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Liao J, Wen Y, Yin Y, Qin Y, Zhang G. Factors Impacting One-year Follow-up Visit Adherence after Bariatric Surgery in West China: A Mixed Methods Study. Obes Surg 2024; 34:2130-2138. [PMID: 38619773 PMCID: PMC11127808 DOI: 10.1007/s11695-024-07227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/05/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Quality follow-up (FU) is crucial after bariatric surgery. However, poor adherence after surgery is prevalent. This research aimed to explore the factors related to FU adherence after bariatric surgery in West China. MATERIALS AND METHODS This study used a sequential explanatory mixed-methods research design. Participants (n = 177) were identified from the West China Hospital. Demographic information, disease profile, treatment information, and post-surgery FU information were obtained from the bariatric surgery database of the Division of Gastrointestinal Surgery of the West China Hospital. The survey data were analyzed using logistic regression. Semi-structured interviews with participants (n = 10) who had low adherence were conducted. The recording was transcribed verbatim and entered into qualitative data analysis software. Qualitative data were analyzed using a content analysis approach. RESULTS Multiple logistic regression revealed that living in Chengdu (OR, 2.308), being employed (OR, 2.532), non-smoking (OR, 2.805), and having less than five years of obesity (OR, 2.480) were positive predictors of FU adherence within one year. Semi-structured interviews suggested that factors related to adherence to FU were lack of motivation, lack of opportunity, insufficient ability, and beliefs regarding consequences. CONCLUSION Factors impacting one-year FU visit adherence after bariatric surgery include not only demographic and disease-related factors but also social and family factors. These results will provide evidence to support healthcare professionals in developing personalized postoperative FU management strategies.
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Affiliation(s)
- Jing Liao
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Yue Wen
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
| | - Yiqiong Yin
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Yi Qin
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Guixiang Zhang
- Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China
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Chan JKY, Vartanian LR. Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review. Obes Sci Pract 2024; 10:e741. [PMID: 38404933 PMCID: PMC10893879 DOI: 10.1002/osp4.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/08/2024] [Accepted: 02/04/2024] [Indexed: 02/27/2024] Open
Abstract
Objective Adherence to lifestyle changes after bariatric surgery is associated with better health outcomes; however, research suggests that patients struggle to follow post-operative recommendations. This systematic review aimed to examine psychological factors associated with adherence after bariatric surgery. Methods PubMed, PsycInfo, and Embase were searched (from earliest searchable to August 2022) to identify studies that reported on clinically modifiable psychological factors related to adherence after bariatric surgery. Retrieved abstracts (n = 891) were screened and coded by two raters. Results A total of 32 studies met the inclusion criteria and were included in the narrative synthesis. Appointment attendance and dietary recommendations were the most frequently studied post-operative instructions. Higher self-efficacy was consistently predictive of better post-operative adherence to diet and physical activity, while pre-operative depressive symptoms were commonly associated with poorer adherence to appointments, diet, and physical activity. Findings were less inconsistent for anxiety and other psychiatric conditions. Conclusions This systematic review identified that psychological factors such as mood disorders and patients' beliefs/attitudes are associated with adherence to lifestyle changes after bariatric surgery. These factors can be addressed with psychological interventions; therefore, they are important to consider in patient care after bariatric surgery. Future research should further examine psychological predictors of adherence with the aim of informing interventions to support recommended lifestyle changes.
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Affiliation(s)
- Jade K. Y. Chan
- School of PsychologyUNSW SydneySydneyNew South WalesAustralia
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Jeong SA, Ko CS, Kim NY, Gong CS, Lee IS, Kim BS, Yoo MW. Factors Associated With Loss to Follow-up After Laparoscopic Sleeve Gastrectomy: A Single-Center Retrospective Study. JOURNAL OF METABOLIC AND BARIATRIC SURGERY 2023; 12:1-10. [PMID: 37416853 PMCID: PMC10320437 DOI: 10.17476/jmbs.2023.12.1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 07/08/2023]
Abstract
Purpose After bariatric surgery, postoperative follow-up is important for evaluating long-term outcomes, such as successful weight loss and improvement of metabolic parameters. However, many patients are lost to follow-up within 1 year. This study aimed to identify the follow-up rate of bariatric surgery and predictive factors of loss to follow-up (LTF). Materials and Methods We retrospectively reviewed the data of 61 patients receiving bariatric surgery for obesity (laparoscopic sleeve gastrectomy; LSG group) and 872 for early gastric cancer (EGC group) from November 2018 to July 2020 in a single center. After 1:1 matching, we compared the LTF rate. In the LSG group, we analyzed the factors associated with LTF. Additionally, we collected weight data in the LTF group by a telephone survey. Results By 1:1 matching, 47 patients for each group were identified. The LTF rates of the LSG and EGC groups were 34.0% (16 patients) and 2.1% (one patient), respectively (P=0.0003). In the LSG group, the LTF rate increased over the postoperative month. Of the patients, 29.5% who missed a scheduled appointment within one year comprised the LTF group. In the analysis, no significant factors associated with LTF were identified. The only factor with borderline significance was dyslipidemia with medication (P=0.094). Conclusion The LSG group demonstrated a high LTF rate, although adherence to follow-up was closely related to postoperative outcomes. Therefore, educating patients on the significance of follow-up is important. Particularly, continuous efforts to identify the associated factors and develop a multidisciplinary management protocol after bariatric surgery are necessary.
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Affiliation(s)
- Seong-A Jeong
- Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Chang Seok Ko
- Department of Gastrointestinal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Na Young Kim
- Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chung Sik Gong
- Department of Gastrointestinal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - In-Seob Lee
- Department of Gastrointestinal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Beom Su Kim
- Department of Gastrointestinal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Moon-Won Yoo
- Department of Gastrointestinal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Shinan-Altman S, Sandbank GK, Natarevich-Katzav H, Soskolne V. Self-management After Bariatric Surgery: a Comparison Between Support Group Participants and Patients Receiving Individual Dietary Follow-Up. Obes Surg 2023; 33:826-835. [PMID: 36645557 DOI: 10.1007/s11695-022-06302-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 01/17/2023]
Abstract
PURPOSE This study aimed to compare self-management after bariatric surgery between support group participants (the study group) and patients receiving only individual follow-up by a dietitian (the comparison group), and to examine the differences between the two groups regarding the associations of cognitive and emotional factors with self-management. MATERIALS AND METHODS This cross-sectional comparative study was conducted among bariatric patients who either participated in bariatric support groups during the years 2018-2020 or received only individual follow-up with a dietitian since their surgery. The structured questionnaire included a self-management questionnaire, cognitive variables (eating self-efficacy, eating awareness as independent variables, weight control motivation) and emotional variables (positive and negative affect, emotional eating), and background control variables. RESULTS The level of self-management was better in the study group than in the comparison group. The hierarchical regression model showed that in the study group, the control variables contributed negligibly to self-management (step 1), while all independent variables contributed the most (27%) to the explained variance (31%) in self-management (step 2). In the comparison group, the contribution of the control variables was 11.5% of the explained variance, with only lower duration of time since surgery being related to higher self-management (step 1). The independent variables contributed significantly - an additional 14.5% to the explained variance (step 2). Emotional eating was the sole variable related to self-management. CONCLUSION The findings emphasize the importance of encouraging patients after bariatric surgery to participate in support groups, as the skills acquired in these groups strengthen the capacity to manage self-care.
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Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, 5290002, Ramat-Gan, Israel.
| | - Galit Kowen Sandbank
- Nutrition Department, Maccabi Healthcare Services, Hamered 27, 68125, Tel Aviv, Israel
| | | | - Varda Soskolne
- Louis and Gabi Weisfeld School of Social Work, Bar-Ilan University, 5290002, Ramat-Gan, Israel
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Shinan-Altman S, Sandbank GK, Katzav HN, Soskolne V. Participating in Bariatric Support Groups: the Effects on Self-management Changes. Int J Behav Med 2023; 30:19-29. [PMID: 35441338 DOI: 10.1007/s12529-022-10066-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND This study focused on changes in self-management as the main outcome of participation in bariatric psychoeducational support groups. We assessed the contribution of changes in cognitive and emotional variables to improved self-management among 155 participants. METHOD Data for this longitudinal study were collected at the beginning (time 1) and at the end (time 2) of the support groups' 10-session program. The structured questionnaire included self-management (the Bariatric Surgery Self-Management Behaviors Questionnaire), cognitive variables (eating self-efficacy, eating awareness, weight control motivation), and emotional variables (positive and negative affect, emotional eating), as well as background variables. RESULTS Significant improvements in self-management and in eating self-efficacy, eating awareness, and emotional eating were found at time 2. The hierarchical regression model showed that the improvements in eating self-efficacy, and in positive and negative affect, contributed significantly to improved self-management. Additionally, a modification effect of negative affect was found. CONCLUSION We conclude that participation in psychoeducational bariatric support groups is beneficial to improving one's self-management.
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Affiliation(s)
- Shiri Shinan-Altman
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, 5290002, Ramat Gan, Israel.
| | | | | | - Varda Soskolne
- Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, 5290002, Ramat Gan, Israel
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Determinants of Patient's Adherence to the Predefined Follow-up Visits After Bariatric Surgery. Obes Surg 2023; 33:577-584. [PMID: 36572837 PMCID: PMC9792310 DOI: 10.1007/s11695-022-06428-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 12/07/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Multidisciplinary care after bariatric surgery is essential for long-term safety and optimal weight loss. However, many patients do not participate in routine postoperative follow-ups. We have explored the determinants of patients' adherence to scheduled follow-up visits after bariatric surgery. METHOD A retrospective cohort study was performed on patients who underwent bariatric surgery from 2009 to 2019. Cohort participants with a proportion of attendance above the median were compared with those below the median in the first-year post-operation and the period after that. We assumed that the contribution of each predefined session to the overall attendance at eligible sessions is not equal. We weighted each predefined session by the proportion of attendance of all cohort members scheduled for that session. We then calculated the proportion of attendance for each individual at each period. Discriminatory logistic regression was used to identify factors separating adherers from non-adherers. RESULTS We followed 5245 patients who underwent bariatric surgery for up to 10 years. The median follow-up was 2 years. Patients with the following characteristics were more likely to comply with the postoperative attendance schedule: female sex, older age, higher body mass index at the first visit, non-smoker, readmission after surgery, being operated in a general hospital, and one-anastomosis gastric bypass (OAGB) or Roux-en-Y gastric bypass (RYGB) surgery type. Comorbidities did not significantly affect patients' adherence to the predefined follow-up schedules. CONCLUSION Younger male smokers are more likely non-adherers. Patients with comorbidities are not at an increased risk of missing predefined postoperative follow-up visits.
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Nguyen KH, Rambachan A, Ward DT, Manuel SP. Language barriers and postoperative opioid prescription use after total knee arthroplasty. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 7:100171. [PMID: 36082144 PMCID: PMC9445381 DOI: 10.1016/j.rcsop.2022.100171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/03/2022] [Accepted: 08/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Patients with limited English proficiency (LEP) face difficulties in access to postoperative follow-up care, including post-discharge medication refills. However, prior studies have not examined how utilization of prescription pain medications after discharge from joint replacement surgeries differs between English proficient (EP) and LEP patients. Objective This study explored the relationship between English language proficiency and opioid prescription refill requests after hospital discharge for total knee arthroplasty (TKA). Methods This was an observational cohort study of patients ≥18 years of age who underwent TKA between January 2015 and December 2019 at a single academic center. LEP status was defined as not having English as the primary language and requesting an interpreter. Primary outcome variables included opioid pain medication refill requests between 0 and 90 days from discharge. Multivariable logistic regression modeling calculated the odds ratios of requesting an opioid refill. Results A total of 2148 patients underwent TKA, and 9.8% had LEP. Postoperative pain levels and rates of prior opioid use did not differ between LEP and EP patients. LEP patients were less likely to request an opioid prescription refill within 30 days (35.3% vs 52.4%, p < 0.001), 60 days (48.7% vs 61.0%, p = 0.004), and 90 days (54.0% vs 62.9%, p = 0.041) after discharge. In multivariable analysis, LEP patients had an odds ratio of 0.61 of requesting an opioid refill (95% CI, 0.41–0.92, p = 0.019) within 30 days of discharge. Having Medicare insurance and longer lengths of hospitalization were correlated with lower odds of 0–30 days opioid refills, while prior opioid use and being discharged home were associated with higher odds of opioid refill requests 0–30 days after discharge for TKA. Conclusions Language barriers may contribute to poorer access to postoperative care, including prescription medication refills. Barriers to postoperative care may exist at multiple levels for LEP patients undergoing surgical procedures.
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Silva ACF, Kazmarek LM, de Souza EM, Cintra ML, Teixeira F. Dermatological manifestations relating to nutritional deficiencies after bariatric surgery: case report and integrative literature review. SAO PAULO MED J 2022; 140:723-733. [PMID: 36043664 PMCID: PMC9514871 DOI: 10.1590/1516-3180.2021.0616.r1.17022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 02/17/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The number of bariatric surgeries performed worldwide is growing. Among the main short, medium or long-term complications after surgery are nutritional deficiencies. Many of these, such as those of Zn, Cu and vitamins A, B1, B3, B6 and B12, are manifested by dermatological lesions before potentially fatal systemic disorders occur. OBJECTIVE To identify the main dermatological manifestations associated with nutritional deficiencies after bariatric surgery, and the associated variables. DESIGN AND SETTING Integrative literature review carried out at a public university in Brazil. METHODS This was a case report and a review of health research portals and databases of national and international biomedical journals, without publication date limitation. The descriptors used for searches followed the ideal methodology for each database/search portal: "bariatric surgery", "skin", "skin disease", "skin manifestation", "deficiency disease" and "malnutrition". RESULTS A total of 59 articles were selected, among which 23 were review articles or articles that addressed specific dermatological manifestations. The other 36 articles described 41 cases, which were organized into a table with the clinical variables. CONCLUSIONS Although nutritional deficiencies are expected as complications after bariatric surgery, few articles relating them to their dermatological manifestations were found. It is important to recognize skin changes caused by nutritional deficiencies in patients treated via bariatric surgery, as these may occur before systemic complications appear and are easier to diagnose when the patient does not have any systemic symptoms yet. However, there is generally a delay between the appearance of skin lesions and making the diagnosis of nutritional deficiency.
