Patients don't receive recommended follow-up care after weight loss surgery

December 16, 2020

Patients who have had weight loss surgery may not be receiving follow up care from their GPs as recommended in clinical guidelines - according to new research from the University of East Anglia and the University of Birmingham.

Clinical guidelines recommend that patients receive nutritional and weight monitoring annually for life following procedures such as having a gastric bypass.

But a new study published today shows that this does not appear to be happening in most cases - which can lead to patients putting weight back on or developing low levels of vitamins and other nutrients, which can have serious health consequences.

The study was funded by the National Institute for Health Research (NIHR) Clinical Research Network West Midlands.

It is the first study to investigate whether patients receive sufficient long-term routine care and monitoring in primary care following weight loss surgery.

Lead researcher Dr Helen Parretti, from UEA's Norwich Medical School, said: "Obesity is a healthcare priority and weight loss surgery, also known as bariatric surgery is an effective treatment.

"It can lead to significant weight loss and improve many obesity-related conditions such as type 2 diabetes or high blood pressure. It is the most cost-effective treatment for severe obesity and it can achieve dramatic weight loss. But it's not a cure for obesity on its own.

"Patients are supported to make changes to their eating before surgery and these changes need to continue after surgery to help avoid putting weight back on and to keep well. In addition, it is important that patients take lifelong nutritional supplements after their surgery.

"But patients need support to achieve this after their operations and current guidance recommends this is offered by GPs. Without this, weight loss surgery has long-term risks such as nutritional deficiencies and weight regain can occur.

"There is international clinical consensus that long-term follow-up care following bariatric surgery is important to optimise patient outcomes and reduce the risk of preventable harms.

"We wanted to find out whether the nutritional care and weight monitoring delivered by GPs following bariatric surgery meets current clinical guidance."

The team studied data from 3,137 patients in the UK who had received bariatric surgery between 2000 and 2015.

Types of surgery included gastric bands (where a silicone band is placed around the stomach), gastric bypass (where the top part of the stomach is joined to the small intestine) and sleeve gastrectomy (where some of the stomach is removed).

They looked to see whether patients had received the recommended advice and monitoring after their operations - particularly weight measurement, blood tests to check for nutritional deficiencies, and the prescription of nutritional supplements.

Dr Parretti said: "We found that in most cases, patients were not receiving the recommended long-term monitoring after they are discharged from bariatric services.

"We found that only around half of the participants were having their weight measured annually. In addition, only around half were having blood tests for nutritional deficiencies commonly seen in general practice, such as anaemia. The percentage of participants having blood tests more specific to bariatric surgery was very low - around five percent or less each year.

"The most common deficiency we found was anaemia - around 40-50 per cent of those patients who had had a blood test.

"We also found that the proportion of patients with prescriptions for recommended nutritional supplements was low.

"This shows that there is an urgent need to support GPs and patients to engage with post-bariatric surgery nutritional reviews and monitoring, for example through education and commissioning of services to provide this long-term care."
'Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study' is published in the British Journal of General Practice.

University of East Anglia

Related Obesity Articles from Brightsurf:

11 years of data add to the evidence for using testosterone therapy to treat obesity, including as an alternative to obesity surgery
New research covering 11 years of data presented at this year's European and International Congress on Obesity (ECOICO 2020) show that, in obese men suffering from hypogonadism (low testosterone), treatment with testosterone injections lowers their weight and improves a wide range of other metabolic parameters.

Overlap between immunology of COVID-19 and obesity could explain the increased risk of death in people living with obesity, and also older patients
Data presented in a special COVID-19 session at the European and International Congress on Obesity (ECOICO 2020) suggests that there are overlaps between the immunological disturbances found in both COVID-19 disease and patients with obesity, which could explain the increased disease severity and mortality risk faced by obese patients, and also elderly patients, who are infected by the SARS-CoV-2 virus that causes COVID-19 disease.

New obesity guideline: Address root causes as foundation of obesity management
besity management should focus on outcomes that patients consider to be important, not weight loss alone, and include a holistic approach that addresses the root causes of obesity, according to a new clinical practice guideline published in CMAJ (Canadian Medical Association Journal)

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.

Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).

How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.

Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?

Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.

Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.

Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.

Read More: Obesity News and Obesity Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to