Updated: Jul 12
Patients who frequently participated in group-based educational programmes had better weight loss outcomes 10–15 years after RYGB and tended to have less weight regain, according to researchers from Norway. They also reported that there were no differences between the two groups in participants compliance to recommended multivitamin supplements and physical activity. The findings, ‘The Long-Term Impact of Postoperative Educational Programs on Weight Loss After Roux-en-Y Gastric Bypass’, were reported in Obesity Surgery.
The Bariatric Surgery Observation Study (BAROBS) is a multi-centre, retrospective, cross-sectional study that sought to evaluate whether participation in post-RYGB educational programmes lasting two–three years impacts long-term weight loss, weight regain, physical activity and compliance to multivitamin supplements.
The study included data on 497 patients’ attendance in group-based educational programmes. A group-based educational program lasting two to three years after surgery was offered to all patients after the RYGB procedure. The purpose of the educational programmes was to prepare the patients for life after surgery and empower the participants by searching for their motivation and skills to handle the lifestyle changes and thereby tackle psychological challenges.
The groups were led by a clinical dietitian and a nurse at all three hospitals although, there were minor differences in the curriculum, and the number of half-day sessions differed from five or ten. Teaching sessions included:
The necessity of lifelong adherence to multivitamin-mineral supplements (MVS)
Healthy food choices; and
The sessions shifted from teaching through motivational techniques and discussions around the table focusing on self-efficacy, expectations, experiences, and daily challenges, with physiotherapists and psychologists attended some of the sessions. The programmes were optional, but strongly recommended by members of the bariatric team in all three hospitals.
Two-hundred and ninety-two (58.8%) participants were categorized as FA in the educational programme and 241 (82.5%) of them were women. Among the 205/497 (41.2%) participants categorised as IFA, 154 (75.1%) were women. The FA were older than the IFA, respectively, 40.8±8.9 years vs 38.4±8.6 years (p=0.003).
The key findings were:
Twelve years after surgery, BMI was 33.9±6.4 kg/m2 in the FA and 36.5±7.3 kg/m2 in the IFA group
The %TWL was 23.2±11.7% in the FA group vs 19.5±12.6% in the IFA group
The %EWL in the FA was 55.7 ± 28.9% vs 46.0 ± 31.2% in the IFA
WR was 32.1 ± 32.8% in the FA vs 38.4 ± 40.0% in the IFA
WR > 20% was found in 191/292 (65.4%) FA and 148/205 (72.2%) of the IFA
Of the 205 participants in the IFA group, 105 (51.2%) participants did not attend at all
From both groups (FA and IFA), there were 120/459 (26.1%) participants who reported physical activity of more than 150 min/week and they had higher %TWL and %EWL after 12 years. Participants with high intensity had higher TWL 22.7 ± 11.5% vs 20.1 ± 12.7% and EWL 54.5 ± 28.4% vs 47.3 ± 31.2% (all p-values<0.05) than those with lower intensity. Thirty-nine percent of the participants (175/451) had low intensity at work-out lasting less than 150 min/week.
“The most novel findings in our study conclude that FA to the educational programs have improved weight loss compared to the IFA and tend to have less weight regain more than ten years after surgery,” the authors noted. “Our results not only indicate that activity more than 150 min/week is advisable to keep the lost weight off and prevent WR in the long term but also indicate that intensity might replace duration and be more effective in terms of weight loss.”
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