Predictors of significant postoperative weight regain after bariatric surgery include indicators of baseline increased food urges, decreased well-being, and concerns over addictive behaviors. Postoperative self-monitoring behaviors are strongly associated with freedom from regain. These data suggest that weight regain can be anticipated, in part, during the preoperative evaluation and potentially reduced with self-monitoring strategies after RYGB.

Bariatric surgery is being increasingly used as a treatment for obesity. With this weight loss intervention, obesity-specific disease remission and mortality reduction benefits are undeniable. After surgical weight loss is complete, one of the greatest challenges becomes long-term weight loss maintenance, which is largely behaviorally based. The fundamental behavioral components to maintaining surgical weight loss include dietary control, commitment to regular physical activity, and behavior modification. Changing these longstanding lifestyle habits, however, is a serious challenge and, unfortunately, many formerly obese individuals ultimately experience weight regain due to noncompliance. Further research is needed to identify optimal treatment strategies for postoperative bariatric surgery patients to minimize weight regain.Adapted from Vogel JA, Franklin BA, Zalesin KC, et al. Reduction in predicted coronary heart disease risk after substantial weight reduction after bariatric surgery.

Obesity has long been recognized as a significant risk factor for type 2 diabetes. Both obesity and type 2 diabetes are associated with an increase in cardiovascular risk. As cardiovascular disease continues to be the number one killer in the USA and western adult populations, the rise in prevalence of obesity and type 2 diabetes is alarming. This is especially disturbing in the tripling of overweight children and adolescents, accompanied by the increase in prevalence of pediatric type 2 diabetes. Optimal strategies for long-term diabetes management aim at effectively controlling, reducing and ultimately preventing obesity. This review explores the clinical recommendations in place, new clinical investigations, diet therapy, medical nutrition therapy, meal replacements, behavior therapy, exercise therapy, pharmacotherapy and surgical therapy as strategies to achieve weight-loss success in diabetic patients and ultimately reduce cardiovascular disease.