Journal of Obesity & Weight Loss Therapy
Open Access

Abstract

Background: The most effective treatment for patients with morbid obesity is Bariatric Surgery (BS). To enhance the sustainability of results, certain pre and postoperative interventions could be implemented. Objectives: This systematic review focuses on behavioral lifestyle and nutrition interventions, applied perioperatively, to enhance the sustainability of the results of BS. Methods: Electronic databases (Ovid MEDLINE, Embase, CENTRAL and Web of Science) were searched using adequate strategies with no language and date restrictions. Studies designed as randomized controlled trials, where any type of lifestyle (individual/group sessions aiming to change diet or physical activity through behavioral strategies) or nutrition intervention was provided during perioperative period to patients undergoing BS were included. The primary outcomes are weight loss measured as change in kg/BMI/percentage weight loss from baseline weight/percentage of excess weight loss, change in fat free mass, fat mass. Secondary outcomes are: Change in comorbidities, quality of life, anthropometric parameters and adverse effects. Title/abstract and full text screening were performed by two reviewers independently and any conflicts were resolved by discussion/help from the third reviewer. Every stage was preceded by calibration. We are in the process of data extraction and quality assessment using the Cochrane Risk of Bias Tool. The certainty of evidence will be assessed using GRADE methods. Results: Databases searches yielded 6798 results which after de-duplication provided 5030 references to screen. The screening resulted in 32 references (25 studies) included for extraction and 37 references have been labeled as awaiting classification. These include conference abstracts of unpublished studies (n=32), study protocols (n=2) and papers with unclear follow-up waiting for response from authors (n=3). Within the included studies, the total number of patients randomized in the trials was 2681. Mean age was 42.7±10.09 SD. Female constituted 77.3% of total sample. In the preliminary mapping of the study results for the purpose of quantitative analysis we faced the problems related to the vast diversity of reporting of study results (weight loss) presents the mapping of the ways weight loss results were presented in the studies. Other problems we faced included incomplete reporting of data; some studies presented specific data incompletely or only on charts, which requires additional contacts with the authors to obtain the data. Conclusion: Incomplete reporting of study results and vast diversity of the ways the results of the studies are presented will make synthesis of all the results related to weight loss very difficult. In order to make future comparisons in the field of bariatric more extensive, developing core outcome set will be very useful tool. We have started the process of data extraction and quality assessment.

Biography

Mateusz J Swierz is a student of Jagiellonian University Medical College, Poland. His main interests focus on this area of medicine. Being a Member of Cochrane Poland, he actively propagates the idea of evidence-based medicine and incorporates it into science projects, currently resolving around bariatric surgery and the use of probiotics in surgery.

E-mail: mjswierz@gmail.com