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      The impact of acute weight loss following bariatric surgery on Eustachian tube function

      research-article
      1 , 1 , 2 , 1 , 1 , * , , 1 , 3
      Journal of Medicine and Life
      Carol Davila University Press
      bariatric surgery, Eustachian Tube Dysfunction, obesity, ASMBS/IFSO: American Society of Metabolic and Bariatric Surgery/International Federation for the Surgery of Obesity and Metabolic Disorders , BS: Bariatric Surgery, BMI: Body Mass Index, DSVE: Dynamic Slow-Motion Video Endoscopy, ET: Eustachian Tube, ETDQ-7: Eustachian Tube Dysfunction Questionnaire-7, LVPM: Levator Veli Palatine Muscle, PET: Patulous Eustachian Tube, RYGB: Roux-en-Y Gastric Bypass, SG: Sleeve Gastrectomy, TVPM: Tensor Veli Palatini Muscle

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          Abstract

          Obesity has emerged as a pressing concern in contemporary society, prompting an increase in bariatric surgery (BS) procedures for severe obesity management. Post-bariatric weight loss might cause complications, such as a reduction in the soft tissue surrounding the Eustachian tube, potentially affecting its function. This cohort prospective study, conducted between May and December 2022, aimed to assess the impact of post-bariatric acute weight loss on Eustachian tube function. A total of 54 cases of bariatric surgery and 157 control subjects were included in the study. Data on socio-demographics, weight, and the type of bariatric surgery were collected for the study group. ET function was assessed using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Approximately 55% of the participants fell within the age range of 18-25 years, with the majority (91.4%) having not undergone bariatric surgery. Conversely, participants who underwent BS were significantly more prevalent in the older age groups, specifically those over 50, between 40-50, and 31-40 years (p<0.001). Our sample consisted of 82.5% females and 17.5% males, with BS being significantly more common among male subjects (45.9%) compared to females (21.3%) (p=0.002). The mean total ETDQ-7 in control subjects was significantly higher (11.29±5.49) compared to those who had BS (9.11±4.09). Moreover, when comparing the ETDQ-7 between subjects who had BS and the control group, no statistically significant differences were observed in the total ETDQ-7 score and across all seven items within the ETDQ-7. Based on these findings, bariatric surgery did not have a major effect on ET function.

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          Most cited references17

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          Obesity: definition, comorbidities, causes, and burden.

          Body mass index of 30 kg/m2 or higher is used to identify individuals with obesity. In the last 3 decades, the worldwide prevalence of obesity has increased 27.5% for adults and 47.1% for children. Obesity is the result of complex relationships between genetic, socioeconomic, and cultural influences. Consumption patterns, urban development, and lifestyle habits influence the prevalence of obesity. The condition may be the result of disease or pharmacologic treatment. It may also be a risk factor for the development of comorbid conditions. Persons who are obese have less school attendance, reduced earning potential, and higher healthcare costs that may result in an economic burden on society. A review of the prevalence and economic consequences of obesity is provided. Potential causes and comorbidities associated with obesity are also discussed.
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            Treatment of Obesity

            This review focuses on the mechanisms underlying, and indications for, bariatric surgery in the reduction of cardiovascular disease (CVD), as well as other expected benefits of this intervention. The fundamental basis for bariatric surgery for the purpose of accomplishing weight loss is the determination that severe obesity is a disease associated with multiple adverse effects on health, which can be reversed or improved by successful weight loss in patients who have been unable to sustain weight loss by nonsurgical means. An explanation of possible indications for weight loss surgery as well as specific bariatric surgical procedures is presented, along with review of the safety literature of such procedures. Procedures that are less invasive or those that involve less gastrointestinal rearrangement accomplish considerably less weight loss but have substantially lower perioperative and longer-term risk. The ultimate benefit of weight reduction relates to the reduction of the comorbidities, quality of life, and all-cause mortality. With weight loss being the underlying justification for bariatric surgery in ameliorating CVD risk, current evidence-based research is discussed concerning body fat distribution, dyslipidemia, hypertension, diabetes mellitus, inflammation, obstructive sleep apnea, and others. The rationale for bariatric surgery reducing CVD events is discussed and juxtaposed with impacts on all-cause mortalities. Given the improvement of established obesity-related CVD risk factors after weight loss, it is reasonable to expect a reduction of CVD events and related mortality after weight loss in populations with obesity. The quality of the current evidence is reviewed, and future research opportunities and summaries are stated.
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              Obesity and Associated Factors — Kingdom of Saudi Arabia, 2013

              Introduction Data on obesity from the Kingdom of Saudi Arabia (KSA) are nonexistent, making it impossible to determine whether the efforts of the Saudi Ministry of Health are having an effect on obesity trends. To determine obesity prevalence and associated factors in the KSA, we conducted a national survey on chronic diseases and their risk factors. Methods We interviewed 10,735 Saudis aged 15 years or older (51.1% women) through a multistage survey. Data on sociodemographic characteristics, health-related habits and behaviors, diet, physical activity, chronic diseases, access to and use of health care, and anthropometric measurements were collected through computer-assisted personal interviews. We first compared sociodemographic factors and body mass index between men and women. Next, we conducted a sex-specific analysis for obesity and its associated factors using backward elimination multivariate logistic regression models. We used SAS 9.3 for the statistical analyses and to account for the complex sampling design. Results Of the 10,735 participants evaluated, 28.7% were obese (body mass index ≥30 kg/m2). Prevalence of obesity was higher among women (33.5% vs 24.1%). Among men, obesity was associated with marital status, diet, physical activity, diagnoses of diabetes and hypercholesterolemia, and hypertension. Among women, obesity was associated with marital status, education, history of chronic conditions, and hypertension. Conclusion Obesity remains strongly associated with diabetes, hypercholesterolemia, and hypertension in the KSA, although the epidemic’s characteristics differ between men and women.

                Author and article information

                Journal
                J Med Life
                J Med Life
                JMedLife
                Journal of Medicine and Life
                Carol Davila University Press (Romania )
                1844-122X
                1844-3117
                September 2023
                : 16
                : 9
                : 1375-1380
                Affiliations
                [1 ]Otolaryngology, Head and Neck Surgery Department, King Faisal University, Hofuf, Saudi Arabia
                [2 ]Surgery Department, King Fahad Hospital, Hofuf, Saudi Arabia
                [3 ]Otolaryngology, Head and Neck Surgery Department, King Fahad Hospital of University, Al-Khobar, Saudi Arabia
                Author notes
                [* ] Corresponding Author: Majd Alsaleh Otolaryngology, Head and Neck Surgery Department, King Faisal University, Hofuf, Saudi Arabia. E-mail: majdalsaleh11@ 123456gmail.com
                Article
                JMedLife-16-1375
                10.25122/jml-2023-0254
                10719784
                38107702
                eeb3e4b2-5f99-4e3e-a49d-d2ce89553009
                ©2023 JOURNAL of MEDICINE and LIFE

                This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0

                History
                : 30 July 2023
                : 30 August 2023
                Categories
                Original Article

                Medicine
                bariatric surgery,eustachian tube dysfunction,obesity,asmbs/ifso: american society of metabolic and bariatric surgery/international federation for the surgery of obesity and metabolic disorders,bs: bariatric surgery,bmi: body mass index,dsve: dynamic slow-motion video endoscopy,et: eustachian tube,etdq-7: eustachian tube dysfunction questionnaire-7,lvpm: levator veli palatine muscle,pet: patulous eustachian tube,rygb: roux-en-y gastric bypass,sg: sleeve gastrectomy,tvpm: tensor veli palatini muscle

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