title: A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery.
abstract: BACKGROUND
  Bariatric surgery is a powerful treatment of severe obesity. During the past several years, a greater appreciation for the need for multidisciplinary care to optimize outcomes has developed, and a number of studies have been started to examine the role of postoperative interventions used in combination with surgery. The purpose of the present study was to investigate the hypothesis that the provision of postoperative dietary counseling, delivered by a registered dietitian, would lead to greater weight loss and more positive improvements in dietary intake and eating behavior compared with standard postoperative care. The study was performed at an academic medical center.
  
  
  METHODS
  Eighty-four individuals who underwent bariatric surgery were randomly assigned to receive either dietary counseling or standard postoperative care for the first 4 months after surgery. The participants completed measures of macronutrient intake and eating behavior at baseline and 2, 4, 6, 12, 18, and 24 months after surgery.
  
  
  RESULTS
  The patients who received dietary counseling achieved greater weight loss than those who received standard postoperative care that did not involve this counseling, although this difference did not reach statistical significance. Patients in the dietary counseling arm did report significant changes in several eating behaviors believed to be important to successful long-term weight maintenance.
  
  
  CONCLUSIONS
  The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery.
authors.affiliation: Department of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania 19104, USA. dsarwer@mail.med.upenn.edu
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.forename: Renee H
authors.initials: RH
authors.lastname: Moore
authors.forename: Jacqueline C
authors.initials: JC
authors.lastname: Spitzer
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
authors.forename: Steven E
authors.initials: SE
authors.lastname: Raper
authors.forename: Noel N
authors.initials: NN
authors.lastname: Williams
mesh_terms: D000328:Adult; D037001:Directive Counseling / Q000379:methods*; D004377:Dumping Syndrome / Q000209:etiology; D004435:Eating; D005247:Feeding Behavior; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009325:Nausea / Q000209:etiology; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000601:surgery; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology; D015431:Weight Loss / Q000502:physiology