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Skoda EM, Steinbach J, Robitzsch A, Pfeiffer C, Schüren L, Tomaszewski J, Niedergethman M, Schweda A, Bäuerle A, Teufel M. Metabolic Surgery Supporting Aftercare via Group-Intervention (MeSSAGES): study protocol of a randomised controlled trial. BMJ Open 2021; 11:e053839. [PMID: 34937721 PMCID: PMC8705074 DOI: 10.1136/bmjopen-2021-053839] [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] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Obesity is a constantly rising and cost-intensive medical issue worldwide. Severe obesity often needs surgery to promote weight loss, but due to the rapid therapeutic success after the surgery, many patients lack the awareness of the need to consistently maintain the postoperative care. However, therapeutic success and psychological well-being can be increased through group interventions and social support of the group members. Therefore, aftercare via group intervention is a promising approach. In this prospective randomised controlled study, the self-efficacy in a social media-based interactive, psychoeducational intervention is to be tested. METHODS AND ANALYSIS The intervention group will complete a social media-supported group intervention for 6 weeks with weekly postings of educative contents and the possibility to exchange in groups via anonymous avatars. The control group will receive treatment as usual (TAU) after the obesity surgery as recommended in the German S3-guidelines Obesity Surgery and Metabolic Surgery. We will examine the effectiveness of a social media-supported intervention group, and therefore, the change in self-efficacy expectation. For the primary outcome, we will perform a mixed analysis of variance with time as the within-subject factor (times of measurement T0-T4) and the group assignment as the between-subject factor (intervention +TAU vs TAU group). ETHICS AND DISSEMINATION The study was approved by the Medical Association North Rhine (Ärztekammer Nordrhein, 2020031) and the patient enrolment will begin in July 2021. TRIAL REGISTRATION NUMBER DRKS00018089.
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Affiliation(s)
- Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Steinbach
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anita Robitzsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Corinna Pfeiffer
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lynik Schüren
- Department of Surgery, Alfried Krupp Klinikum Essen, Essen, Germany
| | | | | | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Andreu A, Jimenez A, Vidal J, Ibarzabal A, De Hollanda A, Flores L, Cañizares S, Molero J, Moizé V. Bariatric Support Groups Predicts Long-term Weight Loss. Obes Surg 2021; 30:2118-2123. [PMID: 32030615 DOI: 10.1007/s11695-020-04434-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Support groups are an integral part of bariatric surgery (BS) programs yet there is limited evidence for an association between support group attendance and BS weight outcomes. SETTINGS University Hospital, Spain. OBJECTIVES This study examined the effect of support group attendance on weight loss (WL) at short- and long-term follow-up (FU) following BS. METHODS Participants were 531 (mean body mass index (BMI) = 45.8 (5.4) kg/m2; mean age 45.9 (11.1) years, 76.4% females) who underwent BS (Roux-en-Y gastric bypass (RYGB): 233 (43.8%); sleeve gastrectomy (SG): 298 (56.2%)) in our clinic. The bariatric support group program (BSGP) consisted of two subprograms: Novel-BSGP (N-BSGP; first 12 months after surgery) and Experienced-BSGP (E-BSGP; FU between 12 months 5 years after BS). RESULTS Three hundred and twenty-three (60.8%) and 129 (24.3%) participants attended at least one session of N-BSGP and E-BSGP, respectively. Linear regression analyses showed that number of sessions attended during year 1 predicted percent total body WL (%TBWL (β = 0.381, p < 0.001)) and percent excess WL (%EWL (β = 0.928, p < 0.001)) at one year and number of sessions attended during years 2-5 were positively related to %TBWL and %EWL achieved at 5 years (%EWL: β = 0.162 (p = 0.014) and %TBWL: β = 0.378 (p = 0.013)) respectively. CONCLUSION We observed a significant beneficial effect of a post-surgical support group program on short- and long-term body WL after BS.
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Affiliation(s)
- Alba Andreu
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Amanda Jimenez
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de obesidad y nutrición (CIBEROBN), Madrid, Spain
| | - Josep Vidal
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Ainitze Ibarzabal
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Ana De Hollanda
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de obesidad y nutrición (CIBEROBN), Madrid, Spain
| | - Lilliam Flores
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain
| | - Silvia Cañizares
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Judit Molero
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain
| | - Violeta Moizé
- Obesity Unit, Hospital Clinic Barcelona, Villarroel 170, 08036, Barcelona, Spain. .,Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain.
