this report. The first author provided consistent oversight of the work. The surgeon whose patients were used for this research played no role in data collection. No data were fabricated or manipulated. Consent to submit the manuscript was obtained from all authors of the work, as well as the institute where the study took place.

Statement of Human/Animal Rights

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Permission was obtained for the study from the Institutional Review Boards of (a) the university at which the first author was affiliated at the time, and (b) the health system at which the study took place. The university classified the study as Expedited Category of Review: 45CFR46.110; 21CFR56.110, Category 5. For this type of study, formal consent is not required. All authors were CITI certified.

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Hulme, P.A., Kupzyk, K.A., Anthone, G.J. et al. Weight Loss and Timing of J Tube Removal in Biliopancreatic Diversion with Duodenal Switch Patients Who Report Physical or Sexual Abuse. OBES SURG 28, 2361–2367 (2018). https://doi.org/10.1007/s11695-018-3166-3

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  • DOI: https://doi.org/10.1007/s11695-018-3166-3

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