BACKGROUND: Clinicians working with patients who undergo bariatric surgery have found loss to follow-up challenging; however, the impact of this factor on postsurgical weight loss has not been adequately examined. The purpose of this study was to determine whether patients who returned for office visits after their gastric bypass (GBP) lost more weight than those who did not. METHODS: All patients treated with GBP by a single surgeon during 2003 were eligible. Measured weights were obtained from surgical and local physician records over 24 months after GBP. Attender status was defined by whether patients attended the 12-month post-GBP visit, and number of visits attended was recorded. When measured weights were not available at 1.5, 6, 12, or 24 months, the previous measured weight was carried forward. Weight loss over time was compared by attender group and by visit number using mixed models and ≥ 50% excess weight loss (EWL) by logistic regression. RESULTS: Weight loss was greater in attenders and men (both p < 0.05). Increasing number of visits and BMI were associated with increased kilogram weight loss and %EWL (both p < 0.001). The odds of ≥ 50% EWL were 3.3-fold greater at 12 months and 2.8-fold greater at 24 months with each unit increase in visit number (both p = 0.001). CONCLUSIONS: For optimal weight loss over 24 months after GBP, follow-up is important. Further studies are needed to develop strategies that will optimize follow-up and weight loss, and to evaluate whether a threshold number of clinic visits can be established.
BACKGROUND: Clinicians working with patients who undergo bariatric surgery have found loss to follow-up challenging; however, the impact of this factor on postsurgical weight loss has not been adequately examined. The purpose of this study was to determine whether patients who returned for office visits after their gastric bypass (GBP) lost more weight than those who did not. METHODS: All patients treated with GBP by a single surgeon during 2003 were eligible. Measured weights were obtained from surgical and local physician records over 24 months after GBP. Attender status was defined by whether patients attended the 12-month post-GBP visit, and number of visits attended was recorded. When measured weights were not available at 1.5, 6, 12, or 24 months, the previous measured weight was carried forward. Weight loss over time was compared by attender group and by visit number using mixed models and ≥ 50% excess weight loss (EWL) by logistic regression. RESULTS:Weight loss was greater in attenders and men (both p < 0.05). Increasing number of visits and BMI were associated with increased kilogram weight loss and %EWL (both p < 0.001). The odds of ≥ 50% EWL were 3.3-fold greater at 12 months and 2.8-fold greater at 24 months with each unit increase in visit number (both p = 0.001). CONCLUSIONS: For optimal weight loss over 24 months after GBP, follow-up is important. Further studies are needed to develop strategies that will optimize follow-up and weight loss, and to evaluate whether a threshold number of clinic visits can be established.
Authors: Melinda A Maggard; Lisa R Shugarman; Marika Suttorp; Margaret Maglione; Harvey J Sugerman; Harvey J Sugarman; Edward H Livingston; Ninh T Nguyen; Zhaoping Li; Walter A Mojica; Lara Hilton; Shannon Rhodes; Sally C Morton; Paul G Shekelle Journal: Ann Intern Med Date: 2005-04-05 Impact factor: 25.391