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Affiliation(s)
- Andressa Christine Ferreira Silva
- MD. Physician, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil
| | - Laura Moya Kazmarek
- MD. Physician, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil
| | - Elemir Macedo de Souza
- MD, PhD. Associate Professor with Tenure (Phased Retirement), Department of Dermatology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil
| | - Maria Letícia Cintra
- MD, PhD. Professor and Head, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil
| | - Fernanda Teixeira
- MD, PhD. Consultant Professor, Department of Pathology, Faculdade de Ciências Médicas da Universidade Estadual de Campinas (FCM-UNICAMP), Campinas (SP), Brazil
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Lourensz K, Himantoko I, Shaw K, Laurie C, Becroft L, Forrest E, Nottle P, Fineberg D, Burton P, Brown W. Long-Term Outcomes of Revisional Malabsorptive Bariatric Surgery: Do the Benefits Outweigh the Risk? Obes Surg 2022; 32:1822-1830. [PMID: 35352269 PMCID: PMC9072481 DOI: 10.1007/s11695-022-06019-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 03/14/2022] [Accepted: 03/16/2022] [Indexed: 11/22/2022]
Abstract
Purpose To evaluate the long-term outcomes of revisional malabsorptive bariatric surgery. Materials and Methods Malabsorptive bariatric procedures are increasingly performed in the revisional setting. We collated and analysed prospectively recorded data for all patients who underwent a revisional Biliopancreatic diversion + / − duodenal switch (BPD + / − DS) over a 17-year period. Results We identified 102 patients who underwent a revisional BPD + / − DS. Median follow-up was 7 years (range 1–17). There were 21 (20.6%) patients permanently lost to follow-up at a median of 5 years postoperatively. Mean total weight loss since the revisional procedure of 22.7% (SD 13.4), 20.1% (SD 10.5) and 17.6% (SD 5.5) was recorded at 5, 10 and 15 years respectively. At the time of revisional surgery, 23 (22.5%) patients had diabetes and 16 (15.7%) had hypercholesterolaemia with remission of these occurring in 20 (87%) and 7 (44%) patients respectively. Nutritional deficiencies occurred in 82 (80.4%) patients, with 10 (9.8%) patients having severe deficiencies requiring periods of parenteral nutrition. Seven (6.9%) patients required limb lengthening or reversal procedures. There were 16 (15.7%) patients who experienced a complication within 30 days, including 3 (2.9%) anastomotic leaks. Surgery was required in 42 (41.2%) patients for late complications. Conclusion Revisional malabsorptive bariatric surgery induces significant long-term weight loss and comorbidity resolution. High rates of temporary and permanent attrition from follow-up are of major concern, given the high prevalence of nutritional deficiencies. These data question the long-term safety of malabsorptive bariatric procedures due to the inability to ensure compliance with nutritional supplementation and long-term follow-up requirements. Graphical abstract ![]()
Key points • Revisional bariatric surgery workload is increasing • Revisional malabsorptive surgery is efficacious for weight loss and comorbidity resolution • Revisional malabsorptive surgery is associated with high rates of nutritional deficiencies • Attrition from follow-up in this specific cohort of patients is of particular concern due to the risk of undiagnosed and untreated nutritional deficiencies Supplementary Information The online version contains supplementary material available at 10.1007/s11695-022-06019-7.
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Robinson A, Husband A, Slight R, Slight SP. Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change. JMIR Hum Factors 2022; 9:e29782. [PMID: 35254271 PMCID: PMC8933804 DOI: 10.2196/29782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 10/05/2021] [Accepted: 11/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background A patient’s capability, motivation, and opportunity to change their lifestyle are determinants of successful outcomes following bariatric surgery. Lifestyle changes before and after surgery, including improved dietary intake and physical activity levels, have been associated with greater postsurgical weight loss and improved long-term health. Integrating patient-centered digital technologies within the bariatric surgical pathway could form part of an innovative strategy to promote and sustain healthier behaviors, and provide holistic patient support, to improve surgical success. Previous research focused on implementing digital technologies and measuring effectiveness in surgical cohorts. However, there is limited work concerning the desires, suggestions, and reflections of patients undergoing bariatric surgery. This qualitative investigation explores patients’ perspectives on technology features that would support behavior changes during the pre- and postoperative periods, to potentially maintain long-term healthy lifestyles following surgery. Objective This study aims to understand how digital technologies can be used to support patient care during the perioperative journey to improve weight loss outcomes and surgical success, focusing on what patients want from digital technologies, how they want to use them, and when they would be of most benefit during their surgical journey. Methods Patients attending bariatric surgery clinics in one hospital in the North of England were invited to participate. Semistructured interviews were conducted with purposively sampled pre- and postoperative patients to discuss lifestyle changes and the use of digital technologies to complement their care. The interviews were audio recorded and transcribed verbatim. Reflexive thematic analysis enabled the development of themes from the data. Ethical approval was obtained from the National Health Service Health Research Authority. Results A total of 20 patients were interviewed (preoperative phase: 40% (8/20); postoperative phase: 60% (12/20). A total of 4 overarching themes were developed and related to the optimization of technology functionality. These centered on providing tailored content and support; facilitating self-monitoring and goal setting; delivering information in an accessible, trusted, and usable manner; and meeting patient information-seeking and engagement needs during the surgical pathway. Functionalities that delivered personalized feedback and postoperative follow-up were considered beneficial. Individualized goal setting functionality could support a generation of digitally engaged patients with bariatric conditions as working toward achievable targets was deemed an effective strategy for motivating behavior change. The creation of digital package of care checklists between patients and clinicians was a novel finding from this study. Conclusions Perceptions of patients undergoing bariatric surgery validated the integration of digital technologies within the surgical pathway, offering enhanced connectedness and support. Recommendations are made relating to the design, content, and functionality of digital interventions to best address the needs of this cohort. These findings have the potential to influence the co-design and integration of person-centered, perioperative technologies.
