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Drakos P, Volteas P, Seeras K, Humayon S, Flink B, Yang J, Zhu C, Spaniolas K, Talamini M, Pryor A. S157-a structured early intervention program in patients with predicted poor long-term outcome following bariatric surgery: a prospective randomized study. Surg Endosc 2022; 36:6903-6914. [PMID: 35075525 DOI: 10.1007/s00464-022-09029-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Early postoperative weight loss can be predictive of one-year outcomes. It is unclear if poor performers identified in the first post-operative month can have improvement in outcomes with additional support and education. PURPOSE To evaluate the impact of a structured targeted support program for patients with lower-than-average early post-operative weight loss on 1-year outcomes. METHODS This was a prospective randomized study of bariatric surgery patients who experienced less than 50th percentile excess body weight loss (%EWL) at 3 weeks. Subjects with EWL < 18% were randomized into two groups: an intervention (IV) arm or a control (NI, no intervention) arm. The IV arm was offered a program with 7-weekly behavioral support sessions, while the NI patients received routine post-operative care. RESULTS A total of 128 patients were randomized: 65 NI and 63 IV. In the IV group, 20 attended all sessions, 7 attended < 4, and 36 did not participate. There was no difference in baseline demographics, procedure type, or BMI. At 1 year, there was no difference in %EWL (ratio 0.993, 95% CI 0.873, 1.131), %EBMIL (ratio 0.997, 95% CI 0.875, 1.137), and %TWL (ratio 1.016, 95% CI 0.901, 1.146) between groups. A subgroup analysis including only the subjects who participated in all seven sessions showed similar results. CONCLUSION Patients who present with suboptimal weight loss early after bariatric surgery do not experience a significant weight loss improvement with a structured behavioral support program. Importantly, despite being alerted to their poor early weight loss, patients demonstrated poor adherence to the proposed interventions.
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Affiliation(s)
- Panagiotis Drakos
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA.
| | - Panagiotis Volteas
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
| | - Kevin Seeras
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Shabana Humayon
- Department of Biostatistics, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Benjamin Flink
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Jie Yang
- Division of Preventive Medicine, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Chencan Zhu
- Department of Biostatistics, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Konstantinos Spaniolas
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Mark Talamini
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
| | - Aurora Pryor
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
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Tewksbury C, Isom KA. Behavioral Interventions After Bariatric Surgery. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2022; 20:366-375. [PMID: 35789675 PMCID: PMC9244319 DOI: 10.1007/s11938-022-00388-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/21/2022] [Indexed: 11/28/2022]
Abstract
Purpose of Review Bariatric surgery is the most effective and durable treatment for severe obesity. Postoperative behavioral weight management approaches are available for optimizing weight change for both short- and long-term outcomes. Recent Findings Varying settings such as groups and telemedicine along with techniques such as cognitive behavioral therapy have been assessed in the post-bariatric surgery population. The assessment and application of these programs have been limited due to methodological, financial, and attrition-related constraints. Summary This review aims to summarize the current evidence for different postoperative behavioral interventions on postoperative outcomes, specifically highlighting weight loss. Future opportunities for study include mechanisms for overcoming some of the barriers to implementing these programs in clinical, non-research settings.
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Affiliation(s)
- Colleen Tewksbury
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Silverstein Building, 4th Floor, Philadelphia, PA 19104 USA
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Samaan JS, Srinivasan N, Mirocha J, Premkumar A, Toubat O, Qian E, Subramanyam C, Malik Y, Lee N, Sandhu K, Dobrowolsky A, Samakar K. Association of Postoperative Dieting, Exercise, Dietitian, and Surgeon Follow up With Bariatric Surgery Outcomes. Am Surg 2022; 88:2445-2450. [PMID: 35575161 DOI: 10.1177/00031348221101491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Although postoperative diet modification, exercise, and regular dietitian and surgeon follow-up are often recommended after bariatric surgery (BS), their impact on weight loss is unclear. A Retrospective chart review was conducted for patients who received sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) between August 2000 and November 2017 with telephone follow-up. Multivariable logistic regression models were used for analyses. There were 514 patients included in our study. Most were female (76.3%), mean age was 46.9 years (Standard Deviation [SD] = 11.8), and mean weight loss was 11.6 (SD = 6.5) BMI points at a mean follow-up of 7 years (SD = 4.3). Current surgeon follow-up OR = 2.08 (P < .01) was positively associated with postoperative weight loss, while current dietitian follow-up=OR .41 (P < .01) was negatively associated. Current weight loss supplement use OR = .45 (P = .03) was associated with reduced willingness to undergo surgery again. Increasing preoperative BMI OR = 1.06 (P = .04) and increasing age OR = 1.04 (P = .02) were associated with improved quality of life (QoL) due to BS. Lack of surgeon follow-up and regular dietician consultation was associated with suboptimal weight loss after BS. Older age was positively associated with improved QoL, while current weight loss supplement use was associated with lower likelihood of undergoing surgery again, both independent of weight loss.
