A Specialized Medical Management Program to Address Post-operative Weight Regain in Bariatric Patients
- 139 Downloads
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.
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).
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).
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.
KeywordsMedical weight loss Bariatric surgery Weight regain Anti-obesity drugs Weight recidivism
We would like to thank The Center for Obesity Medicine (COM) and the Lifestyle Center at Celebration, FL, for the administrative support.
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.
- 13.Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract. 2013;19:337–72. https://doi.org/10.4158/EP12437.GL.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Jensen MD et al. AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2013;129:S102–38. https://doi.org/10.1161/01.cir.0000437739.71477.ee. (2014).
- 15.Stanford FC, Alfaris N, Gomez G, et al. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: a multi-center study. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2017;13:491–500. https://doi.org/10.1016/j.soard.2016.10.018.CrossRefGoogle Scholar