title: Outcomes of Bariatric Surgery in Morbidly Obese Patients with Multiple Sclerosis.
abstract: Obesity is common in patients with multiple sclerosis (MS); however, safety and efficacy of bariatric surgery in this population remain unclear. A database of 2,918 was retrospectively reviewed, yielding 22 (0.75%) severely obese patients with MS who underwent bariatric surgery. Sixteen surgical patients with complete follow-up data were matched to a nonsurgical control group of MS patients, based on age, BMI, MS subtype, and length of follow-up. MS relapse rates and trends in the timed twenty-five foot walk test (T25FW) were compared. In the surgical group (gastric bypassn= 19, sleeve gastrectomyn= 3), preoperative BMI was 46.5 ± 7.2 Kg/m2and average excess weight was 60.4 kg. Follow-up data was collected at 59.0 ± 29.8 months. There were two major and four minor complications. Five patients required readmission and there were no mortalities. Percent excess weight loss was 75.5 ± 27.0%. In the 16 patients with follow-up data, patients who underwent bariatric surgery were significantly faster on the T25FW compared to the nonsurgical population. In conclusion, bariatric surgery is relatively safe and effective in achieving weight loss in patients with MS. In addition, surgery may help patients maintain ambulation. Findings support the need for further studies on bariatric surgery and disease-specific outcomes in this population.
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Kalman
authors.identifier: 0000-0003-0861-6451
authors.initials: K
authors.lastname: Bencsath
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Adham
authors.initials: A
authors.lastname: Jammoul
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Aminian
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Shimizu
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Fisher
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH, USA; Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Rae-Grant
authors.affiliation: Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, USA; Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis; D009767:Obesity, Morbid / Q000401:mortality* / Q000601:surgery; D009820:Ohio; D011183:Postoperative Complications; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss