Improved Quality of Life, Fitness, Mental Health and Cardiovascular Risk Factors with a Publicly Funded Bariatric Lifestyle Intervention for Adults with Severe Obesity: A Prospective Cohort Study

Abstract

Background: Lifestyle modification is the cornerstone of management for patients with severe and complicated obesity, but the effects of structured lifestyle programmes on quality of life, anxiety and depression scores and cardiovascular risk factors are not well-described. We sought to describe changes in self-reported quality of life and mental health-related outcomes as well as cardiovascular risk factors in patients completing a 10-week multidisciplinary lifestyle-modification programme. Methods: We conducted a prospective cohort study of all patients referred from our bariatric service who completed the programme between 2013 and 2019. In addition to weight, body mass index (BMI), blood pressure, HbA1c, lipid profile and functional capacity, we quantified health-related quality of life using the Dartmouth COOP Questionnaire and the European Quality of Life Questionnaire Visual Analogue Scale (EQVAS) and mental health using the Hospital Anxiety and Depression Scale (HADS). Results: Of 1122 patients who started the programme, 877 (78.2%) completed it and were included in per protocol analyses. Mean age was 47.3 ± 11.9 years, 66.9% were female, 34.8% were in full- or part-time employment and 69.4% were entitled to state-provided medical care. BMI decreased from 47.0 ± 7.8 to 46.2 ± 7.8 kg m−2 and weight decreased from 131.6 ± 25.5 to 129.5 ± 25.4 kg (both p < 0.001). There were significant reductions in anxiety and depression scores and improvements in all Dartmouth COOP domains. The EQVAS score increased from 52 ± 22 to 63 ± 19 (p < 0.001). Small but statistically significant reductions in LDL cholesterol, systolic blood pressure and HBA1c were also observed. Conclusions: Adults with severe and complicated obesity completing a specialised bariatric lifestyle-modification programme showed significant improvements in self-reported mental health and quality of life, in addition to reductions in cardiovascular risk factors.

Nurse‐led intervention for the management of bariatric surgery patients: A systematic review

“…59,62 E-Health interventions focused on patient management can improve the care process and patient engagement. However, the approach to bariatric patients should be based on a holistic therapeutic relationship, with empathy, respect, and patient involvement in all care decisions, 62,64,66 while avoiding stigmatization and unrealistic expectations. 74 A multidisciplinary team overseeing bariatric surgery patients is by nature comprised diverse healthcare professionals, each with different goals.…”

“…in weight loss at 12 months after surgery in the intervention group. The educational programs starting in the preoperative period, with multidisciplinary approaches and adapted to the patient, such as the Changings lifestyle with activity and nutrition program (CLANN),64,66 showed positive results in the outcomes related to bariatric surgery. No program that focused exclusively on the postoperative period showed significant improvements in the results directly associated with bariatric surgery.4 | DISCUSSIONThis systematic review aimed to comprehensively examine structural characteristics of case-managing interventions, with or without the support of e-Health, in the process of perioperative management of bariatric surgery patients.…”

Design and evaluation of a new nurse-led case management intervention for bariatric surgery patients

“…Behavioral change is important in bariatric surgery for the maintenance of long-term results, which suggests that it is important that interventions for behavioral change in bariatric surgery patients begin before surgery and continue in the extended postoperative period. This complete, coordinated, and comprehensive long-term follow-up can be achieved through different forms of communication, namely using e-health, in a perspective of continuity and proximity to patients, in a holistic approach to the bariatric patient, based on a relationship with empathy, respect, and patient involvement in all care decisions [20] , [21] , [22] , [23] .…”

Programas de intervención de estilo de vida para la adquisición de hábitos saludables y prevención de enfermedades cardiometabólicas adaptadas al aislamiento en casa ante la pandemia por la COVID-19: una revisión

“…La diferencia en el cambio de peso entre el grupo de intervención y el grupo controla fue de 5,5 kg (P < 0,001). Brazil et al (2021) 877 participantes, con edad media de 47,3 ± 11,9 años y con un IMC ≥ 40 kg/m 2 (o ≥ 35 kg/m 2 con una comorbilidad relacionada con la obesidad).…”