Obesity Surgery

, Volume 29, Issue 11, pp 3419–3431 | Cite as

Does Lifestyle Intervention After Gastric Bypass Surgery Prevent Weight Regain? A Randomized Clinical Trial

  • Susanna E. HanvoldEmail author
  • Kathrine J. Vinknes
  • Elin B. Løken
  • Anette Hjartåker
  • Ole Klungsøyr
  • Eline Birkeland
  • Hilde Risstad
  • Hanne L. Gulseth
  • Helga Refsum
  • Anne-Marie Aas
Original Contributions



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.


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.


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]).


We found no difference in weight regain between LIG and UCG.


RYGB Weight regain Randomized clinical trial Lifestyle intervention 



This research was supported by the Norwegian ExtraFoundation for Health and Rehabilitation through the EXTRA funds, the Throne Holst Foundation, and the Norwegian Research Council. We are grateful to the Section of Nutrition and Dietetics, especially Ingunn Bergstad (former chief dietitian), and the Section of Morbid Obesity and Bariatric Surgery, Oslo University Hospital, for contribution in facilitating the project. We also wish to thank the master students in clinical nutrition for data collection, and the staff at the Department of Nutrition, University of Oslo, for their help with analyses of dietary data, the Diabetes Laboratory, and Central Laboratory, Oslo University Hospital, for blood samples and blood analyses, and the Department of Psychology, University of Oslo, Patient Education Resource Centre and Section of Nutrition and Dietetics, Oslo University Hospital, for their contribution to the intervention.

Author Contribution

SEH, HR, and AMA designed the research; SEH conducted the research; SEH, KJV, EBL, OK, HLG, HR, and AMA analyzed data; SEH, KJV, HR, and AMA wrote the paper; and all co-authors reviewed and commented on the manuscript; SEH had the primary responsibility for the final content.


This study was funded by the Norwegian ExtraFoundation for Health and Rehabilitation through the EXTRA funds, the Throne Holst Foundation, and the Norwegian Research Council.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Regional Committee for Medical and Health Research Ethics. The research was conducted according to the Declaration of Helsinki.

Informed Consent

All subjects signed informed consent before participation in the trial. The study is registered in (NCT01270451).


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Susanna E. Hanvold
    • 1
    • 2
    Email author
  • Kathrine J. Vinknes
    • 2
  • Elin B. Løken
    • 2
  • Anette Hjartåker
    • 2
  • Ole Klungsøyr
    • 3
  • Eline Birkeland
    • 1
  • Hilde Risstad
    • 4
  • Hanne L. Gulseth
    • 4
    • 5
  • Helga Refsum
    • 2
    • 6
  • Anne-Marie Aas
    • 1
    • 7
  1. 1.Section of Nutrition and Dietetics, Department of Clinical Service, Division of MedicineOslo University HospitalOsloNorway
  2. 2.Department of Nutrition, Institute of Basic Medical Sciences, Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Oslo Centre for Biostatistics and Epidemiology, Department for Research and Education, Division of Mental Health and AddictionOslo University HospitalOsloNorway
  4. 4.Department of Endocrinology, Morbid Obesity and Preventive Medicine, Division of MedicineOslo University HospitalOsloNorway
  5. 5.Department of Chronic Diseases and AgeingNorwegian Institute of Public HealthOsloNorway
  6. 6.Department of PharmacologyUniversity of OxfordOxfordUK
  7. 7.Faculty of Medicine, Institute of Clinical MedicineUniversity of OsloOsloNorway

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