The association between patient attendance to a perioperative group-based lifestyle program and weight loss after bariatric surgery

Nijland, Leontien M G; Reiber, Beata M. M.; Monpellier, Valerie M.; Jacobs, Anne; Hazebroek, Eric J.; Veen, Ruben N van; Demirkıran, Ahmet; Castro, S. M. M. de; Liem, Ronald; Swank, Dingeman J.; Knook, Mireille; Acker, Gijs van; Tseng, L. N. L.; Marsman, Hendrik A.; Tets, Willem van; Cense, Huib A.; Greve, Jan; Boerma, Evert-Jan G.; Fransen, Sophie; Witte, Evelien de; Wiezer, René J.; Wijffels, Niels; Riele, Wouter te; Derksen, Wouter J.M.; Takkenberg, Marijn; Aufenacker, Theo; Vening, Wouter; Witteman, Bart; Hengst, Willem den

doi:10.1016/j.soard.2022.02.011

Cited by 8 publications

(5 citation statements)

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“…This is a critical aspect to a successful bariatric procedure, as there is strong evidence supporting that adequate follow-up is associated with improved outcomes, not only for weight loss but also in reducing the burden of related comorbidities [2][3][4]16]. Early follow-up is of particular importance given that some complications, such as dietary intolerances, wound infections, and VTE often present early in the postoperative period and are thought to be more easily managed with prompt intervention [17][18][19]. Recent guidelines provide recommendations for minimum frequency and duration of both short-term and long-term follow-up postbariatric surgery, including the American Society of Metabolic and Bariatric Surgery, who emphasizes the importance of these visits in the view of obesity as a chronic disease [20,21].…”

Section: Discussionmentioning

confidence: 99%

“…Perhaps even more critical is the capacity of early followup to allow for timely recognition of concerning symptoms and expedition of treatment, ultimately resulting in better outcomes [5]. However, the coronavirus disease (COVID- 19) pandemic has disrupted access to routine healthcare, including postoperative follow-up and this impact on the elective bariatric landscape is not yet understood [6].…”

Section: Introductionmentioning

confidence: 99%

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Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

et al. 2022

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Background Effects of the COVID-19 pandemic on rates of early postoperative follow-up after bariatric surgery are poorly understood. Our study characterizes 30-day follow-up after bariatric surgery prior to COVID-19 (years 2015–2019) and during the pandemic of COVID-19 (year 2020) and evaluates general predictive factors of short-term follow-up. Methods Data was extracted from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data registry from 2015 to 2020. Cohorts were divided into pre-pandemic and pandemic years and patients with and without 30-day follow-up. Multivariable logistic regression analysis was used to identify general factors independently predictive of 30-day follow-up. The primary aim was to evaluate the impact of the COVID-19 pandemic on short-term 30-day follow-up adherence. A secondary outcome was to characterize general short-term postoperative 30-day follow-up associated with elective bariatric surgery and identify independent predictors of 30-day follow-up among bariatric surgery patients using multivariable logistic regression analysis. Results A total of 834,646 patients were identified. Follow-up rates significantly increased in the COVID era in 2020 ( p < 0.0001). Patients who achieved 30-day follow-up were older and had an increased burden of medical comorbidities, including non-insulin and insulin-dependent diabetes mellitus, hypertension, dyslipidemia, as well as increased BMI compared to patients lacking follow-up. The cohort with successful 30-day follow-up was more likely to receive gastric bypass and had increased rates of metabolic comorbidities. After adjusting for comorbidities, the greatest independent predictors of follow-up were the 2020 COVID-19 era year, Asian race, black race, and gastroesophageal reflux disease. Conclusions After adjusting for comorbidities, the 2020 COVID-19 era year was one of the greatest predictors of follow-up after bariatric surgery. Postoperative follow-up rates after elective bariatric surgery are excellent at > 95% and increased during the 2020 COVID-19 era year. Several independent predictors of follow-up were identified which may help in development of strategies aimed to mitigate lack of postoperative follow-up. Graphical Abstract Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06423-z.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

