title: An assessment of patient behavioral requirements pre- and post-surgery at accredited weight loss surgical centers.
abstract: BACKGROUND
  Without changes to diet and exercise behaviors, weight losses achieved through surgical procedures may be short lived. There is no data currently available on how accredited bariatric facilities are implementing best-practice guidelines related to behavioral and psychological care to help patients make long-lasting change.
  
  
  METHODS
  One hundred twenty-three ACS-accredited facility websites were analyzed using document and content analyses to determine behavioral and psychological services. Categories of common facility practices were identified according to best-practice recommendations and website data was coded by category. Descriptive statistics were then generated to summarize the implementation of services.
  
  
  RESULTS
  Behavioral and psychological services were more likely to be required prior to surgery than after surgery. In addition, there is great variance in the staff employed by facilities to assist patients, with more facilities employing dietary staff than exercise staff. Data patterns are reported across the categories of psychological assessment, pre- and post-surgical behavioral requirements, type of support groups, follow-up protocol, and staffing.
  
  
  CONCLUSIONS
  Most facilities implement some type of dietary counseling or consultation; however, few include services related to helping patients improve physical activity patterns. Greater incorporation of behavioral and psychological services following surgery is recommended to prevent weight regain and to help patients adopt and maintain regular physical activity.
authors.affiliation: West Virginia University, P.O. Box 6116, Morgantown, WV 26505, USA. jessica.peacock@mail.wvu.edu
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Peacock
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Zizzi
mesh_terms: D000359:Aftercare / Q000592:standards*; D050110:Bariatric Surgery; D019983:Guideline Adherence; D015438:Health Behavior; D006801:Humans; D008605:Mental Health Services; D009765:Obesity / Q000601:surgery*; D011184:Postoperative Period; D013531:Surgicenters / Q000592:standards*; D015431:Weight Loss