extreme overweight Morbidly and Supermorbidly obese Obesity
Conditions
Interventions
Adding a subtotal gastrectomy to a standard LRYGB.
Sponsors
Spaarne Gasthuis
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Age 20-65 years Body Mass Index (BMI) of >=45 kg/m2 at the start of the LRYGB trajectory (defined as the first visit to the surgery outpatient clinic of the Spaarne gasthuis) Stable weight defined as not losing or gaining >2% of total body weight 4 weeks prior to inclusion ASA classification1-2 Written informed consent
Exclusion criteria
Exclusion criteria: Positive serology screening for H.Pylori or positive H.Pylori culture after gastroscopy Auto-immune atrophic gastritis (positive antibodies against intrinsic factor and/or anti-parietal cells) Any psychiatric disease (treated or untreated) or eating disorder Revisional LRYGB surgery Drug addiction (present or in medical history) Frequent use of recreational drugs Childhood-onset obesity Untreated thyroid dysfunction American Society of Anaesthetics (ASA) score >=3 Age >65 years Work with radiation Contraindication for MRI (claustrophobia, metal objects etc.) Shift work Smoking Any medical condition except for stable obesity related conditions (except for insulin-treated DM) History of cardiac diseases Insulin use Pregnancy Genetic causes for the supermorbidily obese state
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Striatal D2/D3 receptor availability and dopamine release as well as whole brain serotonergic activity. | — |
Secondary
| Measure | Time frame |
|---|---|
| Aspects of motivation and impulse control of feeding behaviour (questionnaires and phMRI) Assessment of craving and hunger (questionnaires) Fasting and postprandial acylated ghrelin (IGTT) Glucose metabolism (IGTT) Gut hormones, free fatty acids Body weight loss Feelings of craving and hunger (Questionnaires) Food addiction according to Yale Food Addiction scale General cognitive functioning | — |
Countries
Netherlands
Outcome results
None listed