et al. 2022

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“…All patients included in this study were screened for eligibility for bariatric surgery according to IFSO criteria by a multidisciplinary team [ 17 ]. All patients eligible for a primary bariatric procedure followed a group-based bariatric lifestyle program which consisted of 6 mandatory preoperative group sessions focusing on lifestyle and dietary adjustments over a period of 6 weeks [ 18 ]. After completing the preoperative program, each patient was sent a video with patient information about the surgical options, i.e., the laparoscopic RYGB and SG.…”

Section: Methodsmentioning

confidence: 99%

A Decision Aid to Help Patients Make Informed Choices Between the Laparoscopic Gastric Bypass or Sleeve Gastrectomy

Nijland¹,

Noordman²,

Boehlé³

et al. 2022

OBES SURG

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Purpose In the Netherlands, patients can often choose between the laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) as primary bariatric surgery. Yet, patients confronted with medical options may experience decisional conflict when their stakes are high and outcomes uncertain. This study aimed to assess if a decision aid helps patients make informed choices between two bariatric procedures by lowering the level of decisional conflict. Materials and Methods This study was a single-center comparative cohort of patients who accessed a web-based decision aid (intervention group) and those who did not use the decision aid (control group) to help choose between two bariatric procedures additional to the standard provided care. The primary outcome was the level of decisional conflict in these patients using the decisional conflict scale (DCS). Secondary outcomes were patient satisfaction with the provided information (BODY-QTM—satisfaction with information), preference of involvement in procedure selection, level of shared decision-making (SDM-Q-9 questionnaire), and patient knowledge. Results The level of decisional conflict assessed with the decisional conflict scale (DCS) showed a significantly lower mean total DCS of 25.5 ± 11.5 for the intervention group vs. 29.1 ± 12.4 in the control group ( p = 0.022). Both groups did not significantly differ in satisfaction regarding provided information, involvement in the selection procedure, shared decision-making, and patient knowledge. Conclusion The results suggest that the additional use of a decision aid significantly lowers the level of decisional conflict in patients awaiting bariatric surgery. However, the added value should be further investigated. Graphical Abstract

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“…To address this issue, case-control studies could be conducted, where patients with psychological disorders are matched with those without that disorder. It is also known that loss to follow-up rates are high among patients who have undergone bariatric-metabolic surgery, 117,118 as was affirmed in the current risk of bias assessment and could lead inadequate data and results. To address this, prospective trials should be designed with a strong emphasis on achieving and maintaining higher follow-up rates.…”

Section: Risk Of Biasmentioning

confidence: 99%

Influence of mental and behavioral factors on weight loss after bariatric surgery: A systematic review and meta‐analysis

Jacobs,

Monpellier,

Torensma

et al. 2024

Obesity Reviews

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SummaryIntroductionMultiple factors are related to lower weight loss after bariatric surgery. This review and meta‐analysis evaluates the influence of several mental and behavioral factors on weight loss.MethodSix electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non‐moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow‐up moments were analyzed separately.ResultsIn total, 75 articles were included in the review; 12 meta‐analyses were conducted. Higher postoperative compliance to follow‐up was associated with 6.86%–13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24‐ and 36‐month follow‐up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms.ConclusionDespite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric‐metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss.

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The association between patient attendance to a perioperative group-based lifestyle program and weight loss after bariatric surgery

Cited by 8 publications

References 31 publications

Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

Characterization of Pre- and Postpandemic 30-Day Follow-Up After Elective Bariatric Surgery: a Retrospective MBSAQIP Analysis of 834,646 Patients

A Decision Aid to Help Patients Make Informed Choices Between the Laparoscopic Gastric Bypass or Sleeve Gastrectomy

Influence of mental and behavioral factors on weight loss after bariatric surgery: A systematic review and meta‐analysis

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