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Affiliation(s)
- Anna Robinson
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Andrew Husband
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Robert Slight
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Sarah P Slight
- School of Pharmacy, Newcastle University, Newcastle upon Tyne, United Kingdom.,Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Promoting Weight Loss Success Following Bariatric Surgery Through Telehealth. TOP CLIN NUTR 2022. [DOI: 10.1097/tin.0000000000000269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Yu Y, Ma Q, Johnson JA, O'Malley WE, Sabbota A, Groth SW. Predictors of 30-day follow-up visit completion after primary bariatric surgery: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program data registry. Surg Obes Relat Dis 2021; 18:384-393. [PMID: 34974998 DOI: 10.1016/j.soard.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/01/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Adherence to follow-up visits is often unsatisfactory after bariatric surgery. OBJECTIVES To identify predictors, including surgery type and preoperative demographics, body mass index (BMI), medical conditions, and smoking status, of 30-day follow-up visit completion. SETTING Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program participating centers (2015-2018). METHODS Patients who underwent primary Roux-en-Y gastric bypass or sleeve gastrectomy were included in this analysis. Data were analyzed using weighted logistic regression. Subanalyses included stratification of the sample by sex and age (<45, 45-60, and >60 years). RESULTS Patients (n = 566,774) were predominantly female (79.6%), White (72.4%), non-Hispanic (77.9%), and middle-aged (44.5 ± 11.9 years), with a mean BMI of 45.3 ± 7.8 kg/m2. More than 95% of patients completed the 30-day visits. In the whole-sample analysis, older age (odds ratio [OR], 1.02) and the presence of non-insulin-dependent diabetes (OR, 1.04), hypertension (OR, 1.03), hyperlipidemia (OR, 1.10), obstructive sleep apnea (OR, 1.15), and gastroesophageal reflux disease (OR, 1.16) were positive predictors of the 30-day visit completion (Ps < .01). Conversely, sleeve gastrectomy procedure (OR, .86), Black race (OR, .87), Hispanic ethnicity (OR, .94), and the presence of insulin-dependent diabetes (OR, .96) and smoking (OR, .83) were negative predictors (Ps < .01). Several differences emerged in subanalyses. For example, in sex stratification, Hispanic ethnicity lost its significance in men. In age stratification, BMI and male sex emerged as positive predictors in the age groups of <45 and 45-60 years, respectively. CONCLUSION Although challenged by small effect sizes, this analysis identified subgroups at a higher risk of being lost to follow-up after bariatric surgery.
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Affiliation(s)
- Yang Yu
- School of Nursing, University of Rochester, Rochester, New York.
| | - Qianheng Ma
- School of Public Health Sciences, University of Chicago, Chicago, Illinois
| | - Joseph A Johnson
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - William E O'Malley
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Aaron Sabbota
- Department of Surgery, University of Rochester Medical Center, Rochester, New York
| | - Susan W Groth
- School of Nursing, University of Rochester, Rochester, New York
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Reiber BMM, Leemeyer AMR, Bremer MJM, de Brauw M, Bruin SC. Weight Loss Results and Compliance with Follow-up after Bariatric Surgery. Obes Surg 2021; 31:3606-3614. [PMID: 33963975 PMCID: PMC8270808 DOI: 10.1007/s11695-021-05450-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 01/12/2023]
Abstract
PURPOSE The importance of follow-up (FU) for midterm weight loss (WL) after bariatric surgery is controversial. Compliance to this FU remains challenging. Several risk factors for loss to FU (LtFU) have been mentioned. The aim was therefore to evaluate the association between WL and LtFU 3 to 5 years postoperatively and to identify risk factors for LtFU. MATERIALS AND METHODS A single-center cross-sectional study in the Netherlands. Between June and October 2018, patients scheduled for a 3-, 4-, or 5-year FU appointment were included into two groups: compliant (to their scheduled appointment and overall maximally 1 missed appointment) and non-compliant (missed the scheduled appointment and at least 1 overall). Baseline, surgical, and FU characteristics were collected and a questionnaire concerning socio-economic factors. RESULTS In total, 217 patients in the compliant group and 181 in the non-compliant group were included with a median body mass index at baseline of 42.0 and 42.9 respectively. Eighty-eight percent underwent a laparoscopic Roux-en-Y gastric bypass. The median percentage total weight loss for the compliant and non-compliant groups was 30.7% versus 28.9% at 3, 29.3% versus 30.2% at 4, and 29.6% versus 29.9% at 5 years respectively, all p>0.05. Age, persistent comorbidities and vitamin deficiencies, a yearly salary <20,000 euro, no health insurance coverage, and not understanding the importance of FU were risk factors for LtFU. CONCLUSION Three to 5 years postoperatively, there is no association between LtFU and WL. The compliant group demonstrated more comorbidities and vitamin deficiencies. Younger age, not understanding the importance of FU, and financial challenges were risk factors for LtFU.
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Affiliation(s)
- Beata M M Reiber
- Department of Gastro-Intestinal Surgery, Amsterdam University Medical Center, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, the Netherlands.
| | - Anna-Marie R Leemeyer
- Department of Intensive Care Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Maurits de Brauw
- Department of Bariatric Surgery, Spaarne Gasthuis, Haarlem, the Netherlands
| | - Sjoerd C Bruin
- Department of Bariatric Surgery, Spaarne Gasthuis, Haarlem, the Netherlands
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14
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Huang X, Wu L, Gao L, Yu S, Chen X, Wang C, Yang W. Impact of Self-Monitoring on Weight Loss After Bariatric Surgery. Obes Surg 2021; 31:4399-4404. [PMID: 34319468 DOI: 10.1007/s11695-021-05600-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 07/10/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Weight loss after bariatric surgery varies among patients. Patients who do not comply with self-monitoring are predicted to lose less weight than those who comply with self-monitoring. OBJECTIVE To assess the effect of compliance with self-monitoring behavior on long-term %excess weight loss (%EWL) and %total weight loss (%TWL) among patients receiving laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS We used retrospective analysis to evaluate the self-monitoring behavior of patients and their weight changes throughout a 2-year follow-up. The participants were divided into two groups: group 1 consisted of participants who kept self-monitoring behavior records for all follow-ups and group 2 consisted of participants who kept self-monitoring behavior records for only six months of follow-up. Our investigators used telephone interviews to collect the data. By comparing %EWL and %TWL, we assessed the possible relationship between the long-term self-monitoring behavior, weight loss outcome, and operation type. RESULTS There were 384 included samples. %EWL was significantly different between group 1 and group 2, and group 1 participants had better outcomes regardless of operational method. In group 2, LRYGB patients had better %EWL outcomes than LSG patients. CONCLUSIONS Patients with long-term self-monitoring behaviors have better %EWL and %TWL. Patients in LRYGB group had better weight loss outcomes than the LSG group.
