Background

Weight recurrence after bariatric surgery represents an important problem for bariatric surgeons. Our Back on Track (BOT) program was established as a lifestyle modification approach to address patients with weight recurrence and determine revisional surgery eligibility with guidance from an interdisciplinary team including fitness, nutrition, and behavioral health. The aim was to evaluate the impact of the program on patient weight and progress to revisional surgery.

Methods

Following consultation with a bariatric surgeon for weight recurrence (>15% from nadir weight loss) or insufficient weight loss (<50% EWL) after bariatric surgery, patients were referred to the BOT program for evaluation and treatment. For those who enrolled, weight was monitored during monthly meetings with the specialists, and their disposition was documented after program completion.

Results

From 2019 to 2022, 155 patients were referred and 90 (58%) attended at least one BOT session. Of those, 36 (40%) completed the program after 8.5+/-5.1 months. Participants lost an average of 1.9+/-7.2 kg compared with enrollment weight (p = 0.043). Patients who completed the program lost more weight than those who did not (2.44 +/-7.8 vs. 1.1+/-6.5 kg, respectively). Of all patients referred, 20 (12.9%) qualified and underwent revision bariatric surgery (RBS).

Conclusions

Participation of patients with weight recurrence after bariatric surgery in a multidisciplinary BOT program is associated with a small amount of weight loss and a high rate of attrition. Whether such a program improves patient selection for revisional bariatric surgery or limits access to care needs further study.