title: Lifestyle modification parallels to sleeve success.
abstract: BACKGROUND
  The role of laparoscopic sleeve gastrectomy (LSG) has increased over the past 10 years. We present our results of patients who were 5 years out from surgery with regard to safety and long-term efficacy.
  
  
  METHODS
  Retrospective analysis was carried out from prospectively collected data of patients who underwent LSG for morbid obesity. Bariatric Analysis and Reporting Outcome System (BAROS) and Food Tolerance Scores (FTS) were assessed. At 5 years, two lifestyle modification questions (regarding nutrition habits and physical fitness) were separately assessed.
  
  
  RESULTS
  One hundred fourteen patients underwent LSG and were available for postoperative visits. Mean excess weight loss (EWL) was >65% during the initial 3 years and declined to 45.3% in 5 years. Of the patients, 71.92% did not reach 50% EWL at 60 months and were considered objective failures. BAROS and FTS scores were 7.15 and 4.32, and 23.5 and 22.5 at 30 and 60 months, respectively. Analyzing the 32 patients with EWL >50% in the 5-year group, 26 (81.25%) of them had scored ≥0.5 on the two lifestyle modification questions compared with 6 (18.75%) that scored <0.5 (P < 0.001).
  
  
  CONCLUSIONS
  LSG is an effective bariatric surgical procedure with significant long-term (5 year) weight loss, resolution of comorbid medical conditions and significant improvement in the quality of life. The basis for this success, which must be always emphasized preoperatively by the bariatric team, is knowledge and implementation of better nutritional habits and increasing physical fitness or, in other words, in significant lifestyle modification.
authors.affiliation: Gastroenterology Unit, Bariatric Gastroenterology Clinic, Bnai-Zion Medical Center, Technion Institute of Technology, 47 Golomb Ave, POB 4840, Haifa, 31048, Israel, dr.deankeren@gmail.com.
authors.forename: Dean
authors.initials: D
authors.lastname: Keren
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Matter
authors.forename: Alexandra
authors.initials: A
authors.lastname: Lavy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004032:Diet; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000517:prevention & control* / Q000523:psychology / Q000601:surgery; D011788:Quality of Life; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss