PROPANTHELINE AS AN ADJUVANT TO WEIGHT-LOSS AFTER VERTICAL GASTROPLASTY

Background: Weight loss after gastroplasty surgery is sometimes unsati sfactory despite normal surgical anatomy and no evidence of deliberate dietary indiscretion. Methods: Two morbidly obese female patients wer e treated with a modified Long vertical gastroplasty following failed attempts at weight loss using nonsurgical means. One of these (109 kg) complained of a lack of satiety soon after the surgery and her weight loss was unsatisfactory at 11 kg after 90 days. The other patient (12 8 kg) lost weight as expected but at 3 months leveled off her weight a t 93 kg also with an associated loss of satiety. Both patients noted a n increased capacity for food and ease of eating solids including red meat. Gastroscopy revealed normal gastric anatomy in both and the pati ents were prescribed oral propantheline. Results: There was an immedia te subjective improvement in satiety, a reduction in capacity for food and an increase in difficulty with eating some solids. There was a re sumption of weight loss that has been sustained down to healthy weight range. Conclusion: In two patients with unsatisfactory weight loss af ter gastroplasty but no demonstrable surgical defect, adjuvant propant heline appeared to induce an excellent further weight loss.