Frequent Follow-Up Visits Reduce Weight Regain in Long-Term Management After Bariatric Surgery

Purpose: The objective of this retrospective study was to observe whether more frequent long-term medical follow-up visits than what occurs with the current typical follow-up schedule might prevent weight regain and nutritional deficiencies, and improve the resolution of comorbidities in bariatric patients. Materials and Methods: Clinical reports were examined of bariatric patients (n=71, 16 males, age 42±11.6 years, body mass index [BMI] 48.6±7.9 kg/m2) who had a minimum of 36 months of post-surgery follow-up. All patients had a typical follow-up after surgery at 1, 3, and 6 months. The intervention group (IG) had follow-ups at 9, 12, 15, 18, 24, 30, and 36 months, while the control group (CG) at 12, 18, 24, and 36 months after surgery. Results: Roux-en-Y gastric bypass was performed in 18 patients, while 43 patients had sleeve gastrectomy and 10 subjects had adjustable gastric banding. After 3 years, the BMI difference for the IG was 16.8±6.1 kg/m2 [95% CI 14.8–18.9], and for the CG it was 11.9±7.8 kg/m2 [95% CI 9.3–14.4] (p=0.004). The % excess weight loss was 66.3±20.9% [95% CI 59.4–73.2] for the IG and 55.7±32.2% [95% CI 45.2–66.3] for the CG (p=0.04). IG subjects had a higher rate of complete remission of diabetes mellitus (77% vs. 56%) and hypertension (74% vs. 57%). There were no statistical differences for nutritional deficiencies between the groups. The use of dietary supplements was similar (66% IG, 73% CG). Conclusions: After 3 years, there does not appear to be any influence of the frequency of follow-up visits on the risk of nutritional deficiencies and the rate of dietary supplement use. Adding more follow-up visits to the guideline schedule may help reduce weight regain and improve comorbidities.