Obesity Surgery

, Volume 28, Issue 10, pp 3054–3061 | Cite as

Predictors for Adherence to Multidisciplinary Follow-Up Care after Sleeve Gastrectomy

  • Ariela Goldenshluger
  • R. Elazary
  • M. J. Cohen
  • M. Goldenshluger
  • T. Ben-Porat
  • J. Nowotni
  • H. Geraisi
  • M. Amun
  • A. J. Pikarsky
  • L. Keinan-Boker
Original Contributions



A considerable proportion of patients who undergo bariatric surgeries (BS) do not attend routine postoperative follow-up despite recommendations for such. Data are sparse regarding the various aspects of patient adherence to consultations following sleeve gastrectomy (SG).


To examine predictors of adherence to SG follow-up, reasons for attrition from follow-up, and the relationship between adherence to follow-up and weight loss results.


A retrospective cohort study was performed with a mean follow-up of 3 years. Data were collected from electronic medical records and telephone questionnaires. Adherence was defined both as a numerical variable (ranking 0–9 according to the number of pre-scheduled postoperative visits) and as a dichotomous variable (adherent and non-adherent groups).


Of 178 patients, 46.63% were defined as “adherent,” according to the dichotomous definition. Compared to the “non-adherent group,” patients in the “adherent group” more regularly used vitamin D after the surgery, had fewer rehospitalizations, and reported a lower intake of sweetened beverages. The main reasons for attrition were work-related and difficulties in mobility. Adherence to postoperative follow-up was not found to be correlated to weight loss. Older age (OR = 1.04; p = 0.026) and postoperative side effects (OR = 2.33; p = 0.035) were found to be positive predictors for adherence, whereas rehospitalizations (OR = 0.08; p = 0.028) and ethnical minority status were negative predictors (OR = 0.42; p = 0.019).


Adherence to postoperative follow-up was found to be associated with positive lifestyle behaviors; however, no correlation was found to mid-term weight loss outcomes.


Sleeve gastrectomy Bariatric surgery Adherence Follow-up Predictors of adherence Reasons for attrition 



This study was undertaken as part of the requirements for the MPH degree of Mrs. Ariela Goldenshluger, supervised by Prof. Lital Keinan-Boker, from the Faculty of Medicine of Tel-Aviv-University, Israel, and Dr. Ram Elazary from the Department of General Surgery, at Hadassah-Hebrew University Medical Center.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Boards of the Hadassah-Hebrew University Medical Center, Jerusalem, and Tel-Aviv University, Israel.

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


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Copyright information

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

Authors and Affiliations

  1. 1.Department of NutritionHadassah-Hebrew University Medical CenterJerusalemIsrael
  2. 2.Department of General SurgeryHadassah-Hebrew University Medical CenterJerusalemIsrael
  3. 3.Clalit Health ServicesJerusalem DistrictIsrael
  4. 4.General and Oncological Department C, Chaim Sheba Medical Center-Affiliated to the Sackler Faculty of MedicineTel Aviv UniversityTel HashomerIsrael
  5. 5.Department of Vascular SurgeryHadassah-Hebrew University Medical CenterJerusalemIsrael
  6. 6.Israel Ministry of HealthCenter for Disease ControlRamat GanIsrael

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