Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass

Gould, Jon C.; Beverstein, Gretchen; Reinhardt, Susan; Garren, Michael J.

doi:10.1016/j.soard.2007.07.005

« Previous Next »Surgery for Obesity and Related Diseases
Volume 3, Issue 6 , Pages 627-630, November 2007

Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass

Presented at the 24th Annual Meeting of the American Society for Bariatric Surgery, June 11–16, 2007, San Diego, California

Department of Surgery, University of Wisconsin School of Medicine and Public Health and the UW Health Bariatric Surgery Program, Madison, Wisconsin

Received 11 May 2007; received in revised form 5 July 2007; accepted 21 July 2007. published online 18 October 2007.

Abstract

Background

Weight loss after gastric bypass varies among patients. It is difficult to maintain contact with patients who have undergone surgery several years previously. Continued and long-term follow-up care at a bariatric surgery clinic might be a factor affecting long-term excess weight loss (EWL).

Methods

Patients with 3–4 years of follow-up data after laparoscopic gastric bypass were included in this retrospective analysis. The patients were divided into 3 groups: group 1 patients had attended every scheduled postoperative appointment, group 2 patients had attended every appointment for 1 year before being lost to follow-up, and group 3 patients had been lost to follow-up before 1 year. Comparisons were made to determine the relationship between the length of follow-up and EWL.

Results

We identified 34 group 1 patients and 51 group 2 or 3 patients of 130 patients eligible to be included as determined by their date of surgery. The interval since surgery was similar at approximately 3 years. Although the EWL did not differ at 1 year of follow-up (mean EWL 70% for group 1 versus 65% for group 2, P >.05), a significant difference in the EWL was observed at 3–4 years (74% for group 1 versus 61% for group 2 versus 56% for group 3; P <.05). The distance traveled to the clinic was similar for all 3 groups. The most common explanation for missed follow-up appointments was a lack of insurance coverage.

Conclusion

Laparoscopic gastric bypass patients who attended all scheduled follow-up appointments experienced greater long-term weight loss than those who did not. On-going, multidisciplinary care is likely a critical component in maintaining the benefit after surgery. Patients must be encouraged to continue to attend their bariatric medical appointments, and payors should provide coverage for these visits.

Keywords: Laparoscopic gastric bypass, Bariatric surgery, Follow-up, Long-term weight loss, Insurance coverage