A Specialized Medical Management Program to Address Post-operative Weight Regain in Bariatric Patients

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Abstract

Introduction

Although bariatric surgery results in massive weight loss, weight regain over time up to as much as 25% is not uncommon. Weight regain in this population often leads to long-term weight loss failure and non-compliance in clinical follow-up and program recommendations.

Methods

We analyzed early weight outcomes at 3 and 6 months of 48 bariatric patients referred to an individualized, multidisciplinary medical management program at the Center for Obesity Medicine (COM) to address weight regain in 2015 and compared to a group of matched non-bariatric patients. The medical management center, under the direction of a medical obesity specialist and complementary to the surgical program and multidisciplinary team, addressed weight regain with intensive lifestyle (diet, activity, anti-stress therapy, behavioral counseling, sleep) and with medical intervention (one or more anti-obesity medications).

Results

According to early findings, the average percentage post-operative weight regain of patients entering the weight management program was 20% above nadir and time since surgery averaged 6 years (range = 1 to 20 years) with a mean weight loss of − 2.3 kg after 3 months and − 4.4 kg at 6 months into the program. Individuals most successful with weight loss were those treated with anorexigenic pharmaceuticals. Weight and percent weight loss were significantly greater for the non-surgical than the surgical patients at 3 and 6 months (p < 0.05).

Conclusions

A medically supervised weight management program complementary to surgery is beneficial for the treatment of weight regain and may prove important in assisting the surgical patient achieve long-term weight loss success.

Keywords

Medical weight loss Bariatric surgery Weight regain Anti-obesity drugs Weight recidivism 

Notes

Acknowledgements

We would like to thank The Center for Obesity Medicine (COM) and the Lifestyle Center at Celebration, FL, for the administrative support.

Contributions

GS and CB equally contributed to the contents of this manuscript.

Compliance with Ethical Standards

For this type of study, formal consent is not required.

Conflict of Interest

GS serves as a consultant for Johnson and Johnson. CB declares no competing interests.

Informed Consent Statement

Does not apply.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight ManagementBoston University School of MedicineBostonUSA
  2. 2.The Center for Obesity MedicineFlorida Hospital Medical GroupCelebrationUSA
  3. 3.Florida HospitalCelebrationUSA

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