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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.

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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.

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Authors and Affiliations

  1. Department of Medicine, Section of Endocrinology, Diabetes, Nutrition and Weight Management, Boston University School of Medicine, Boston, MA, 02118, USA

    Gitanjali Srivastava

  2. The Center for Obesity Medicine, Florida Hospital Medical Group, Celebration, FL, 34747, USA

    Gitanjali Srivastava

  3. Florida Hospital, Celebration, FL, 34747, USA

    Gitanjali Srivastava & Cynthia Buffington

Authors
  1. Gitanjali Srivastava
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  2. Cynthia Buffington
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Correspondence to Gitanjali Srivastava.

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Conflict of Interest

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

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Srivastava, G., Buffington, C. A Specialized Medical Management Program to Address Post-operative Weight Regain in Bariatric Patients. OBES SURG 28, 2241–2246 (2018). https://doi.org/10.1007/s11695-018-3141-z

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  • DOI: https://doi.org/10.1007/s11695-018-3141-z

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