title: Evaluation of clinical outcomes for gastric bypass surgery: results from a comprehensive follow-up study.
abstract: BACKGROUND
  Laparoscopic gastric bypass (LGB) surgery markedly increases percent excess weight loss (%EWL) and obesity-related co-morbidities. However, poor study quality and minimal exploration of clinical, behavioral, and psychosocial mechanisms of weight loss have characterized research to date.
  
  
  METHODS
  We conducted a comprehensive assessment of n = 100 LGB patients surveyed 2-3 years following surgery using standardized measures.
  
  
  RESULTS
  Mean %EWL at follow-up was 59.1 ± 17.2%. This high level of weight loss was associated with a low rate of metabolic syndrome (10.6%), although medications were commonly used to achieve control. Mean adherence to daily vitamin and mineral supplements important to the management of LGB was only 57.6%, and suboptimal blood chemistry levels were found for ferritin (32% of patients), hematocrit (27%), thiamine (25%), and vitamin D (19%). Aerobic exercise level (R (2) = 0.08) and pre-surgical weight (R (2) = 0.04) were significantly associated with %EWL, but recommended eating style, fluid intake, clinic follow-up, and support group attendance were not. Psychosocial adjustment results showed an absence of symptomatic depression (0%), common use of antidepressant medications (32.0%), low emotional distress related to the post-surgical lifestyle (19.8 ± 14.0; scale range 0-100), a high level of perceived benefit from weight loss in terms of functioning and emotional well-being (82.7 ± 17.9; scale range 0-100), and a change in marital status for 26% of patients.
  
  
  CONCLUSIONS
  At 2-3 years following LGB surgery aerobic exercise, but not diet, fluid intake, or attendance at clinic visits or support groups, is associated with %EWL. Depression is symptomatically controlled by medications, lifestyle related distress is low, and marital status is significantly impacted.
authors.affiliation: Behavioral Medicine Research, Baystate Medical Center, 140 High Street, Room 2104, Springfield, MA 01199, USA. Garry.Welch@BHS.Org
authors.forename: Garry
authors.initials: G
authors.lastname: Welch
authors.forename: Cheryl
authors.initials: C
authors.lastname: Wesolowski
authors.forename: Sofija
authors.initials: S
authors.lastname: Zagarins
authors.forename: Jay
authors.initials: J
authors.lastname: Kuhn
authors.forename: John
authors.initials: J
authors.lastname: Romanelli
authors.forename: Jane
authors.initials: J
authors.lastname: Garb
authors.forename: Nancy
authors.initials: N
authors.lastname: Allen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000523:psychology; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D010349:Patient Compliance; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult