de Jong Pieter, Smeenk Robert, Janssen Miranda
Department of Surgery, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Your Health Spot, Zwijndrecht, The Netherlands.
J Metab Bariatr Surg. 2025 Apr;14(1):65-75. doi: 10.17476/jmbs.2025.14.1.65. Epub 2025 Mar 21.
Combined lifestyle interventions (CLI) is a program designed to treat (morbid) obesity and can possibly be an adjunct to bariatric surgery. Bariatric surgery can lead to 25-50% total weight loss (TWL) and up to 71% excess weight loss, yet the longevity of the weight reduction remains variable, primarily attributed to a lack of lifestyle change. This pilot study aims to assess the effect of a 3-year structured CLI program, additional to a 5-year bariatric surgery program in a regional hospital, on the short-term outcome following bariatric surgery.
A single-center prospective cohort study was performed on patients who underwent bariatric surgery between September 2021 and October 2022 (n=28). A structured CLI program was organized and offered by an official out-of-hospital CLI provider. CLI participants were matched with patients following regular follow-up. Primary outcome was quarterly measured excess weight loss (EWL). Secondary outcomes were TWL, fat measurements, sports participation and comorbidities.
There were significant differences in sports participation after 1 year (92.9% vs. 62.5%; P=0.050), EWL at 21 months (18.3 kg; 95% confidence interval [CI], 0.14-36.4; P=0.049), fat mass at 18 months (-8.7 kg; 95% CI, -14.1, -3.3; P=0.008) and fat percentage at 18 months (-10.0%; 95% CI, -17.9, -2.0; P=0.017) in the CLI group compared to the control group.
Preliminary short-term results show that a structured additional CLI program to bariatric surgery could benefit in terms of weight loss, perhaps due to better sports participation, but long-term results have to be awaited for.
综合生活方式干预（CLI）是一项旨在治疗（病态）肥胖的项目，可能是减肥手术的辅助手段。减肥手术可导致总体重减轻（TWL）25%-50%，超重减轻可达71%，然而体重减轻的持久性仍存在差异，主要归因于缺乏生活方式的改变。本前瞻性研究旨在评估在一家地区医院进行的为期3年的结构化CLI项目（在一个5年减肥手术项目基础上）对减肥手术后短期结果的影响。
对2021年9月至2022年10月期间接受减肥手术的患者（n=28）进行了一项单中心前瞻性队列研究。一个结构化的CLI项目由一家官方院外CLI提供商组织并提供。CLI参与者与接受常规随访的患者进行匹配。主要结局指标是每季度测量的超重减轻（EWL）。次要结局指标包括TWL、脂肪测量、体育活动参与情况和合并症。
与对照组相比，CLI组在1年后的体育活动参与情况（92.9%对62.5%；P=0.050）、21个月时的EWL（18.3千克；95%置信区间[CI]，0.14-36.4；P=0.049）、18个月时的脂肪量（-8.7千克；95%CI，-14.1，-3.3；P=0.008）和18个月时的脂肪百分比（-10.0%；95%CI，-17.9，-2.0；P=0.017）存在显著差异。
初步短期结果表明，减肥手术附加结构化CLI项目可能在体重减轻方面有益，这可能归因于更好的体育活动参与情况，但仍需等待长期结果。
