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PREVALENCE OF GASTROINTESTINAL ISSUES AND DISORDERED EATING PATTERNS AMONG PATIENTS SEEKING ENDOSCOPIC REVISION OF PRIOR BARIATRIC SURGERY
Erika Staneff
*, Madison L. Simons, Stephen Lupe, Bailey Flora, Roberto Simons-Linares
Gastroenterology, Hepatology, and Nutrition, Cleveland Clinic, Cleveland, OH
Introduction: Multidisciplinary assessment and evaluation for disordered eating patterns are the standard of care for patients prior to performing endoscopic revisions of prior bariatric surgery such as Transoral Outlet Reduction (TORe) procedure. The occurrence of gastrointestinal (GI) symptoms can equally complicate the pattern of eating and may impact treatment of obesity and weight regain. However, the prevalence and impact of other GI issues is unknown for patients seeking or undergoing endoscopic bariatric revisional procedures.
Methods: A retrospective cohort study was conducted among patients established within the bariatric endoscopy program between January 1, 2022 and June 30, 2024. Inclusion criteria were: history of bariatric surgery with weight regain. Patients with other complications post-bariatric surgery (stenosis, ulcer, leaks, hernias) were excluded. The prevalence of GI issues and eating disorders were identified by ICD-10 codes and standard descriptive statistics were used to characterize the presenting symptoms of patients at the time of evaluation for endoscopic bariatric revision.
Results: A total of 466 patients were included for analysis. The majority of the sample was White (68.5%) and non-Hispanic (92.3%). The mean age was 53 years old. 92% did not meet criteria for any eating disorder upon evaluation in our program. 79% of patients had no history of any eating disorder prior to enrollment in our bariatric endoscopy program. The median number of GI issues patients presented with at the time of entry to the bariatric endoscopy program was 1 (n=88; 18.9%) with 223 patients (47.9%) reporting 2 or more GI issues at the time of seeking endoscopic bariatric revision. Prevalences of GI issues are listed in table 2.
Conclusions: This study found that the prevalence of eating disorder (7.9%) was not common among patients seeking endoscopic bariatric revisions. However, the prevalence of GI issues was more common and could also contribute to challenges with lifestyle modification, such as eating adequate caloric intake and patterns of choosing less nutrient dense food options that could also impact the management of obesity and weight regain in post-bariatric surgery patients. Interventions to support chronic disease management of obesity as well as related GI issues following bariatric surgery are needed.
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