title: Goal-directed program after sleeve gastrectomy improves weight loss.
abstract: BACKGROUND
  The aim of our study is to determine if a goal-directed program improves weight loss after sleeve gastrectomy.
  
  
  METHODS
  Our goal-directed program involves setting excess weight loss targets at fixed intervals after sleeve gastrectomy. We identified patients in 3 bariatric centers between April 2010 and July 2013 and compared the center that has a goal-directed weight loss program (goal-directed program) with the other 2 centers (standard program).
  
  
  RESULTS
  A total of 211 patients were included, with 129 patients in the goal-directed weight loss program. The 2 groups were similar in terms of gender distribution, ethnicity distribution, age, and preoperative weight, preoperative body mass index, and surgical technique. The follow-up rates at 3, 6, 9, and 12 months for patients in the goal-directed program was 84.5%, 75.2%, 59.7%, and 82.2%, respectively, compared with 65.9%, 68.3%, 51.2%, and 68.3% for the standard program. The percentage total weight loss at 3, 6, 9, and 12 months was 17.1%, 23.3%, 26.8%, and 28.6%, respectively, for the goal-directed program, compared with 15.3%, 21.8%, 24.4%, and 25.4%, respectively, for the standard program. The mean excess weight loss at 3, 6, 9, and 12 months were 40%, 54%, 62%, and 67%, respectively, for the goal-directed program group, and 36%, 50%, 54%, and 55%, respectively, for the standard program, where statistical significance (P<.005) was achieved at 12 months.
  
  
  CONCLUSIONS
  Our results suggest that a goal-directed protocol may improve weight loss outcomes after laparoscopic sleeve gastrectomy.
authors.affiliation: University Surgical Cluster, National University Health System, Singapore.
authors.forename: Guowei
authors.initials: G
authors.lastname: Kim
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, National University Health System, Singapore.
authors.forename: Chuen Seng
authors.initials: CS
authors.lastname: Tan
authors.affiliation: University Surgical Cluster, National University Health System, Singapore.
authors.forename: Jing Yu
authors.initials: JY
authors.lastname: Ng
authors.affiliation: Department of General Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Anton K S
authors.initials: AKS
authors.lastname: Cheng
authors.affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Jaideepraj
authors.initials: J
authors.lastname: Rao
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Khin T
authors.initials: KT
authors.lastname: Soe
authors.affiliation: Department of General Surgery, Khoo Teck Puat Hospital, Singapore.
authors.forename: Lucy Wc
authors.initials: LW
authors.lastname: Kong
authors.affiliation: Department of Dietetics, National University Health System, Singapore.
authors.forename: Fathimath
authors.initials: F
authors.lastname: Naseer
authors.affiliation: Department of Dietetics, National University Health System, Singapore.
authors.forename: Pamela S Y
authors.initials: PSY
authors.lastname: Er
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Davide
authors.initials: D
authors.lastname: Lomanto
authors.affiliation: Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Jimmy B Y
authors.initials: JBY
authors.lastname: So
authors.affiliation: University Surgical Cluster, National University Health System, Singapore. Electronic address: cfsasim@nus.edu.sg.
authors.forename: Asim
authors.initials: A
authors.lastname: Shabbir
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006040:Goals; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*
keywords: Bariatric program; Goal-directed program; Sleeve gastrectomy