title: Attendance at clinical visits predicts weight loss after gastric bypass surgery.
abstract: BACKGROUND
  Clinicians working with patients who undergo bariatric surgery have found loss to follow-up challenging; however, the impact of this factor on postsurgical weight loss has not been adequately examined. The purpose of this study was to determine whether patients who returned for office visits after their gastric bypass (GBP) lost more weight than those who did not.
  
  
  METHODS
  All patients treated with GBP by a single surgeon during 2003 were eligible. Measured weights were obtained from surgical and local physician records over 24 months after GBP. Attender status was defined by whether patients attended the 12-month post-GBP visit, and number of visits attended was recorded. When measured weights were not available at 1.5, 6, 12, or 24 months, the previous measured weight was carried forward. Weight loss over time was compared by attender group and by visit number using mixed models and ≥ 50% excess weight loss (EWL) by logistic regression.
  
  
  RESULTS
  Weight loss was greater in attenders and men (both p < 0.05). Increasing number of visits and BMI were associated with increased kilogram weight loss and %EWL (both p < 0.001). The odds of ≥ 50% EWL were 3.3-fold greater at 12 months and 2.8-fold greater at 24 months with each unit increase in visit number (both p = 0.001).
  
  
  CONCLUSIONS
  For optimal weight loss over 24 months after GBP, follow-up is important. Further studies are needed to develop strategies that will optimize follow-up and weight loss, and to evaluate whether a threshold number of clinic visits can be established.
authors.affiliation: University of Pennsylvania School of Nursing, University of Pennsylvania, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA. compherc@nursing.upenn.edu
authors.forename: Charlene W
authors.initials: CW
authors.lastname: Compher
authors.forename: Alexandra
authors.initials: A
authors.lastname: Hanlon
authors.forename: Youjeong
authors.initials: Y
authors.lastname: Kang
authors.forename: Liza
authors.initials: L
authors.lastname: Elkin
authors.forename: Noel N
authors.initials: NN
authors.lastname: Williams
mesh_terms: D015992:Body Mass Index; D003266:Continuity of Patient Care; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000706:statistics & numerical data*; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D009819:Office Visits / Q000706:statistics & numerical data*; D011184:Postoperative Period; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D015431:Weight Loss