Long-term Control of obesity; expectations, weight regain and follow up What can we offer? SUE CUMMINGS, MS, RDN

Transcription

1 Long-term Control of obesity; expectations, weight regain and follow up What can we offer? SUE CUMMINGS, MS, RDN

2 Despite impressive outcomes, suboptimal weight loss and regain are a concern Approximately half of all patients experience some weight regain within 2 years The mean weight regain within 7 years is 7% More substantial weight regain occurs in a large minority of patients Lent et al, 17% of 3,000 patients failed to maintain 20% of their initial weight loss at 5 years post RGBP The SOS observed a mean weight regain of 34% of initial weight loss by 10 years post RYGB Adams et al found that 40% of patients maintained at least a 30% total body weight loss by 12 years post RYGBP

3 Starting Principles Why? Obesity is a Chronic Disease Obesity is Heterogenetic

4 Weight Loss Variability Every bariatric procedure studied demonstrates similar wide variations in outcome among patients. RYGB SG

5 Managing Weight Loss Expectations

6 What can Bariatric Specialists do? EDUCATE PRIMARY CARE PROVIDERS Obesity Complexity of Obesity and it s etiology Chronic and Hetergenetic both biopsychosocially complex in its origins and clinically diverse in its presentation Metabolic Bariatric Surgery What it is; What it does and What it doesn t do How to support their patients Monitor: weight; micronutrient status and comorbidities

7 What can Bariatric Program Do? BUILD OUR TEAMS

8 What can Bariatric Program Do?

9 ASMBS Bariatric Surgery Support Group Facilitator Manual asmbs.org The ASMBS Bariatric Surgery Support Group Facilitator Manual is intended to help bariatric support group leaders to create and provide a productive, safe, and caring environment that will allow patients and their support networks to freely express their concerns and to give them an opportunity to learn from others.

10 The IH Support Group Manual Discusses the value of patient support groups Offers an up-to-date look at group research Suggestions for keeping patients Engaged Presents various types of patient groups Provides detailed relevant topics and Highlights new technologies and alternative formats Living and breathing document content

11 POST-SURGERY GROUPS For patients only or patients and their support people Closed membership vs. open membership groups Time-limited vs. ongoing Specific, scheduled topics vs. open forum

12 May stratify by: Time since surgery (e.g. < 1 year vs. > 1 year post-surgery) Type of surgery (specific groups for LAGB, LSG, RYGB) Gender Age (e.g. adolescent vs. adult) Specific needs Process/problem oriented Back on track focus Targeted audience Alcohol or substance abusers Binge or night eaters

13 ALTERNATIVE SUPPORT GROUP MODALITIES Online support groups Can tailor to various patient needs while also reaching a broader population May utilize social media such as Facebook, Google+, and Yahoo Groups Video conferencing using programs such as GoToMeeting, WebEx, Fuze Phone conference groups Mentorship programs

14 ANATOMY OF A SUPPORT GROUP What are patients looking for? Value Motivation Camaraderie Mentorship Common Interest Socialization Support for their Bariatric Journey

15 ANATOMY OF A SUPPORT GROUP Must Haves A Safe Place to share thoughts, feelings, ideas and rationales Goal Directed Meetings Encourage Positive Reinforcement and Problem Solving Ideas Encourages Dialog Promote the idea that, Helping Others Helps Me Guidance Fresh New Topics How to Overcoming Barriers Patient Buy-In

16 THANK YOU