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Affiliation(s)
- Xinke Huang
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Lina Wu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
| | - Lilian Gao
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuqing Yu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiaomei Chen
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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15
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Rios INMS, Lamarca F, Vieira FT, de Melo HAB, Magalhães KG, de Carvalho KMB, Pizato N. The Positive Impact of Resistance Training on Muscle Mass and Serum Leptin Levels in Patients 2-7 Years Post-Roux-en-Y Gastric Bypass: A Controlled Clinical Trial. Obes Surg 2021; 31:3758-3767. [PMID: 34041699 DOI: 10.1007/s11695-021-05494-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/26/2022]
Abstract
PURPOSE Resistance training program (RTP) assist the maintenance of optimal body composition and inflammatory response modulation in individuals in late Roux-en-Y gastric bypass (RYGB). This study aimed to investigate the effect of RTP on body composition and serum inflammatory profile in individuals 2-7 years post-RYGB. METHODS Volunteers were matched on body mass index (BMI), age, sex, and years after surgery, and they were allocated as control or RTP group. Body composition, visceral fat area (VFA), and inflammatory serum markers were measured at baseline and after 12 weeks of RTP. RESULTS The sample baseline characteristics (n = 63; BMI = 29.7 ± 5.3 kg/m2) were similar between the groups. After intervention, the RTP group presented higher fat-free mass (Δ 1.17 ± 1.12 kg, p = 0.003) and skeletal muscle mass (Δ 0.77 ± 0.66 kg, p = 0.002) and decreased leptin levels (Δ -0.15 ± 0.60 pg/mL, p = 0.028). Ultrasensitive C-reactive protein (CRPus), interleukin-6, adiponectin, and monocyte chemotactic protein-1 showed no significant time-by-group interaction. After the categorization of RTP group individuals by VFA median values (129.8 cm2, IQR 90.9; 152.5), participants with VFA values above the median presented a significant decrease in CRPus (Δ -0.20 mg/L, IQR -7.59; -0.03, p = 0.022) when compared to the participants with VFA values below the median. CONCLUSION The RTP improved individuals' body composition by a modest but significant enhancing muscle mass and decreasing serum leptin and CRPus levels, especially in individuals with VFA values above the median. RTPs assist in maintaining the adequate body composition as they contribute to a decrease in proinflammatory markers in long-term RYGB.
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Affiliation(s)
| | - Fernando Lamarca
- Graduate Program in Human Nutrition, University of Brasília (UnB), Brasília, Brazil
- Department of Applied Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | | | | | - Kelly Grace Magalhães
- Laboratory of Immunology and Inflammation, Department of Cell Biology, University of Brasilia (UnB), Brasilia, Brazil
| | | | - Nathalia Pizato
- Graduate Program in Human Nutrition, University of Brasília (UnB), Brasília, Brazil.
- Faculty of Health Sciences, Graduate Program in Human Nutrition, University of Brasilia, Zip Code 70910-900, Asa Norte, Brasília, Federal District, Brazil.
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16
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Dos Santos EM, de Lima DSC, Padilha BM, Cabral PC, do Nascimento LCP, Feitosa PHF, Ferraz ÁAB. Vitamin D in the Preoperative and Postoperative Periods of Bariatric Surgery. Obes Surg 2021; 31:2723-2728. [PMID: 33725295 DOI: 10.1007/s11695-021-05329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the evolution of vitamin D levels (25OHD) in patients submitted to bariatric surgery. METHODS Retrospective study, conducted with patients submitted to bariatric surgery between 2013 and 2018, in a city in the Northeast of Brazil. The variations of 25OHD, weight, body mass index (BMI), and total lymphocyte count were analyzed and compared for preoperative and postoperative periods of 6 and 12 months. Vitamin D levels below 30ng/mL were considered insufficient. Analysis of variance (ANOVA) was used for repeated measures, followed by Bonferroni post hoc test. To identify variables related to vitamin D, Pearson's correlation test and linear regression analysis were used. A significance level of 5% (p <0.05) was adopted. RESULTS A total of 646 patients were evaluated, with a mean age of 41.3 ± 10.8 years. Most of the patients were female (75%) and had 25OHD insufficiency in the preoperative period (79.1%). It was found that in the postoperative period there was an increase in vitamin D levels. Linear regression showed that the variation in vitamin D is negatively influenced by BMI in the preoperative period (β = -0.20; p = 0.02) and by BMI (β = -0.38; p <0.001) and by age (β = -0.08; p = 0.02) in the 6-month postoperative period. CONCLUSION There was an increase in vitamin D levels in the postoperative period. BMI proved to be a negative factor for obtaining adequate levels of vitamin D in the preoperative period and in the 6-month postoperative period.
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Affiliation(s)
- Eryka M Dos Santos
- Postgraduate Program in Surgery at the Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil.
| | - Denise S C de Lima
- Postgraduate Program in Nutrition at UFPE, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil
| | - Bruna M Padilha
- Postgraduate Program in Nutrition at UFPE, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil
| | - Poliana C Cabral
- Postgraduate Program in Nutrition at UFPE, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil
| | - Luciana C P do Nascimento
- Postgraduate Program in Nutrition at the Federal University of Paraíba (UFPB), Campus I - Lot. Cidade Universitaria, João Pessoa, PB, 58051-900, Brazil
| | - Pedro H F Feitosa
- Postgraduate Program in Surgery at the Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil
| | - Álvaro A B Ferraz
- Postgraduate Program in Surgery at the Federal University of Pernambuco (UFPE), Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, PE, 50670-901, Brazil
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17
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Lima RCD, Rodrigues TMDS, Scheibe CL, Campelo GP, Pinto LEV, Valadão GJC, Carvalho GPCD, Machado Junior MRD, Valadão JA, Lima PCRD, Leal PDC, Oliveira CMBD, Moura ECR. Weight loss and adherence to postoperative follow-up after vertical gastrectomy for obesity treatment. Acta Cir Bras 2021; 36:e360203. [PMID: 33624720 PMCID: PMC7902054 DOI: 10.1590/acb360203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 01/11/2021] [Indexed: 11/22/2022] Open
Abstract
Purpose To analyze the effectiveness of vertical gastrectomy in the treatment of
obese patients, adherence to clinical follow-up and the influence of factors
such as gender and age. Methods This is a retrospective, observational and descriptive study, conducted with
patients undergoing vertical gastrectomy, operated at Hospital São Domingos,
between January 2016 and July 2018. Results Most patients undergoing vertical gastrectomy were female (n = 193, 72.28%)
and had a mean age of37.11 ± 8.96 years old. The loss of follow-up was
56.18%. Among adherent patients (n = 117; 43.82%), most patients were female
(n = 89; 76.07%) and had a mean age of 37.92 ± 9.85 years old. The mean body
mass index (BMI) of the adherents in the preoperative was 37.85 ± 3.72
kg/m2. Both BMI and excess weight (EW) showed a statistically
significant difference between pre- and postoperative period. Percentage of
excess weight loss (% EWL) was satisfactory for 96.6% of adherent patients.
