@article{5ba79acab1b147a1964bae4c0ca2fa41,
title = "Association of Obesity Subtypes in the Longitudinal Assessment of Bariatric Surgery Study and 3-Year Postoperative Weight Change",
abstract = "Objective: The study objective was to empirically identify subgroups of patients with obesity and investigate their association with postoperative weight change. Methods: A longitudinal analysis of 2,458 adults in the Longitudinal Assessment of Bariatric Surgery (LABS) study was used. Baseline data were used to identify subgroups. The outcome was 3-year weight change after bariatric surgery. Results: We identified four classes (subtypes) of obesity, which could be characterized as diabetes with low rates of high-density lipoprotein (Class 1), disordered eating (Class 2), mixed (Class 3), and extreme obesity with early onset (Class 4). Approximately 98% of participants in Class 1 had diabetes compared with < 40% in the other classes. There were high rates of binge eating in Class 2, and more than 92% of those in this class reported eating when not hungry. Class 4 was characterized by a higher BMI at baseline. Adults in Class 4 lost an average of 25.0% (males) and 30.3% (females) of their baseline weight over 3 years. In contrast with participants in Class 1, those in Classes 2 and 3 had significantly larger 3-year weight losses than their peers in Class 4. Conclusions: Obesity is a heterogeneous disease. Bariatric surgery may be most beneficial for adults with disordered eating.",
author = "Field, {Alison E.} and Inge, {Thomas H.} and Belle, {Steven H.} and Johnson, {Geoffrey S.} and Wahed, {Abdus S.} and Pories, {Walter J.} and Konstantinos Spaniolas and Mitchell, {James E.} and Alfons Pomp and Dakin, {Gregory F.} and Bruce Wolfe and Courcoulas, {Anita P.}",
note = "Funding Information: See Commentary, pg. 1868. Funding agencies: LABS-2 was a cooperative agreement funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Grant numbers: Data Coordinating Center (U01 DK066557); Columbia University Medical Center (U01-DK66667; in collaboration with Cornell University Medical Center Clinical and Translational Research Center (CTRC) [Grant UL1-RR024996]); University of Washington (U01-DK66568; in collaboration with CTRC [Grant M01RR-00037]); Neuropsychiatric Research Institute (U01-DK66471); East Carolina University (U01-DK66526); University of Pittsburgh Medical Center (U01-DK66585; in collaboration with CTRC [Grant UL1-RR024153]); Oregon Health & Science University (U01-DK66555); and in collaboration with the Teen-LABS consortium (UM1DK072493). The NIDDK scientists contributed to the design and conduct of the study, which included collection and management of data. The project scientist from the NIDDK served as a member of the steering committee, along with the principal investigator from each clinical site and the data coordinating center. The data coordinating center housed all data during the study and performed data analyses according to a prespecified plan developed by the data coordinating center biostatistician and approved by the steering committee and independent data and safety monitoring board. The decision to publish was made by the LABS-2 steering committee, with no restrictions imposed by the sponsor. Disclosure: APC has received research grants from Covidien and Ethicon J & J Healthcare. THI has received research grant funding from Ethicon Endosurgery and has served as consultant for Sanofi Corporation. WJP receives research grants from Johnson & Johnson and Nestle{\textquoteright}s Corp. AP receives honoraria for speaking from Medtronic/Covidien, Ethicon, and W.L. Gore & Associates. SHB, GFD, JEM, AEF, ASW, KS, BW, and GSJ declared no conflict of interest. Authors contributions: APC, AEF, and THI are responsible for study concept and design; APC, KS, JEM, BW, and WJP for the acquisition of data; AEF, SHB, GSJ, and ASW for analysis and interpretation of data; AEF for drafting of the manuscript; APC, SHB, THI, AP, GFD, JEM, BW, and WJP for critical revision of the manuscript for important intellectual content; AEF, GSJ, and ASW for statistical analysis; APC, SHB, JEM, and BW for obtaining funding; and APC, SHB, and BW for study supervision. SHB, APC, ASW, and GSJ had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Received: 23 May 2018; Accepted: 29 July 2018; Published online 13 November 2018. doi:10.1002/oby.22287",
year = "2018",
month = dec,
doi = "10.1002/oby.22287",
language = "English (US)",
volume = "26",
pages = "1931--1937",
journal = "Obesity",
issn = "1930-7381",
publisher = "Wiley-Blackwell",
number = "12",
}