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Objective: To assess whether severe gastroesophageal reflux (GER) is associated with abnormalities in lung function including measures of lung volume and gas diffusion. Methods: Data from 147 patients with obesity [...]

Background: Obstructive sleep apnea (OSA) is common in severely obese subjects (body mass index [BMI] > 35). Overnight polysomnography (OPS) is the 'gold standard' method of evaluating this condition; however, [...]

Background: Obesity causes sleep disturbance and is the most significant risk factor for sleep apnea. Only surgical methods provide substantial sustained weight loss for most severely obese subjects. Objective: To study sleep disturbance in patients undergoing laparoscopic adjustable gastric banding with a commercially available product (Lap-Band). Methods: In this study, 313 consecutive patients with severe obesity (body mass index [calculated as weight in kilograms divided by the square of height in meters] [is greater than]35) completed a preoperative sleep questionnaire and clinical assessment. One hundred twenty-three patients completed the same assessment 12 months after surgery. The characteristics of sleep disturbance and changes in responses to weight loss have been assessed. Results: There was a high prevalence of significantly disturbed sleep in men (59%) and women (45%), with women less likely to have had their sleep disturbance investigated. Observed sleep apnea was more common in men, but daytime sleepiness was not affected by sex. Waist circumference was the best clinical measure predicting observed sleep apnea (R = 0.36; P[is less than].001). The group lost an average of 48% (SD, 16%) of excess weight by 12 months. There was a significant improvement in the responses to all questions at follow-up, with habitual snoring reduced to 14% (preoperative value, 82%), observed sleep apnea to 2% (preoperative value, 33%), abnormal daytime sleepiness to 4% (preoperative value, 39%), and poor sleep quality to 2% (preoperative value, 39%) (P[is less than].001 for all). Conclusions: Obesity-related sleep disorders improve markedly with weight loss. Sustainable weight loss should be a primary aim in the management of severely obese patients with significant sleep disturbance, including sleep apnea. Low-risk laparoscopic obesity surgery should be considered for selected patients with this important comorbidity.

Several observational studies suggest that bariatric surgery leading to sustained weight loss confers substantial benefit on obese individuals with type 2 diabetes, but no randomized controlled trials have been reported. This unblinded randomized controlled trial enrolled 60 obese persons 20 to 60 years of age who had a body mass index above 30 but less than 40. Type 2 diabetes had been clearly documented within the past 2 years. Thirty patients were randomly assigned to undergo laparoscopic adjustable gastric banding, while 30 others received conventional treatment for diabetes focusing on weight loss through lifestyle changes. Remission of diabetes was defined as a fasting glucose level below 126 mg/dL and a glycated hemoglobin (HbA1c) value below 6.2% without glycemic medication.