Introduction

For the morbidly obese (BMI > 40), surgery is the only treatment that has been proven to have positive long-term effects.  A recent study showed that the rate of complication after bariatic surgery is 39.6 % over the 180 days after discharge.  Identification of factors that may facilitate patient adherence and improve quality of life after bariatric surgery is essential to decrease complications and ensure sustained weight loss in these patients.

Purpose

The purpose of this study was to examine variables that relate to patients adherence to scheduled appointments and examine quality of life following bariatric surgery.

Methodology

A block entry logistic regression analysis was done from a data base of an outpatient bariatric program.  Patient adherence to follow-up was defined as having one post surgical follow-up appointment within 90 days of having surgery.  Three hundred and seventy five subjects completed the preoperative program and had either laparoscopic Roux-en-Y gastric bypass (84.3 %) or Laparoscopic adjustable gastric banding (15.7 %).  A Quality of life questionnaire (SF-12) was sent to 77 patients one year following surgery.

Results

Of the fourteen variables used in the analysis, five variables were found to be statistically significant (p<0.05):  older patients, single, employed, less BMI and patients with health insurance that pay for health services were found to be more adherent.  In the quality of life questionnaire 27 % reported psychosocial limitations and 34 % attended a weekly/monthly support group sessions.

Implications

Incorporation of the identified predictors into preoperative screening tools to flag patients at risk for non-adherence may improve follow-up care and patient outcomes.  Low attendance at support group sessions may account for 27 % psychosocial limitations.  Further research is needed to identify high-risk patients and develop interventions to decrease complications and improve quality of life following bariatric surgery.