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Obesity Surgery

, Volume 26, Issue 2, pp 452–458 | Cite as

Pharmacotherapy in Conjunction with a Diet and Exercise Program for the Treatment of Weight Recidivism or Weight Loss Plateau Post-bariatric Surgery: a Retrospective Review

  • Jennifer Schwartz
  • Andrew Suzo
  • Allison M. Wehr
  • Kathy S. Foreman
  • Dean J. Mikami
  • Bradley J. Needleman
  • Sabrena F. NoriaEmail author
New Concept

Abstract

Background

Bariatric surgery is an effective therapeutic option for management of obesity. However, weight recidivism (WR) and weight loss plateau (WLP) are common problems. We present our experience with the use of two pharmacotherapies in conjunction with our standard diet and exercise program in those patients who experienced WR or WLP.

Methods

From June 2010 to April 2014, bariatric surgery patients who experienced WR or WLP after undergoing Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB), and who were treated with phentermine (Ph) or phentermine–topiramate (PhT), were reviewed retrospectively. Generalized estimating equations were used to compare patient weights through 90 days between initial surgery type and medication type. Patient weights, medication side effect, and co-morbidities were collected during the first 90 days of therapy.

Results

Fifty-two patients received Ph while 13 patients received PhT. Overall, patients in both groups lost weight. Among those whose weights were recorded at 90 days, patients on Ph lost 6.35 kg (12.8 % excess weight loss (EWL); 95 % confidence interval (CI) 4.25, 8.44) and those prescribed PhT lost 3.81 kg (12.9 % EWL; CI 1.08, 6.54). Adjusting for baseline weight, time since surgery, and visit through 90 days, patients treated with Ph weighed significantly less than those on PhT throughout the course of this study (1.35 kg lighter; 95 % CI 0.17, 2.53; p = 0.025). There were no serious side effects reported.

Conclusions

Phentermine and phentermine–topirimate in addition to diet and exercise appear to be viable options for weight loss in post-RYGB and LAGB patients who experience WR or WLP.

Keywords

Phentermine Phentermine–topiramate Weight recidivism Weight loss plateau Bariatric surgery 

Notes

Compliance with Ethical Standards

All procedures performed in studies 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.

Conflict of Interest

Dr. Mikami is a consultant for WL Gore, on the Advisor Board at CareFusion, and a consultant for Covidien. Allison Wehr, MS and Kathy Foreman, CNP have no relevant disclosures. Drs. Schwartz, Needleman, and Noria have no conflicts of interest or financial ties to disclose.

Informed Consent

For this type of study, formal consent is not required.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jennifer Schwartz
    • 1
  • Andrew Suzo
    • 1
  • Allison M. Wehr
    • 1
  • Kathy S. Foreman
    • 1
  • Dean J. Mikami
    • 1
  • Bradley J. Needleman
    • 1
  • Sabrena F. Noria
    • 1
    Email author
  1. 1.The Comprehensive Weight Management and Bariatric Surgery Program, Center for Minimally Invasive SurgeryThe Ohio State University Wexner Medical CenterColumbusUSA

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