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Does Lifestyle Intervention After Gastric Bypass Surgery Prevent Weight Regain? A Randomized Clinical Trial. Obes Surg 2020; 29:3419-3431. [PMID: 31363961 DOI: 10.1007/s11695-019-04109-7] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Weight regain after bariatric surgery often starts after 1-2 y, but studies evaluating strategies to prevent weight regain are lacking. The aim of this intervention was to evaluate the efficacy of a 2-y-group-based lifestyle intervention starting approximately 2 y after Roux-en-Y gastric bypass (RYGB) compared with usual care on weight regain and related metabolic risk factors. METHODS A total of 165 patients with a mean of 21 months (range 14-32) after RYGB were randomized to a lifestyle intervention group (LIG) or a usual care group (UCG). Of the 165 participants 86% completed the study. The LIG was offered 16 group meetings over 2 y with focus on healthy diet, physical activity, and behavioural strategies to prevent weight regain, in addition to usual care. RESULTS Mean (SD) total weight loss at study start was 30.1 ± 8.2%, while weight regain during the intervention was 4.9 ± 7.4 and 4.6 ± 9.2% in the LIG and UCG, respectively (P = 0.84). There were no differences in metabolic risk factors between the groups. The LIG participants attended 8 ± 4 group meetings, with no difference in weight regain between participants with high compared to lower participation. In all the participants, a positive association between weight increase from nadir to study start and weight regain during the intervention was found. Participants who reported physical activity ≥ 150 min/wk had smaller % weight regain compared with less active participants (β = - 5.2 [SE 2.0, 95% CI - 9.1 to - 1.4]). CONCLUSION We found no difference in weight regain between LIG and UCG.
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Messiah SE, Sacher PM, Yudkin J, Ofori A, Qureshi FG, Schneider B, Hoelscher DM, de la Cruz-Muñoz N, Barlow SE. Application and effectiveness of eHealth strategies for metabolic and bariatric surgery patients: A systematic review. Digit Health 2020; 6:2055207619898987. [PMID: 32030193 PMCID: PMC6977226 DOI: 10.1177/2055207619898987] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 12/12/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To date the application of eHealth strategies among adults and adolescents undergoing metabolic and bariatric surgery (MBS) has not been systematically reviewed. This study comprehensively examines eHealth intervention studies among MBS patients within the RE-AIM framework to assess reach, effectiveness, adoption, implementation and maintenance of these efforts. METHODS A search was conducted using PubMed, EMBASE, CINAHL, PsycNET and SCOPUS of original research relating to eHealth strategies for MBS patients published in peer-reviewed journals and revealed 38 published articles between 2011 and 2019. RESULTS Studies varied widely in terms of design (qualitative to randomized controlled trials) and eHealth delivery method (telemedicine to blog post content) with a balance of pre- or post-MBS use. No studies included adolescents and very few reported (1) a conceptual framework to support study design/outcomes; and (2) race/ethnicity composition. CONCLUSIONS Although some studies report that eHealth strategies/interventions are effective in producing post-MBS weight loss and other positive health outcomes, most are pilot studies or have study design limitations. There is an opportunity for development of (1) tailored eHealth interventions to support pre- and post-MBS sustained behavior change and improved outcomes; and (2) rigorous studies that employ robust conceptual frameworks so dissemination and implementation efforts can be mapped to construct-driven outcomes.
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Affiliation(s)
- Sarah E Messiah
- University of Texas Health Sciences Center at Houston, School of
Public Health & the Center for Pediatric Population Health, Children's Health,
Dallas, USA
| | - Paul M Sacher
- Childhood Nutrition Research Centre, University College London,
UK
| | - Joshua Yudkin
- University of Texas Health Sciences Center at Houston, School of
Public Health & the Center for Pediatric Population Health, Children's Health,
Dallas, USA
| | - Ashley Ofori
- University of Texas Health Sciences Center at Houston, School of
Public Health & the Center for Pediatric Population Health, Children's Health,
Dallas, USA
| | - Faisal G Qureshi
- Department of Surgery, Division of Pediatric Surgery, University of
Texas Southwestern Medical Center, Dallas, USA
| | - Benjamin Schneider
- Department of Surgery, University of Texas Southwestern Medical
Center, Dallas, USA
| | - Deanna M Hoelscher
- Michael & Susan Dell Center for Healthy Living, University of
Texas Health Science Center at Houston, School of Public Health, Austin, USA
| | | | - Sarah E Barlow
- Department of Pediatrics, Division of Pediatric Gastroenterology,
University of Texas Southwestern Medical Center, Dallas, USA
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Barros LM, Frota NM, de Araújo TM, Tellez M, Ciqueto HHP, Caetano JÁ. Analysis of Portuguese language blogs about bariatric surgery: key doubts of internauts regarding the postoperative period. Eat Weight Disord 2019; 24:1113-1120. [PMID: 29256174 DOI: 10.1007/s40519-017-0465-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 11/13/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The Internet, particularly blogs have become an important tool for patients to disseminate and exchange information on a variety of health topics, including bariatric surgery. By virtue of its interactivity being free of judgement from health care providers, blogs expose gaps in patients' knowledge and understanding. PURPOSE This study analyzes the main doubts expressed in blogs by patients in the postoperative period of bariatric surgery. METHOD This is a qualitative exploratory study of 11 blogs of patients, who underwent bariatric surgery, that were available on the Internet between October 2013 and May 2017. The data were collected through a structured instrument and analyzed according to Bardin's suggestions. The sampling method used was intentional. RESULTS Evolution of diet, weight loss, plateau effect, weight regain, physical exercises, physiological changes, complications, use of contraceptive and pregnancy were the main areas of concern. CONCLUSION More needs to be done to educate and prepare bariatric patients for the postoperative period. The content found in blogs serves towards building better links with patients, helps them make better decisions, and provides them an opportunity to be active participants in their own treatment.
