Long-Term Follow-Up of Bariatric Patients
Our emerging recognition of the chronic and relapsing nature of the metabolic dysfunction that contributes to obesity, as well as the numerous life-threatening comorbidities related to excess weight, dictates the importance of long-term follow-up in obese populations. This tenet cannot be overstated in the success of bariatric surgery patients. While follow-up has frequently been relegated to primary care personnel in the past, recent investigations have shown the benefit of longitudinal monitoring by a multidisciplinary bariatric team. Such support is associated with greater improvements in sustained weight loss, prevention of vitamin deficiencies, and better maintenance of comorbidities. Establishing a successful long-term follow-up protocol is vital for bariatric practitioners in order to optimize patient outcomes. This should include but is not limited to a standard clinic visit schedule, periodic laboratory monitoring, ongoing dietary counseling, and bariatric support groups. In addition, specialty providers such as psychologists and physical therapists should be available to help guide patients successfully through the myriad changes that accompany extreme weight loss.
KeywordsBariatric Follow-up Long- term Nutrition Weight Regain Laboratory Monitoring Office visits Support
Excess weight loss
- Hgb A1C
Primary care provider
Roux-en-y gastric bypass
- 3.Turrentine FE, Mehaffey JH, Mehaffey RL, Mullen MG, Schirmer BD, Hallowell PT. Patient reported outcomes 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017. https://doi.org/10.1007/s11695-017-2641-6.
- 9.Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, MM MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S, American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. 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. Obesity. 2013;21(Suppl 1):S1–27.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Allied Health Sciences Section Ad Hoc Nutrition Committee, Aills L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS allied health nutritional guidelines for the surgical weight loss patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S73–108.Google Scholar
- 12.Teich S, Michalsky P. Long-term follow up protocol of bariatric patients. In: Nguyen NT, De Maria EJ, Ikramuddin S, Hutter MM, editors. The SAGES manual; a practical guide to bariatric surgery. New York: Springer Science; 2008. p. 67–73.Google Scholar
- 16.Dogan K, Homan J, Aarts EO, de Boer H, van Laarhoven CJ, Berends FJ. Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery. Clin Nutr. 2017. pii: S0261–5614(17)30046–8.Google Scholar
- 24.Castellani RL, Toppino M, Favretti F, Camoglio FS, Zampieri N. National survey for bariatric procedures in adolescents: long time follow-up. J Pediatr Surg. 2017. pii: S0022–3468(17)30154–9.Google Scholar
- 26.Khorgami Z, Haskins IN, Aminian A, Andalib A, Rosen MJ, Brethauer SA, Schauer PR. Concurrent ventral hernia repair in patients undergoing laparoscopic bariatric surgery: a case-matched study using the National Surgical Quality Improvement Program Database. Surg Obes Relat Dis. 2017;13(6):997–1002.CrossRefPubMedGoogle Scholar