Older patients had a statistically significant lower % EWL compared to the
other groups. Conclusions Vertical gastrectomy was effective in the treatment of obese patients, with
significant weight loss.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Plinio da Cunha Leal
- Universidade Federal de São Paulo, Brazil; Universidade Federal do Maranhão, Brazil
| | | | - Ed Carlos Rey Moura
- Universidade Federal de São Paulo, Brazil; Universidade Federal do Maranhão, Brazil
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18
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Braga JGR, Concon MM, Lima AP, Callejas GH, Macedo ADEC, CÂndido EC, Chaim FDM, Utrini MP, Gestic MA, Ramos AC, Cazzo E, Chaim EA. Revisional surgery in severe nutritional complications after bariatric surgical procedures: report of four cases from a single institution and review of the literature. Rev Col Bras Cir 2021; 48:e20202666. [PMID: 33503141 PMCID: PMC10846396 DOI: 10.1590/0100-6991e-20202666] [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: 06/12/2020] [Accepted: 09/18/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION bariatric surgery is currently the only treatment that leads to long-term and sustained weight loss and decreased morbidity and mortality in morbidly obese individuals. Roux-en-Y bypass causes weight loss by restricting food intake associated with reduced intestinal absorption, in addition to multiple endocrine and satiogenic effects. Biliopancreatic diversion promotes weight loss mainly due to poor absorption of the nutrients ingested. Both procedures exclude parts of the gastrointestinal tract. OBJECTIVE to describe four cases of revisional surgery after primary bariatric surgery, due to serious nutritional complications, and to review the literature regarding this subject. METHODS a retrospective analysis of patients of Unicamps bariatric center database and review of the literatures were performed. RESULTS four patients were identified, 2 women and 2 men, with a mean age of 48 years. The mean body mass index before revisional surgery was 23.7 kg/m2. Three patients underwent Scopinaro biliopancreatic diversion, and onde patient underwent Roux-en-Y gastric bypass. The revisional surgeries were revision, conversion, and reversion. One patient died. For the review of the literature 12 articles remained (11 case reports and 1 case series). Another five important original articles were included. CONCLUSION fortunately, revision surgery is rarely necessary, but when indicated it has increased morbidity, It can be revision, reverion or conversion according to the severity of the patient and the primary surgery performed.
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Affiliation(s)
| | - Matheus Mathedi Concon
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Amanda Pereira Lima
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | | | - Ary DE Castro Macedo
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Elaine Cristina CÂndido
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | | | - Murillo Pimentel Utrini
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Martinho AntÔnio Gestic
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Almino Cardoso Ramos
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Everton Cazzo
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
| | - Elinton Adami Chaim
- - Universidade Estadual de Campinas, Departamento de Cirurgia Digestiva - Campinas - SP - Brasil
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19
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Lamarca F, Vieira FT, Lima RM, Nakano EY, da Costa THM, Pizato N, Dutra ES, de Carvalho KMB. Effects of Resistance Training With or Without Protein Supplementation on Body Composition and Resting Energy Expenditure in Patients 2-7 Years PostRoux-en-Y Gastric Bypass: a Controlled Clinical Trial. Obes Surg 2021; 31:1635-1646. [PMID: 33409971 DOI: 10.1007/s11695-020-05172-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Resistance training (RT) and adequate protein intake are recommended as strategies to preserve fat-free mass (FFM) and resting metabolic demand after bariatric surgery. However, the effect of both interventions combined in the late postoperative period is unclear. This study investigated the effects of RT, isolated and combined with protein supplementation, on body composition and resting energy expenditure (REE) in the late postoperative period of Roux-en-Y gastric bypass (RYGB). METHODS This controlled trial involved patients who were 2-7 years postRYGB. Participants were partially matched on body mass index (BMI), age, sex, and years after surgery, and divided into four groups, placebo maltodextrin (control [CON]; n = 17), whey protein supplementation (PRO; n = 18), RT combined with placebo (RTP; n = 13), and RT combined with whey protein supplementation (RTP + PRO; n = 15)-considering the participants who completed the protocol. REE was measured by indirect calorimetry and body composition by multifrequency electrical bioimpedance. RESULTS Participant characteristics (40.3 ± 8.3 years old; average BMI 29.7 ± 5.3 kg/m2; 88.9% females) were similar among groups. The RTP+PRO group showed an increase of 1.46 ± 1.02 kg in FFM and 0.91 ± 0.64 kg in skeletal muscle mass (SMM), which was greater than the equivalent values in the CON group (- 0.24 ± 1.64 kg, p = 0.006 and - 0.08 ± 0.96 kg, p = 0.008, respectively). There was no significant time-by-group interaction for absolute or relative REE. CONCLUSION Combined RT and adequate protein intake via supplementation can increase FFM and SMM in the late postoperative period without changing REE. These associated strategies were effective in improving muscle-related parameters and potentially in improving the patients' physical function.
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Affiliation(s)
- Fernando Lamarca
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil.,Department of Applied Nutrition, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Flávio Teixeira Vieira
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Ricardo Moreno Lima
- Graduate Program in Physical Education, University of Brasília, Brasília, Brazil
| | | | - Teresa Helena Macedo da Costa
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
| | - Eliane Said Dutra
- Graduate Program in Human Nutrition, University of Brasília, 70910-900, Asa Norte, Brasília, Federal District, Brazil
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20
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Weight loss after bariatric surgery: a comparison between delayed and immediate qualification according to the last resort criterion. Surg Obes Relat Dis 2020; 17:718-725. [PMID: 33468427 DOI: 10.1016/j.soard.2020.11.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/07/2020] [Accepted: 11/26/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In the Netherlands, patients only qualify for bariatric surgery when they have followed a 6-month mandatory weight loss program (MWP), also called the "last resort" criterion. One of the rationales for this is that MWPs result in greater weight loss. OBJECTIVES To determine weight loss during MWPs and the effect of delayed versus immediate qualification on weight loss 3 years after bariatric surgery. SETTING Outpatient clinic. METHODS This is a nationwide, retrospective study with prospectively collected data. All patients who underwent a primary bariatric procedure in 2016 were included. We compared weight loss between patients who did not qualify according to the last resort criterion at screening (delayed group) with patients that qualified (immediate group). RESULTS In total 2628 patients were included. Mean age was 44.4 years, 81.3% were female, and baseline BMI was 42.3 kg/m2. Roux-en-Y gastric bypass (RYGB) was the most frequently performed surgery (77.0%), followed by sleeve gastrectomy (15.8%) and banded RYGB (7.3%). The delayed group (n = 831; 32%) compared with immediate group (n = 1797; 68%), showed less percentage of total weight loss (%TWL) during the MWP (1.7% versus 3.9%, P < .001) and time between screening and surgery was longer (42.3 versus 17.5 wk, P < .001). Linear mixed model analysis showed no significant difference in %TWL at 18- (P = .291, n = 2077), 24- (P = .580, n = 1993) and 36-month (P = .325, n = 1743) follow-up. CONCLUSION This study shows that delayed qualification for bariatric surgery compared with immediate qualification does not have a clinically relevant impact on postoperative weight loss 3 years after bariatric surgery.
