Attendance at Clinical Visits Predicts Weight Loss After Gastric Bypass Surgery
- 428 Downloads
Clinicians working with patients who undergo bariatric surgery have found loss to follow-up challenging; however, the impact of this factor on postsurgical weight loss has not been adequately examined. The purpose of this study was to determine whether patients who returned for office visits after their gastric bypass (GBP) lost more weight than those who did not.
All patients treated with GBP by a single surgeon during 2003 were eligible. Measured weights were obtained from surgical and local physician records over 24 months after GBP. Attender status was defined by whether patients attended the 12-month post-GBP visit, and number of visits attended was recorded. When measured weights were not available at 1.5, 6, 12, or 24 months, the previous measured weight was carried forward. Weight loss over time was compared by attender group and by visit number using mixed models and ≥50% excess weight loss (EWL) by logistic regression.
Weight loss was greater in attenders and men (both p < 0.05). Increasing number of visits and BMI were associated with increased kilogram weight loss and %EWL (both p < 0.001). The odds of ≥50% EWL were 3.3-fold greater at 12 months and 2.8-fold greater at 24 months with each unit increase in visit number (both p = 0.001).
For optimal weight loss over 24 months after GBP, follow-up is important. Further studies are needed to develop strategies that will optimize follow-up and weight loss, and to evaluate whether a threshold number of clinic visits can be established.
KeywordsGastric bypass Office visits Weight loss Adherence
- 3.U.S. Census Bureau. 2010 Census Data. http://2010.census.gov/2010census/data/. Accessed May/27, 2011.
- 4.Gastrointestinal surgery for severe obesity. National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 1992; 55:614S–9S.Google Scholar
- 6.Blackburn GL. The 2008 Edward E. Mason Founders Lecture: interdisciplinary teams in the development of best practice obesity surgery. Surg Obes Relat Dis. 2008;4(5):679–684. http://www.sciencedirect.com.floyd.lib.umn.edu/science/article/pii/S1550728908005261. doi:10.1016/j.soard.2008.06.002.Google Scholar
- 7.DeMaria EJ, Pate V, Warthen M, et al. Baseline data from American Society for Metabolic and Bariatric Surgery-designated Bariatric Surgery Centers of Excellence using the Bariatric Outcomes Longitudinal Database. Surg Obes Relat Dis. 2010;6(4):347–55. doi:10.1016/j.soard.2009.11.015.PubMedCrossRefGoogle Scholar
- 23.Welch G, Wesolowski C, Zagarins S, et al. Evaluation of clinical outcomes for gastric bypass surgery: results from a comprehensive follow-up study. Obes Res. 2011;21:18–28.Google Scholar