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Affiliation(s)
- Jamil S Samaan
- Department of Medicine, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Nitin Srinivasan
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - James Mirocha
- Cedars-Sinai Medical Center, Biostatistics and Bioinformatics Research Center, Los Angeles, CA, USA
| | - Agnes Premkumar
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Omar Toubat
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Elaine Qian
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Chaitra Subramanyam
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Yousaf Malik
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Nayun Lee
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kulmeet Sandhu
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Adrian Dobrowolsky
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Kamran Samakar
- Division of Upper GI & General Surgery, Department of Surgery, 12223Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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Hinnen C, Hermens M. A Lifestyle Group Intervention Aimed at Losing Sufficient Weight After Laparoscopic Roux-en-Y Gastric Bypass May Be Helpful for a Small Group of Patients. Bariatr Surg Pract Patient Care 2022. [DOI: 10.1089/bari.2021.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Chris Hinnen
- Leids University Medical Center, Leiden, The Netherlands
| | - Mark Hermens
- Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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Batar N, Kermen S, Sevdin S, Yıldız N, Güçlü D. Assessment of the Quality and Reliability of Information on Nutrition After Bariatric Surgery on YouTube. Obes Surg 2020; 30:4905-4910. [PMID: 32990890 DOI: 10.1007/s11695-020-05015-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND YouTube™ is a platform that many people, including patients, use to access health information. Recent studies have revealed that videos on YouTube™ are misleading or that medical videos may not contain appropriate information. This study aimed to assess the quality and reliability of videos on nutrition after bariatric surgery. MATERIALS AND METHODS The keywords "after bariatric surgery diet" and "weight loss surgery postop diet" were used, and the first 100 videos for each keyword on YouTube™ were analyzed by considering the source, duration, content, and the number of likes of the video. The popularity of the video was calculated using the video power index (VPI) and view rate. The educational quality of the videos was evaluated using the DISCERN score, the Journal of the American Medical Association (JAMA) score, the Global Quality Score (GQS), the usefulness score, and a novel postoperation nutrition score (PONS). RESULTS One hundred fourteen patients were included in the study. The mean duration and number of views were 12.51 min and 87,558.46, respectively. The DISCERN score, JAMA score, GQS, and usefulness score of the physicians or dietician-based videos were significantly higher than those of the patient-based videos (p < 0.001). Positive correlations were found between the VPI and view ratio, as well as between the duration and number of likes. Additionally, the DISCERN score was significant correlated with the duration and number of likes. Significantly positive correlations were found between the usefulness score and duration, usefulness score and number of likes, and PONS and duration (p < 0.01). CONCLUSIONS Informational videos on nutrition after bariatric surgery on YouTube™ are of low quality. Although the videos uploaded by physicians and dieticians have higher quality, only a few are available. Additionally, patients prefer to watch low-quality videos.
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Affiliation(s)
- Nazlı Batar
- Health Sciences Faculty, Department of Nutrition and Dietetics, Istanbul Kültür University, Bahcelievler, 34191, Istanbul, Turkey.
| | - Seda Kermen
- Health Sciences Institute, İstanbul University, Istanbul, Turkey
| | - Sezen Sevdin
- Health Sciences Faculty, Department of Nutrition and Dietetics, Fenerbahçe University, Istanbul, Turkey
| | - Nida Yıldız
- Health Sciences Faculty, Department of Nutrition and Dietetics, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Duygu Güçlü
- Health Sciences Faculty, Department of Nutrition and Dietetics, Bezmialem Vakif University, Istanbul, Turkey
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