Post‐operative behavioural management in bariatric surgery: a systematic review and meta‐analysis of randomized controlled trials
Abstract
Summary: Recent research has provided evidence that bariatric surgery maximizes long‐term weight loss in patients with severe obesity. However, a substantial number of patients experience poor weight loss outcome and weight regain over time. Post‐operative behavioural management may facilitate long‐term weight control in bariatric surgery population. The objective of this systematic review and meta‐analysis was to determine the effects of post‐operative behavioural management on weight loss following bariatric surgery. Eligible articles were systematically searched in electronic databases. Among the 414 citations, five randomized controlled trials, two prospective and eight retrospective cohort trials analysing behavioural lifestyle interventions and support groups fulfilled the inclusion criteria. The main finding is that behavioural management had a positive effect on weight loss following surgery. In 13 studies, patients receiving behavioural management had greater weight loss than patients receiving usual care or no treatment. A meta‐analysis of five randomized controlled trials suggests greater weight loss in patients with behavioural lifestyle interventions compared with control groups. Post‐operative behavioural management has the potential to facilitate optimal weight loss following bariatric surgery, but conclusions were limited by the small and heterogeneous samples of studies. A more rigorous empirical evaluation on its clinical significance is warranted to improve effectiveness of bariatric surgery.
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Scheduled multidisciplinary post-operative follow-up resulted in slightly greater excess weight loss compared with standard care (WMD 1.6%, 95% CI 0.82% to 2.38%).
“Scheduled multidisciplinary post-operative follow-up resulted in slightly greater EWL (WMD 1.6%, 95% CI 0.82% to 2.38%) compared to the control group (Supplementary Table S31).”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [128]
A meta-analysis of five RCTs reported more pronounced weight loss with scheduled multidisciplinary post-operative follow-up versus standard care in patients undergoing bariatric procedures.
“A meta-analysis of summary data from five RCTs reporting patients undergoing a variety of bariatric procedures and assessing the impact of scheduled multidisciplinary post-operative follow-up versus standard care reported more pronounced weight loss in the treatment group [128].”
From Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP (2020) · cites this paper as [128]
A systemic review of 15 behavioral management studies after Roux-en-Y gastric bypass/laparoscopic adjustable gastric banding found that patients achieved greater weight loss than controls across both interventions.
“A systemic review of 15 behavioral management studies after RYGB/LAGB (8 studies provided cognitive behavioral therapy, 7 studies provided group support) found that patients achieved greater WL than controls across both interventions [90].”
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- Authors
- Rudolph, A., & Hilbert, A.
- Affiliations
- Leipzig University (DE)
- Corresponding author
- Rudolph, A.
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2013-01-07
- Volume
- 14
- Issue
- 4
- Pages
- 292-302
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W1526169644
- Cited by
- 173
- References
- 59
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 10 · 2023: 19 · 2022: 23 · 2021: 10 · 2020: 18 · 2019: 15 · 2018: 9 · 2017: 17 · 2016: 17 · 2015: 13 · 2014: 9 · 2013: 6
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Update notices
- erratum (2013-12-16)
- Open access
- closed
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Society for Metabolic and Bariatric Surgery
- Bundesministerium für Bildung und Forschung
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- bariatric surgery, weight loss, morbid obesity, weight regain, support groups
- MeSH terms
- Behavior Therapy, Humans, Life Style, Obesity, Morbid, Postoperative Period, Weight Loss, Randomized Controlled Trials as Topic, Databases, Factual, Bariatric Surgery
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