Elsevier

Surgery for Obesity and Related Diseases

Volume 8, Issue 5, September–October 2012, Pages 561-568
Surgery for Obesity and Related Diseases

Original article
A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery

https://doi.org/10.1016/j.soard.2012.02.010Get rights and content

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.

Conclusion

The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery.

Section snippets

Participants

The study participants were 84 patients who underwent bariatric surgery at the Hospital of the University of Pennsylvania. The institutional review board of the University of Pennsylvania approved the study, and all participants provided informed consent.

Recruitment

Consistent with the standard of care in our program, prospective patients attend an information session to learn about bariatric surgery and then meet with a bariatric surgeon to determine their medical appropriateness for surgery. After this

Participant characteristics

The 84 participants had a mean preoperative age of 42.0 ± 9.9 years, weight of 152.7 ± 33.7 kg, height of 171.0 ± 11.4 cm, and body mass index of 51.64 ± 9.2 kg/m2. Of the 84 participants, 53 were women. Approximately 60% of all participants were European-American, 18% were African-American, and the remainder of other ethnic origin. The participants reported 14.2 ± 2.3 years of education. More than one half (53.1%) reported being married, 28.1% were single, and the remainder were separated,

Discussion

The results of the present pilot study provide some support for the potential utility of postoperative dietary counseling to improve outcomes after bariatric surgery. The patients who received every-other-week dietary counseling for the first 4 months after surgery achieved greater weight loss than those who received standard postoperative care. Patients who received dietary counseling were also found to consume significantly fewer calories, reported greater cognitive restraint, and reported

Conclusion

The results of the present pilot study provide some support for the efficacy of postoperative dietary counseling to improve weight loss and eating behavior after bariatric surgery. Future studies in this area should strive to include large sample sizes but should also consider the optimal timing of the intervention in relation to the surgical procedure. Continuous care interventions, which have been shown to be successful in nonsurgical weight loss studies, might be 1 approach with the greatest

Disclosures

D. B. Sarwer is a consultant for Allergan, BaroNova, Enteromedics, and Ethicon Endo-Surgery and has received consulting fees from these organizations. The remaining authors have no commercial associations that might be a conflict of interest in relation to this article.

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    Grant support for this study was provided by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (grant R03-DK067885).

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