Checkups key to success of obesity surgery

From Reuters: By Megan Rauscher

Seriously overweight people who undergo gastric bypass surgery to shed pounds should try to make as many scheduled post-op doctors appointments as possible, according to a new study. It shows that follow-up care is a key component of the long-term success of the weight-loss surgery.

With gastric bypass surgery -- the most common method of "bariatric" surgery -- surgeons reduce the size of the stomach, which substantially limits the amount of food a person can eat.

"Weight loss following gastric bypass varies from patient to patient," note Dr. Jon C. Gould and colleagues of the University of Wisconsin in Madison in a report to the annual meeting of the American Society for Bariatric Surgery. Continued and long-term follow-up care at a dedicated bariatric surgery clinic may impact the amount of weight that is lost, they add.

The investigators took a look back at 85 adults who had gastric bypass surgery at their center and found that the results were best in those who attended follow-up appointments for at least 3 years after they had the surgery.

Patients who attended every scheduled post-surgery follow-up appointment for 3 to 4 years lost 74 percent of their excess weight, whereas patients who kept every appointment for only 1 year lost 60 percent of their excess weight. Patients who missed appointments in the first year lost 56 percent of their excess weight.

"Our follow-up routine calls for visits at 2 weeks post-op, 6 weeks post-op, 6 months, and then annually after surgery indefinitely," Gould noted in a telephone interview with Reuters Health. "If we identify problems, we bring people in more often." The follow-up visits include meeting with a dietitian and medical health professional and often a health psychologist.

The most common reason given for missing scheduled appointments after gastric bypass surgery was lack of coverage by the patients' insurance company.

"This study shows that the more you put into bariatric surgery, the more you get out of it," Gould said in a written statement. "Patients must continue to attend their bariatric medical appointments and insurers should provide coverage for these visits."

In 2006 an estimated 177,600 severely obese people in the United States had bariatric surgery, according the American Society for Bariatric Surgery estimates. About 15 million or 1 in 50 adults in the US have morbid obesity, which is associated with a number of other diseases and conditions including type 2 diabetes, heart disease, sleep disturbances, asthma, cancer, and joint problems.