Associations of dietitian follow-up counselling visits and physical exercise with weight loss one year after sleeve gastrectomy
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To examine associations of patients’ attendance to follow-up meetings with a registered dietitian (RD) and physical exercise practices with weight loss during the 1 year following laparoscopic sleeve gastrectomy (SG).
Of 241 patients with obesity who underwent SG during 2012, 184 (76.3%) participated in a 1-year follow-up telephone interview and had information on number of RD follow-up meetings. Clinical information was available from computerized patient files. Multiple logistic regression analysis, adjusting for propensity score, was computed to reveal factors associated with greater weight loss.
The mean %TWL was 31.4 ± 6.1 and the mean number of reported RD meetings during the year following SG was 4.6. The proportion of physically active patients increased by 15% (from 23 to 42) among those who attended at least 3 RD follow-up meetings (n = 123), and by 5% (from 18 to 23) among those who attended fewer than 3 meetings (n = 61) (p = 0.05). Patients conducting physical exercise reported a lower level of pain/discomfort on the EQ5D quality-of-life questionnaire (p = 0.03). The adjusted regression model revealed no association between the number of RD follow-up meetings and weight-reduction success, but physical exercise during the year following SG conferred a 2.6 times greater odds of belonging to the upper two tertiles of the % excess body weight loss ( 95% CI 1.2–5.3).
Patients with better adherence to RD follow-up meetings were also more physically active. Patients on physical exercise also achieved greater weight reduction following SG, and reported less pain or discomfort. Nutritional counselling and physical exercise are necessary to ensure maximal and sustainable benefits from SG.
Level of Evidence
Level III, Cohort study.
KeywordsSleeve gastrectomy Health-related quality of life Weight loss Bariatric surgery % excess body weight loss % total weight loss Registered dietitian
This work was performed in partial fulfillment of the requirements for a M.Sc. degree of Ms. Yafir Kessler, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
The study was approved by the institutional review board of the Maccabi Health Services. All participants were given an explanation about the study at the beginning of the telephone interview, and only those who expressed their verbal consent to participate were included in the study. The study was exempted from a signed informed consent.
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