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21
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Lujan J, Tuero C, Landecho MF, Moncada R, A Cienfuegos J, Rotellar F, Silva C, Lapuente F, Martínez P, Frühbeck G, Valenti V. Impact of Routine and Long-Term Follow-Up on Weight Loss after Bariatric Surgery. Obes Surg 2020; 30:4293-4299. [PMID: 32583298 DOI: 10.1007/s11695-020-04788-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Weight loss after bariatric surgery varies among patients. Patients who do not complete long-term follow-up are considered to loose less weight than those with regular follow-up visits. OBJECTIVE To evaluate the influence of patients' follow-up compliance on long-term excess weight loss (%EWL) and total weight loss (%TWL) after bariatric surgery, comparing results between gastric bypass (GB) and sleeve gastrectomy (SG). METHODS Patients with up to 5 years of follow-up data after bariatric surgery were included in this retrospective analysis. Patients were divided in 2 groups: those in group 1 who had attended every scheduled postoperative appointment and those in group 2 who had been lost to follow-up before 1 year and were later contacted by telephone. %EWL and %TWL were compared to determine the possible relationship between type of surgery and regularity of the follow-up. RESULTS A total of 385 patients were included. A significant difference in EWL was observed at 5 years in the SG group (78% for group 1 versus 39% for group 2; p = 0.02) and GB group (75% for group 1 versus 62% for group 2; p = 0.01). No significant differences between surgeries were found when comparing long-term EWL in group 1 patients 77% for SG versus 75% for GB. For group 2 patients, GB achieved greater EWL than SG; p = 0.005. %TWL patients in group 2 showed significant differences in all periods of study (p < 0.05). CONCLUSION Bariatric surgery patients who attended all scheduled follow-up appointments experienced significantly greater long-term EWL and TWL than those who did not. GB has apparent increased benefits for weight loss in long-term follow-up when compared with SG for patients who did not attend long-term follow-up. Therefore, continued long-term follow-up of bariatric patients should be encouraged to increase postoperative weight loss results.
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Affiliation(s)
- J Lujan
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain
| | - C Tuero
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain
| | - M F Landecho
- Department of Internal Medicine, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - R Moncada
- Department of Anesthesiology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.,Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Navarra, Spain
| | - J A Cienfuegos
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain.,Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - F Rotellar
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain.,Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain
| | - C Silva
- Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.,Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - F Lapuente
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain
| | - P Martínez
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain
| | - G Frühbeck
- Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Navarra, Spain.,Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
| | - Victor Valenti
- Department General Surgery, Bariatric and Metabolic Surgery, Clínica Universidad de Navarra, Avenida Pio XII 36, 31008, Pamplona, Navarra, Spain. .,Department of Endocrinology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Pamplona, Navarra, Spain.
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22
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King NA, Meknat A, Guevara DE, Alawwa G, Herron D, Fernandez-Ranvier G. Efficacy of Bariatric Surgery Among Adolescent Patients with Super-Obesity. Bariatr Surg Pract Patient Care 2020. [DOI: 10.1089/bari.2019.0056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Neil A. King
- Department of Surgery, Mount Sinai Medical Center, New York, New York
| | - Aryan Meknat
- Department of Surgery, Mount Sinai Medical Center, New York, New York
- Department of Surgery, Brookdale University Hospital, Brooklyn, New York
| | | | - Ghayth Alawwa
- Department of Surgery, Mount Sinai Medical Center, New York, New York
| | - Daniel Herron
- Department of Surgery, Mount Sinai Medical Center, New York, New York
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Loss to follow-up after laparoscopic gastric bypass surgery - a post hoc analysis of a randomized clinical trial. Surg Obes Relat Dis 2019; 15:880-886. [PMID: 31014947 DOI: 10.1016/j.soard.2019.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 03/05/2019] [Accepted: 03/05/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Follow-up after bariatric surgery is important if we are to identify long-term complications at an early stage and thereby improve long-term outcome. Despite great efforts, many patients are lost to follow-up. Definition of characteristics of patients failing to attend follow-up could help in defining a specific group for whom extra resources may be applied to improve the situation. OBJECTIVES To identify characteristics of patients failing to attend follow-up 2 years after laparoscopic gastric bypass surgery. SETTING Multicenter study, Sweden. METHODS Post hoc analysis of a randomized clinical trial in which preoperative patient characteristics and postoperative outcome measures were compared between patients who attended or did not attend a 2-year follow-up visit after laparoscopic gastric bypass surgery. RESULTS Of the 2495 patients included, 260 did not attend a 2-year follow-up visit. Factors associated with higher risk for failure to attend were younger age (adjusted odds ratio [OR] .96, 95% confidence interval [CI] .94-.98/yr, P < .001); male sex (adjusted OR 2.34, 95% CI 1.51-3.63, P < .001); depression (adjusted OR 1.61, 95% CI 1.05-2.47, P = .029); history of smoking (adjusted OR 1.78, 95% CI 1.26-2.51, P = .001); being single (adjusted OR 1.47, 95% CI 1.03-2.11, P = .036); and being first-generation immigrant (adjusted OR 1.74, 95% CI 1.05-2.88; P = .032). Elementary occupation (adjusted OR .42, 95% CI .18-.99, P = .047) was associated with lower risk. CONCLUSION These findings indicate that there are preoperative characteristics that may help in identifying patients likely to fail to attend follow-up visits after laparoscopic gastric bypass surgery. Special effort should be made to inform these patients of the importance of follow-up and to encourage them to attend.
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deMeireles A, Ross R, Ghaferi AA. Leveraging mobile technologies to improve longitudinal quality and outcomes following bariatric surgery. Mhealth 2019; 5:6. [PMID: 30976598 PMCID: PMC6414359 DOI: 10.21037/mhealth.2019.02.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 02/20/2019] [Indexed: 11/06/2022] Open
Affiliation(s)
- Alirio deMeireles
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Rachel Ross
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
| | - Amir A. Ghaferi
- Department of Surgery, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, Ann Arbor, MI, USA
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Response to Letter to the Editor: Alcohol Use Disorders and Bariatric Surgery. Obes Surg 2018; 28:3306-3307. [PMID: 30054876 DOI: 10.1007/s11695-018-3425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Blume CA, Machado BM, da Rosa RR, Rigoni MDS, Casagrande DS, Mottin CC, Schaan BD. Association of Maternal Roux-en-Y Gastric Bypass with Obstetric Outcomes and Fluid Intelligence in Offspring. Obes Surg 2018; 28:3611-3620. [DOI: 10.1007/s11695-018-3407-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Belo GDEQMB, Siqueira LTDE, Melo Filho DAA, Kreimer F, Ramos VP, Ferraz ÁAB. Predictors of poor follow-up after bariatric surgery. ACTA ACUST UNITED AC 2018; 45:e1779. [PMID: 29846460 DOI: 10.1590/0100-6991e-20181779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/01/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE to identify predictive factors of loss of follow-up of patients submitted to Roux-en-Y gastric bypass and sleeve gastrectomy in a 48-month period. METHODS we conducted a retrospective, cohort study from January 2010 to December 2012. We analyzed thirteen variables and compared them to loss of follow-up. RESULTS among the 559 patients studied, there was a great reduction in the frequency (43.8%) of the consultations from the second postoperative year on, with a significant loss in the 4th year (70.8%). In the univariate analysis, only the variable "excess weight" was associated with loss of follow-up. The proportion of overweight (>49.95kg) was higher in the follow-up group with greater loss (>3 absences) (p=0.025). In the logistic regression, patients exposed to a greater excess weight (>49.95kg) presented a two-fold higher risk for loss of follow-up (>3 absences) (OR=2.04, 95% CI 1.15-3.62; p=0.015). In the univariate analysis, at the 48th postoperative month, only the variable "mesoregion of origin" was associated with loss of follow-up (p=0.012). CONCLUSION there was a progressive loss of follow-up from the second postoperative year on. Among the factors analyzed, only the variable "excess weight" greater than 49.95kg in the preoperative period was associated with loss of medical-surgical follow-up. In the 48th month of the postoperative period, there was a higher prevalence of loss of medical-surgical follow-up for patients outside the perimeter of the city of Recife (51%, p=0.052).
