Does patient compliance with preoperative bariatric office visits affect postoperative excess weight loss?
BACKGROUND
The amount of excess weight loss (EWL) achieved after bariatric surgery has varied considerably. Reliable preoperative predictors of the postoperative %EWL do not exist. Patient compliance with the physician recommendations has generally been believed to be important for long-term success after bariatric surgery, especially after gastric banding. We hypothesized that poor preoperative patient compliance with office visits, a likely indicator of overall compliance, would be associated with lower %EWL after bariatric surgery at a teaching hospital in the United States.


METHODS
We performed an institutional review board-approved review of prospectively collected data from all patients undergoing bariatric surgery from 2007 to 2009. The patients were categorized into 2 groups: those who had missed <25% of all preoperative appointments at our bariatric center and those who had missed >25%. The average %EWL at 12 months between the 2 groups was compared using the unpaired t test separately for the gastric bypass and gastric banding patients.


RESULTS
The gastric band patients with >25% missed appointments had lost 23% EWL at 12 months compared with 32% EWL for the gastric band patients who had missed <25% of their appointments (P = .01). No difference was found in the %EWL for the gastric bypass patients according to the missed preoperative appointments. The postoperative compliance was significantly poorer than preoperatively.


CONCLUSIONS
The patients with a greater percentage of missed preoperative appointments had a lower postoperative %EWL at 1 year after gastric banding but not after gastric bypass. This information could prove useful during patient selection or when counseling patients about the type of bariatric surgery to pursue.
Section of Bariatric Surgery, Division of Minimally Invasive Surgery and Bariatric Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.
Maher
M
El Chaar
Kathleen
K
McDeavitt
Sarah
S
Richardson
Keith S
KS
Gersin
Timothy S
TS
Kuwada
Dimitrios
D
Stefanidis
D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D009819:Office Visits; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011300:Preoperative Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*