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Affiliation(s)
- Lívia Moreira Barros
- Graduate Program in Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil.
| | - Natasha Marques Frota
- Graduate Program in Nursing, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Thiago Moura de Araújo
- Nursing Department, University of International Integration of the Afro-Brazilian Lusophony (UNILAB), Redenção, CE, Brazil
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Shang L, Zuo M, Ma D, Yu Q. The Antecedents and Consequences of Health Care Professional-Patient Online Interactions: Systematic Review. J Med Internet Res 2019; 21:e13940. [PMID: 31573908 PMCID: PMC6785718 DOI: 10.2196/13940] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/05/2019] [Accepted: 07/31/2019] [Indexed: 01/26/2023] Open
Abstract
Background Online health care services effectively supplement traditional medical treatment. The development of online health care services depends on sustained interactions between health care professionals (HCPs) and patients. Therefore, it is necessary to understand the demands and gains of health care stakeholders in HCP-patient online interactions and determine an agenda for future work. Objective This study aims to present a systematic review of the antecedents and consequences of HCP-patient online interactions. It seeks to reach a better understanding of why HCPs and patients are willing to interact with each other online and what the consequences of HCP-patient online interactions are for health care stakeholders. Based on this, we intend to identify the gaps in existing studies and make recommendations for future research. Methods In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic retrieval was carried out from the Web of Science, PubMed, and Scopus electronic databases. The search results were confined to those papers published in English between January 1, 2000 and June 30, 2018. Selected studies were then evaluated for quality; studies that did not meet quality criteria were excluded from further analysis. Findings of the reviewed studies related to our research questions were extracted and synthesized through inductive thematic analysis. Results A total of 8440 records were found after the initial search, 28 papers of which were selected for analysis. Accessibility to HCPs, self-management, and unmet needs were the main triggers for patients to participate in online interaction. For HCPs, patient education, career needs, and self-promotion were the major reasons why they took the online approach. There were several aspects of the consequences of HCP-patient online interactions on health care stakeholders. Consequences for patients included patient empowerment, health promotion, and acquisition of uncertain answers. Consequences for HCPs included social and economic returns, lack of control over their role, and gaining more appointments. HCP-patient online interactions also improved communication efficiency in offline settings and helped managers of online health care settings get a better understanding of patients’ needs. Health care stakeholders have also encountered ethical and legal issues during online interaction. Conclusions Through a systematic review, we sought out the antecedents and consequences of HCP-patient online interactions to understand the triggers for HCPs and patients to participate and the consequences of participating. Potential future research topics are the influences on the chain of online interaction, specifications and principles of privacy design within online health care settings, and roles that sociodemographic and psychological characteristics play. Longitudinal studies and the adoption of text-mining method are worth encouraging. This paper is expected to contribute to the sustained progress of online health care settings.
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Affiliation(s)
- Lili Shang
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Meiyun Zuo
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Dan Ma
- Research Institute of Smart Senior Care, School of Information, Renmin University of China, Beijing, China
| | - Qinjun Yu
- School of Basic Medicine, Peking University Health Science Center, Beijing, China
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7
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Abstract
PURPOSE OF REVIEW The purpose of this paper is to review the current status of research on psychosocial concerns following bariatric surgery. RECENT FINDINGS Bariatric surgery has a positive overall impact on weight and obesity-related comorbidities, as well as a positive short-term impact on mental health and psychosocial functioning. Nonetheless, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating, substance use disorders, suicide, lack of social support, and excess skin. Moreover, special populations of patients may have distinctive psychosocial concerns based on sociodemographic factors such as age or severity of obesity. Available studies suggest that psychosocial interventions have a positive impact on post-surgery outcomes, particularly maladaptive eating. However, research is limited, and long-term data are lacking. Monitoring patients after bariatric surgery for negative psychosocial outcomes is warranted. Research is needed to develop and evaluate personalized approaches to optimize long-term weight loss and psychosocial adjustment.