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Affiliation(s)
| | | | | | - Flávio Kreimer
- Department of Surgery, Federal University of Pernambuco, Recife, PE, Brazil
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Isaman DJM, Rothberg AE, Herman WH. The Effect of Attrition on Reported Diabetes Remission Rates Following Roux-en-Y Gastric Bypass: a Sensitivity Analysis. Obes Surg 2018; 28:1308-1312. [PMID: 29086185 PMCID: PMC5927849 DOI: 10.1007/s11695-017-2995-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Attrition, or loss to follow-up, is a common problem in studies of type 2 diabetes remission following roux-en-Y gastric bypass (RYGB) and is often correlated with weight loss. Thus, reported rates of remission may be inflated by attrition bias. We investigate the effect of attrition bias on reported diabetes remission rates following RYGB. METHODS Using sensitivity analyses, we identified sets of attrition and remission rates that produced simulated outcomes within 95% confidence intervals of the reported outcomes from five studies of diabetes remission following RYGB. RESULTS Potential attrition bias varied greatly, yielding possible remission rates of diabetes ranging from 20 to 40% at 1 year. For studies with the attrition greater than ~ 20%, estimates that ignored attrition overestimated diabetes remission rates. Kaplan-Meier estimates were less affected by attrition. Potential for bias was most evident in the study with the largest sample size. CONCLUSION Researchers, clinicians, and policymakers can measure potential attrition bias in clinical studies. In the case of remission of diabetes following RYGB, the potential bias in reported remission rates is generally less than 10%, varies considerably among studies, and is primarily driven by attrition rate and study size. Studies with very large sample sizes may provide a narrow confidence interval around a biased estimate.
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Affiliation(s)
- Deanna J M Isaman
- Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
| | - Amy E Rothberg
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Human Nutrition, University of Michigan, Ann Arbor, MI, USA
| | - William H Herman
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
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Hood MM, Kelly MC, Feig EH, Webb V, Bradley LE, Corsica J. Measurement of adherence in bariatric surgery: a systematic review. Surg Obes Relat Dis 2018; 14:1192-1201. [PMID: 29853195 DOI: 10.1016/j.soard.2018.04.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/16/2018] [Accepted: 04/17/2018] [Indexed: 12/22/2022]
Abstract
After bariatric surgery, rates of adherence to behavioral recommendations, including attending regular appointments and following specific dietary, physical activity, and vitamin use recommendations, tend to be highly variable across studies. Lack of consistency in measurement of adherence is a likely contributor to this variability, making it challenging to determine the prevalence and impact of nonadherence in this population. PubMed was searched for articles measuring behavioral adherence or compliance in patients after bariatric surgery, resulting in 85 articles. Articles were reviewed for the definition and measurement of adherence in each area (appointment attendance, as well as dietary, physical activity, and vitamin use adherence), and on the use and reporting of recommended adherence measurement strategies. Over half of the articles measured adherence to appointment attendance. Significant variability was found across adherence definitions and measurement methods, and use of recommended adherence measurement strategies was poor. Adherence was mostly commonly measured via self-report (either verbal or written) using cutoffs for adherent versus nonadherent behavior. Over half of studies assessed adherence up to ≥2 years postsurgery. Recommendations for ways to improve adherence measurement in patients who have had bariatric surgery are outlined.
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Affiliation(s)
- Megan M Hood
- Rush University Medical Center, Chicago, Illinois.
| | | | - Emily H Feig
- Rush University Medical Center, Chicago, Illinois
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Schwoerer A, Kasten K, Celio A, Pories W, Spaniolas K. The effect of close postoperative follow-up on co-morbidity improvement after bariatric surgery. Surg Obes Relat Dis 2017; 13:1347-1352. [DOI: 10.1016/j.soard.2017.03.024] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/13/2017] [Accepted: 03/27/2017] [Indexed: 11/25/2022]
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Reddy SD. Bariatric Surgery and Suicide Risk. Bariatr Surg Pract Patient Care 2017. [DOI: 10.1089/bari.2017.0003] [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
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Messiah SE, Vidot DC, Baeker Bispo J, Arheart KL, Khorgami Z, De La Cruz-Muñoz N. Ethnic and Gender Differences in the Prevalence of Nonalcoholic Steatohepatitis Among Bariatric Surgery Patients. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Sarah E. Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Denise C. Vidot
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Jordan Baeker Bispo
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Kristopher L. Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Zhamak Khorgami
- Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Nestor De La Cruz-Muñoz
- Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Hood MM, Corsica J, Bradley L, Wilson R, Chirinos DA, Vivo A. Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. J Behav Med 2016; 39:1092-1103. [PMID: 27444752 DOI: 10.1007/s10865-016-9772-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 07/12/2016] [Indexed: 01/11/2023]
Abstract
Severe obesity (body mass index ≥40 kg/m2) is a chronic disease that is associated with significantly increased risk of serious and chronic health problems as well as impaired quality of life. For those with severe obesity, bariatric surgery is the most effective treatment for significant and long-term weight loss and resolution of comorbid medical conditions, particularly diabetes. Long-term success is thought to depend to some degree on the patient's ability to adhere to a complex set of behaviors, including regular attendance at follow up appointments and following stringent dietary, exercise, and vitamin recommendations. Here, we summarize the current research on behavioral adherence in patients with severe obesity presenting for bariatric surgery and we highlight challenges and make recommendations for improved self-management before and after surgery.
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Affiliation(s)
- Megan M Hood
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA.
| | - Joyce Corsica
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Lauren Bradley
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Rebecca Wilson
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Diana A Chirinos
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
| | - Amanda Vivo
- Department of Behavioral Sciences, Rush University Medical Center, 1645 W Jackson, Suite 400, Chicago, IL, 60612, USA
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Excess Weight Loss and Cardiometabolic Parameter Reduction Diminished among Hispanics Undergoing Bariatric Surgery: Outcomes in More than 2,000 Consecutive Hispanic Patients at a Single Institution. J Am Coll Surg 2016; 222:166-73. [DOI: 10.1016/j.jamcollsurg.2015.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 10/19/2015] [Accepted: 10/19/2015] [Indexed: 11/23/2022]
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Singh A, Watkins D, Lin E. Good News (and Caution) for Sleeve Gastrectomy. Bariatr Surg Pract Patient Care 2015. [DOI: 10.1089/bari.2015.29002.as] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Arvinpal Singh
- Emory Bariatrics Center, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Danny Watkins
- Emory Bariatrics Center, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Edward Lin
- Emory Bariatrics Center, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
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