title: The role of dietician follow-up in the success of bariatric surgery.
abstract: BACKGROUND
  A growing number of patients have been undergoing bariatric surgery in recent years. The role of adherence with regular dietician follow-up in successful long-term weight reduction has yet to be determined, and there are no studies characterizing the utilization of nutritional services after bariatric surgery. The objective of this study was to determine whether dietary counseling by a dietician can contribute to weight reduction after surgery in a follow-up of morbidly obese adult patients who underwent bariatric surgery.
  
  
  METHODS
  Inclusion criteria were age 20-70 at the time of the bariatric surgery and available body mass index (BMI) measurements before and at least 1 month after the surgery. Medical history and blood test results (triglycerides, cholesterol, and glucose) were recorded. Furthermore, data were collected on the utilization of healthcare services.
  
  
  RESULTS
  The final study sample consisted of 1680 patients. Only 681 (40.54%) patients in the cohort attended dietician counseling in Maccabi, and only 471 (28%) patients received such counseling at least twice. Patients attending significant diet counseling had significantly higher proportions of at least 5% reduction in BMI. Two or more visits to dietician counseling were significantly and independently associated (odds ratio = 1.56, 1.02-2.38, 95% CI, P = .04) with a BMI reduction of at least 5%, adjusting for age, gender, number of expert counseling sessions, additional surgery, type of operation, and the interval between BMI measurements.
  
  
  CONCLUSIONS
  Structured nutritional counseling after bariatric surgery can help in achieving clinically significant weight reduction.
authors.affiliation: School of Public Health, University of Haifa, Mount Carmel, Haifa, Israel; Maccabi Health Care Services, Tel Aviv, Israel. Electronic address: rendevelt@univ.haifa.ac.il.
authors.forename: Ronit
authors.initials: R
authors.lastname: Endevelt
authors.forename: Ofir
authors.initials: O
authors.lastname: Ben-Assuli
authors.forename: Ehud
authors.initials: E
authors.lastname: Klain
authors.forename: Shira
authors.initials: S
authors.lastname: Zelber-Sagi
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D015596:Nutrition Assessment; D009751:Nutritional Requirements; D064686:Nutritionists; D009767:Obesity, Morbid / Q000175:diagnosis / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods; D024382:Professional Role; D012189:Retrospective Studies; D015431:Weight Loss
keywords: Bariatric surgery; Follow-up nutrition; Nutritional treatment