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Affiliation(s)
- Melissa A Kalarchian
- School of Nursing, Duquesne University School of Nursing, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA.
| | - Marsha D Marcus
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Bradley LE, Thomas JG, Hood MM, Corsica JA, Kelly MC, Sarwer DB. Remote assessments and behavioral interventions in post-bariatric surgery patients. Surg Obes Relat Dis 2018; 14:1632-1644. [DOI: 10.1016/j.soard.2018.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/21/2018] [Accepted: 07/09/2018] [Indexed: 12/14/2022]
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Daniel F, Jabak S, Sasso R, Chamoun Y, Tamim H. Patient-Physician Communication in the Era of Mobile Phones and Social Media Apps: Cross-Sectional Observational Study on Lebanese Physicians' Perceptions and Attitudes. JMIR Med Inform 2018; 6:e18. [PMID: 29625955 PMCID: PMC5910531 DOI: 10.2196/medinform.8895] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The increased prevalence of virtual communication technology, particularly social media, has shifted the physician-patient relationship away from the well-established face-to-face interaction. The views and habits of physicians in Lebanon toward the use of online apps and social media as forms of patient communication have not been previously described. OBJECTIVE The aim of this study is to describe the views of Lebanese physicians toward the use of social media and other online apps as means of patient communication. METHODS This was a cross-sectional observational study using an online survey that addressed physicians' perceptions on the use of virtual communication in their clinical practice. The study took place between April and June 2016, and was directed toward physicians at the American University of Beirut Medical Center. RESULTS A total of 834 doctors received the online survey, with 238 physicians completing the survey. Most of the participants were from medical specialties. Most responders were attending physicians. Less than half of the respondents believed that Web-based apps and social media could be a useful tool for communicating with patients. Email was the most common form of professional online app, followed by WhatsApp (an instant messaging service). The majority of participants felt that this mode of communication can result in medicolegal issues and that it was a breach of privacy. Participants strictly against the use of virtual forms of communication made up 47.5% (113/238) of the study sample. CONCLUSIONS The majority of physicians at the American University of Beirut Medical Center are reluctant to use virtual communication technology as a form of patient communication. Appropriate policy making and strategies can allow both physicians and patients to communicate virtually in a more secure setting without fear of breaching privacy and confidentiality.
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Affiliation(s)
- Fady Daniel
- Department of Internal Medicine, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon
| | - Suha Jabak
- Department of Internal Medicine, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon
| | - Roula Sasso
- Department of Emergency Medicine, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon
| | - Yara Chamoun
- Hotel-Dieu de France Medical Center, Department of Psychiatry, Université Saint Joseph, Beirut, Lebanon
| | - Hani Tamim
- Biostatistics Unit, Clinical Research Institute, American University of Beirut Medical Center, American University of Beirut, Beirut, Lebanon
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Shukla AP, He D, Saunders KH, Andrew C, Aronne LJ. Current concepts in management of weight regain following bariatric surgery. Expert Rev Endocrinol Metab 2018; 13:67-76. [PMID: 30058859 DOI: 10.1080/17446651.2018.1447922] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Although bariatric surgery is the most effective and durable treatment for obesity, weight regain is common. AREAS COVERED In this article, we have critically reviewed data from retrospective and prospective studies pertaining to prevalence and predictors of weight regain following bariatric surgery, as well as the utility of behavioral and pharmacotherapeutic interventions to address post-surgical weight regain. EXPERT COMMENTARY The initial step in management of post-surgical weight regain is a comprehensive evaluation of the patient including a thorough assessment of contributing factors. While lifestyle interventions including diet, exercise and behavior modification are fundamental, they have limited efficacy which can be enhanced by pharmacotherapy. The optimal time to commence pharmacotherapy may be at weight plateau to maximize weight loss outcomes after bariatric surgery. Further prospective studies are needed to determine the best combination of behavioral and pharmacological therapies, and also the timing of pharmacotherapeutic intervention.
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Affiliation(s)
- Alpana P Shukla
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Diana He
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Katherine H Saunders
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Caroline Andrew
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
| | - Louis J Aronne
- a Comprehensive Weight Control Center, Division of Endocrinology, Diabetes & Metabolism , Weill Cornell Medical College , New York , USA
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Hameed S, Salem V, Tan TM, Collins A, Shah K, Scholtz S, Ahmed AR, Chahal H. Beyond Weight Loss: Establishing a Postbariatric Surgery Patient Support Group-What Do Patients Want? J Obes 2018; 2018:8419120. [PMID: 29666701 PMCID: PMC5832182 DOI: 10.1155/2018/8419120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 11/18/2017] [Accepted: 12/06/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE There are limited resources for long-term specialist follow-up after bariatric surgery. In selected centres, patients can access a postoperative support group, but there is no clear evidence to guide their delivery. MATERIALS AND METHODS A retrospective study of bariatric surgery patients (n = 152) who had been discharged from specialist follow-up (mean time since surgery 5.5 years), covering weight history, physical and psychosocial comorbidities, and the need for a postoperative bariatric support group. RESULTS Fifty-eight percent wanted a postbariatric surgery patient support group. This was not associated with operation type or the amount of weight lost or regained. However, those who wanted a support group were significantly more likely to be struggling to keep the weight off, to be unhappy with the way they look, or to be experiencing difficulties returning to work. CONCLUSIONS These data point to an unmet patient requirement for a postoperative support group that is independent of weight loss success. More research is required to ascertain how such a group should be delivered, but our data would suggest that supporting patients with weight loss maintenance, body image, and return to work is an important part of postoperative care, and these needs extend well beyond the immediate period of specialist follow-up.
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Affiliation(s)
- Saira Hameed
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Section of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, Hammersmith Hospital, 6th Floor Commonwealth Building, Du Cane Road, London W12 0NN, UK
| | - Victoria Salem
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Section of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, Hammersmith Hospital, 6th Floor Commonwealth Building, Du Cane Road, London W12 0NN, UK
| | - Tricia M. Tan
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Section of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, Hammersmith Hospital, 6th Floor Commonwealth Building, Du Cane Road, London W12 0NN, UK
| | - Alma Collins
- Imperial College School of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - Krishna Shah
- Imperial College School of Medicine, Imperial College London, South Kensington Campus, London SW7 2AZ, UK
| | - Samantha Scholtz
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
| | - Ahmed R. Ahmed
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Department of Surgery and Cancer, Imperial College London, St Mary's Campus, Praed Street, London W2 1NY, UK
| | - Harvinder Chahal
- Imperial Weight Centre, Imperial College Healthcare NHS Trust, St Mary's Hospital, Praed Street, London W2 1NY, UK
- Section of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, Hammersmith Hospital, 6th Floor Commonwealth Building, Du Cane Road, London W12 0NN, UK
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Abstract
PURPOSE OF REVIEW Bariatric surgery is the most effective treatment for morbid obesity. However, 20-30% of patients undergoing bariatric surgery experience premature weight stabilization or weight regain postoperatively. We report on the recent literature of predictors of weight loss and the efficacy of cognitive behavioral therapy (CBT) in bariatric patients. RECENT FINDINGS Preoperative disordered eating behaviors do not appear to be significantly predictive of postoperative weight loss. Postoperative disordered eating behaviors, eating disorders, and depressive symptoms have been found to be associated with less optimal weight loss results. Recent studies show that CBT can contribute in reducing disordered eating behaviors and depressive symptoms. Some studies also show that pre and postoperative CBT interventions can promote weight loss. New applications of CBT such as by telephone, internet, or virtual reality might contribute to more accessible and low-cost treatments for the large group of bariatric patients worldwide. SUMMARY CBT seems to be effective in reducing risk factors for weight regain after bariatric surgery, such as disordered eating behavior and depression. Controlled studies with long-term follow-up and larger sample sizes are needed to investigate the long-term effect of CBT interventions on weight loss results and psychological well-being.
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Reoperative Bariatric Surgery: a Systematic Review of the Reasons for Surgery, Medical and Weight Loss Outcomes, Relevant Behavioral Factors. Obes Surg 2017; 27:2707-2715. [DOI: 10.1007/s11695-017-2855-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Conceição EM, Mitchell JE, Pinto-Bastos A, Arrojado F, Brandão I, Machado PP. Stability of problematic eating behaviors and weight loss trajectories after bariatric surgery: a longitudinal observational study. Surg Obes Relat Dis 2017; 13:1063-1070. [DOI: 10.1016/j.soard.2016.12.006] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/14/2016] [Accepted: 12/13/2016] [Indexed: 02/06/2023]
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