Division of Gastroenterology and Hepatology, Mayo Clinic School of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA.
Obes Surg. 2019 Dec;29(12):4036-4042. doi: 10.1007/s11695-019-04102-0.
The combination of intragastric balloons (IGB) with comprehensive lifestyle and behavioral changes is critical for ongoing weight loss. Many community and rural practices do not have access to robust obesity resources, limiting the use of IGBs. Online aftercare programs were developed in response to this need, delivering lifestyle coaching to maximize effectiveness. How these programs compare to traditional follow-up is currently unknown.
Using propensity scoring (PS) methods, two large prospective databases of patients undergoing IGB therapy were compared to estimate the difference in percent total body weight loss (%TBWL) between groups while identifying predictors of response.
Seven hundred fifty-eight unique patients across 78 different participating practices (online n = 437; clinical registry n = 321) was analyzed. The mean %TBWL at balloon removal was 11% ± 6.9 with an estimated treatment difference (ETD) between online and traditional follow-up of - 1.5% TBWL (95% CI - 3-0.4%; p = 0.125). Three months post-balloon removal, the combined %TBWL was 12.2% ± 8.3 with an ETD of only 1% TBWL (95%CI - 3-3%; p = 0.08). On multivariable linear regression, each incremental follow-up was associated with increased %TBWL (β = 0.6% p = 0.002).
Online IGB aftercare programs provide similar weight loss compared with traditional programs. Increased lifestyle coaching whether in person or remotely is associated with more %TBWL at removal and during follow-up. Close follow-up for clinical symptoms is still warranted.
胃内球囊（IGB）与全面的生活方式和行为改变相结合对于持续减肥至关重要。许多社区和农村实践无法获得强大的肥胖资源，限制了 IGB 的使用。在线随访计划就是为了满足这一需求而开发的，为最大限度地提高效果提供生活方式指导。目前尚不清楚这些计划与传统随访相比如何。
使用倾向评分（PS）方法，比较了两个接受 IGB 治疗的大型前瞻性数据库，以估计两组之间的总体重减轻百分比（%TBWL）差异，同时确定反应的预测因素。
分析了来自 78 个不同参与实践（在线 n=437；临床注册 n=321）的 758 名独特患者。球囊去除时的平均%TBWL 为 11%±6.9，在线和传统随访之间的估计治疗差异（ETD）为-1.5%TBWL（95%CI -3-0.4%；p=0.125）。球囊去除后 3 个月，联合%TBWL 为 12.2%±8.3，ETD 仅为 1%TBWL（95%CI -3-3%；p=0.08）。在多变量线性回归中，每次随访增量与%TBWL 的增加相关（β=0.6%，p=0.002）。
在线 IGB 随访计划与传统计划提供相似的减肥效果。无论在现场还是远程进行的生活方式指导增加都与去除和随访期间更多的%TBWL 相关。仍需密切关注临床症状。
