A Multidisciplinary Approach for Nonresponders Following Bariatric Surgery: What Is the Value?

M.M. Romeijn*, M. Uittenbogaart, F.M.H. van Dielen, A.A.P.M. Luijten, L. Janssen, W.K.G. Leclercq

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background: Approximately 25% of patients after bariatric surgery either do not lose enough weight or regain a considerable amount of weight, both are referred to as nonresponse. This study aimed to describe the added value of a multidisciplinary approach on treatment strategies in patients with nonresponse.Materials and Methods: The primary outcome of this retrospective cohort study was the initiated treatment by the multidisciplinary team (MDT). Outcomes were described separately for patients with primary (i.e., <50% excess weight loss [EWL]) and secondary nonresponse (i.e., >= 50% EWL followed by >5% regain).Results: Of the 83 included patients, 10 patients underwent revisional surgery. A total of 73 patients received a conservative treatment as they either had not been able to change their lifestyle or due to certain behavioral factors. Conservatively treated patients stabilized in weight after 2 years (-0.9 kg +/- 5.8, n = 27), while surgically treated patients did lose weight (-12.1 kg +/- 16.9, n = 7). One patient suffered from an ulcerative stenosis at the gastroenterostomy after limb length alteration.Conclusions: a conservative treatment was the most frequently advocated treatment by the MDT. A surgical treatment resulted in successful weight loss, although only a few patients were selected for this by the MDT. A multidisciplinary approach can be beneficial for the identification of lifestyle and behavioral factors.
Original languageEnglish
Pages (from-to)9-16
Number of pages8
JournalBariatric Surgical Practice and Patient Care
Volume17
Issue number1
Early online date6 May 2021
DOIs
Publication statusPublished - 1 Mar 2022

Keywords

  • bariatric surgery
  • obesity
  • weight regain
  • multidisciplinary team
  • revisional surgery
  • GASTRIC BYPASS
  • WEIGHT REGAIN
  • MANAGEMENT
  • OUTCOMES
  • CANCER

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