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Predictors of Attrition in Bariatric Aftercare: A Systematic Review of the Literature

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Abstract

Bariatric surgery results in greater weight loss and maintenance than non-surgical interventions in obese patients. Inadequate adherence to aftercare is associated with poor weight loss and maintenance, poorer control of obesity-related comorbidities, and the development of post-operative complications. This study aims to identify factors influencing failure to attend follow-up visits in the adult post-bariatric surgery patients. A systematic review was undertaken to identify factors associated with attrition from bariatric aftercare in adult (18–65 years) obese (BMI > 30) patients. Eight studies published before May 2011 and addressing factors associated with bariatric aftercare attendance were identified. Few consistent findings were evident. Greater pre-surgical weight and greater travel distance to the follow-up centre were more commonly associated with attrition. Conclusions were limited by the very small number of studies, the different types of bariatric surgery studied and the variety of methodologies employed and variables considered. There is a need for research identifying the modifiable attrition risk factors that can be targeted to improve surgical aftercare attendance. This has the potential to facilitate long-term weight loss and maintanence as well as to reduce post-operative complications and costs; thus improving both the effectiveness and the cost-effectiveness of bariatric surgery.

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Acknowledgments

We would like to thank Ms Kylie Murphy for reviewing and editing the final version of this manuscript.

Disclosure statement

Moroshko Irina, Brennan Leah, Paul O'Brien: The Centre for Obesity Research and Education (CORE) receives a grant from Allergan for research support. The grant is not tied to any specified research projects and Allergan have no control of the research protocols, analysis or reporting of any studies. CORE also receives a grant from Applied Medical towards the educational programs.

Paul O'Brien: Professor Paul O'Brien wrote a patient information book entitled “The LAP-BAND Solution: A Partnership for Weight Loss” which was published by Melbourne University Publishing in 2007. Most copies are given to patients without charge but Professor O'Brien derives a financial benefit from the copies that are sold. Professor O'Brien also reports receiving compensation as the national medical director of the American Institute of Gastric Banding, a multicenter facility, based in Dallas, Texas, that treats obesity predominantly by gastric banding.

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Authors and Affiliations

  1. Centre for Obesity Research and Education, Monash University, Level 6. The Alfred Centre, 99 Commercial Road, Melbourne, 3004, Australia

    Irina Moroshko, Leah Brennan & Paul O’Brien

  2. School of Health Sciences, RMIT University, Plenty Road, Bundoora, Melbourne, 3083, Australia

    Irina Moroshko

Authors
  1. Irina Moroshko
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  2. Leah Brennan
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  3. Paul O’Brien
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Correspondence to Leah Brennan.

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Moroshko, I., Brennan, L. & O’Brien, P. Predictors of Attrition in Bariatric Aftercare: A Systematic Review of the Literature. OBES SURG 22, 1640–1647 (2012). https://doi.org/10.1007/s11695-012-0691-3

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