A Specialized Medical Management Program to Address Post-operative Weight Regain in Bariatric Patients.

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.