Rogers, RJ, Courcoulas AP, Davis KK, Levine M, Jakicic JM. Effect of a Technology-based intervention on Weight Change Post-bariatric Surgery
In the United States, the prevalence rate for overweight is 68.8% and the prevalence of obesity is 35.7% in adults. Of great concern is the prevalence of severe obesity, with 15.4% of adults having a BMI>35.0 kg/m2 and 6.3% of adults having a BMI>40.0 kg/m2. While behavior modification serves as the cornerstone of interventions for weight loss, additional medical-based treatments have been implemented to treat obesity and severe obesity. Current clinical guidelines recommend that bariatric surgery be considered as a treatment modality for severely obese patients (BMI >40.0 kg/m2) or moderately obese patients (BMI 35.0 to 2) who also have obesity-related medical comorbidities. Bariatric surgery has also been used as a treatment modality for individuals with less severe obesity and uncontrolled Type 2 diabetes. Despite the effectiveness of bariatric surgery, the ability of patients to sustain weight loss long-term following bariatric surgery is not optimal. In fact, weight regain starts as early as 1 year post-surgery. Thus, it appears that intervention strategies may need to be implemented as this point in the treatment plan to prevent or minimize weight regain following bariatric surgery.
We have completed a series of studies that have shown that minimal intervention contact combined with technology can be an effective intervention for weight loss, and this has been shown to be as effective as an intensive in-person intervention over a period of 3-6 months. However, this technology-based intervention has not been applied to patients who have undergone bariatric surgery in an attempt to improve weight loss outcomes, which is the primary focus of this proposal.
The primary aim of this pilot study is to examine the effect of applying a minimal contact technology-based intervention at 1-year post-bariatric surgery on weight change compared to Standard Care. This study will recruit 40 patients at 1-year after they have undergone bariatric surgery, with subjects randomized to a Technology-Based Intervention or Standard Care for a period of 6 months (12 to 18 months post-surgery). We will also conduct analyses to compare these interventions on behavioral process measures (diet, physical activity, engagement in intervention components), psychosocial measures, satisfaction and barriers to the interventions, and cost-effectiveness of these approaches. The Technology-Base Intervention will consist of a wearable monitor that provides feedback on energy expenditure and physical activity, electronic tracking of dietary intake, and integration of an electronic scale to provide comprehensive feedback to the participant on all components of weight management. Moreover, the participant will receive a weekly telephone call from the intervention staff to provide guidance on their weight loss efforts, and the information from the technology system will be available to the interventionist during this telephone interaction to facilitate guidance provided to the participant. The results from this study will provide valuable information on the effectiveness, effect size, and feasibility of applying this technology-based intervention to bariatric surgery patients, and these data will be used to support a larger grant application to the NIH or other comparable funding agency.