title: Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53792, USA.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Gould
authors.forename: Gretchen
authors.initials: G
authors.lastname: Beverstein
authors.forename: Susan
authors.initials: S
authors.lastname: Reinhardt
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Garren
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010349:Patient Compliance; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D015431:Weight Loss