The association between patient attendance to a perioperative group-based lifestyle program and weight loss after bariatric surgery

Background To enable maximal and sustainable weight loss after bariatric surgery, bariatric lifestyle programs through multidisciplinary support are advised. Objectives To assess the association between patient attendance to a perioperative group-based bariatric lifestyle program (GBLP) and weight loss up to 48 months postoperatively. Setting A multicenter retrospective cohort study in the Netherlands. Methods Patients who underwent primary laparoscopic Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) attended a GBLP in 2016 consisting of 18 sessions. A linear mixed model was used to assess the association between the patient attendance rate to the GBLP and total weight loss (%TWL). Independent predictors for the patient attendance rate and adequate %TWL were analyzed. Results A total of 3015 patients were included. Percentage of patients lost to follow-up was 5% at 1 year, 25% at 2 years, 34% at 3 years, and 42% at 4 years follow-up. Average TWL was 33% at 12 months after surgery, 33% at 24 months, 31% at 36 months, and 31% at 48 months. A small but significant adjusted positive association between the attendance rate and %TWL at 3 months until 36 months postoperatively was found (Beta between .03–.07), which disappeared at 48 months after surgery. Independent factors associated with a low attendance rate were younger age, male sex, and SG. Independent factors negatively associated with %TWL were male sex, SG, and diabetes. Conclusion A higher patient attendance to GBLP sessions is associated with a small but significant increase in postoperative weight loss up to 3, but not 4 years after surgery.