Center |
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Award Year | 2024 |
Pilot Study | Comparison of changes in body composition as a measure of obesity improvement |
Awardee |
Jason Samuels MD
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Abstract |
Obesity stands as an established risk factor for metabolic derangements, including insulin resistance; however, the precise targets for weight loss in individuals grappling with obesity remain enigmatic. While weight reduction unquestionably corresponds with improvements in these derangements, the magnitude of weight loss, specifically the requisite alterations in adipose mass necessary for true remission of such metabolic issues, remains a topic of ongoing research. Various metrics of adiposity are available, encompassing body mass index, waist circumference, total body fat, as well as visceral and subcutaneous fat mass. Nevertheless, the relationship between changes in these measures following weight loss and improvements in the metabolic derangements associated with obesity remains elusive. This knowledge gap presents a formidable challenge in the establishment of lucid, evidence-based guidelines for obesity treatment, hindering efforts to mitigate the risks of obesity-related mortality. The landscape of medical interventions for weight loss has evolved significantly, notably with the advent of Glucagon-like peptide-1 receptor agonists (GLP1RAs) such as Semaglutide. This development offers a unique opportunity to augment both the magnitude and sustainability of post-bariatric surgery weight loss, providing a valuable model to explore the potential advantages of further weight reduction in individuals grappling with obesity, with the aim of ameliorating comorbidities and reducing mortality risks. The objectives of this study are twofold: Aim 1: To assess and contrast the predictive value of changes in total body fat percentage, visceral and subcutaneous adipose volume, and body mass index in determining the resolution of obesity-related diseases. We hypothesize that improvements in total body fat percentage will prove to be the most predictive factor for improvements in obesity-related metabolic derangements. This will be accomplished by conducting Dual-Energy X-ray Absorptiometry assessments at baseline (pre-surgery) and one year after surgery. Aim 2: To examine the safety, tolerance, and efficacy of GLP1RA therapy in facilitating further weight loss among patients with a BMI > 35 kg/m² one year or more following bariatric surgery. We hypothesize that administering GLP1RA at least one year post-operatively to patients with a BMI > 35 kg/m² will result in more substantial weight loss compared to those undergoing bariatric surgery alone. This will be explored by administering Semaglutide or non-GLP1RA therapies in a non-randomized, observational manner, one year after bariatric surgery. |