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Intensive pre-operative information course (IPIC) and pre-operative weight loss results in long-term sustained weight loss following bariatric surgery: 11 years results from a tertiary referral centre

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Abstract

Introduction

Outcomes of long-term (5–10-year) weight loss have not been investigated thoroughly and the role of pre-operative weight loss on long-term weight loss, among other factors, are unknown. Our regional bariatric service introduced a 12 week intensive pre-operative information course (IPIC) to optimise pre-operative weight loss and provide education prior to bariatric surgery. The present study determines the effect of pre-operative weight loss and an intense pre-operative information course (IPIC), on long-term weight outcomes and sustained weight loss post-bariatric surgery.

Methods

Data were collected prospectively from a bariatric center (2008–2022). Excess weight loss (EWL) ≥ 50% and ≥ 70% were considered outcome measures. Survival analysis and logistic regression identified variables associated with overall and sustained EWL ≥ 50% and ≥ 70%.

Results

Three hundred thirty-nine patients (median age, 49 years; median follow-up, 7 years [0.5–11 years]; median EWL%, 49.6%.) were evaluated, including 158 gastric sleeve and 161 gastric bypass. During follow-up 273 patients (80.5%) and 196 patients (53.1%) achieved EWL ≥ 50% and ≥ 70%, respectively. In multivariate survival analyses, pre-operative weight loss through IPIC, both < 10.5% and > 10.5% EWL, were positively associated with EWL ≥ 50% (HR 2.23, p < 0.001) and EWL ≥ 70% (HR 3.24, p < 0.001), respectively. After a median of 6.5 years after achieving EWL50% or EWL70%, 56.8% (154/271) had sustained EWL50% and 50.6% (85/168) sustained EWL70%. Higher pre-operative weight loss through IPIC increased the likelihood of sustained EWL ≥ 50% (OR, 2.36; p = 0.013) and EWL ≥ 70% (OR, 2.03; p = 0.011) at the end of follow-up.

Conclusions

IPIC and higher pre-operative weight loss improve weight loss post-bariatric surgery and reduce the likelihood of weight regain during long-term follow-up.

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Authors and Affiliations

  1. Department of Bariatric and Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, UK

    James Lucocq, Vikram Thakur, Georgios Geropoulos, Daniel Stansfield, Laura Irvine, Mhairi Duxbury, Andrew C. de Beaux, Bruce Tulloh, Beverley Wallace, Brian Joyce, Lisa Harrow, Gillian Drummond, Peter J. Lamb & Andrew G. Robertson

  2. Department of Clinical Surgery, NHS Lothian, University of Edinburgh, Edinburgh, UK

    Andrew G. Robertson

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  1. James Lucocq
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  2. Vikram Thakur
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Correspondence to Andrew G. Robertson.

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James Lucocq, Vikram Thakur, Georgios Geropoulos, Daniel Stansfield, Laura Irvine, Mhairi Duxbury, Andrew C de Beaux, Bruce Tulloh, Beverley Wallace, Brian Joyce, Lisa Harrow, Gillian Drummond, Peter J Lamb and Andrew G Robertson have no conflicts of interest or financial ties to disclose.

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Lucocq, J., Thakur, V., Geropoulos, G. et al. Intensive pre-operative information course (IPIC) and pre-operative weight loss results in long-term sustained weight loss following bariatric surgery: 11 years results from a tertiary referral centre. Surg Endosc (2024). https://doi.org/10.1007/s00464-024-10791-1

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