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. 2023 Jan;37(1):607-612.
doi: 10.1007/s00464-022-09356-x. Epub 2022 Jun 13.

Despite regression of healthy lifestyle habits, weight loss after bariatric surgery is not affected during the COVID-19 pandemic

Estella Y Huang #  1   2 , Eduardo Grunvald #  3 , Rachel R Blitzer  4 , Arielle M Lee  4 , Ryan C Broderick  4 , Jonathan Z Li  4 , Joslin N Cheverie  4 , Bryan J Sandler  4 , Santiago Horgan  4 , Garth R Jacobsen  4
Affiliations

Despite regression of healthy lifestyle habits, weight loss after bariatric surgery is not affected during the COVID-19 pandemic

Estella Y Huang et al. Surg Endosc. 2023 Jan.

Abstract

Background: The coronavirus pandemic has caused a worldwide health crisis. Bariatric patients require extensive pre- and post-operative follow-up, which may be less feasible during public health social distancing mandates. We assessed the impact of the pandemic on the behaviors and weight loss outcomes of our pre- and post-operative bariatric patients.

Methods: A retrospective review of a prospectively maintained database identified patients who underwent either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) at a single institution between March 2018 and May 2020. A cohort undergoing surgery within 12 months before the pandemic as well as a cohort undergoing a medically supervised diet prior to surgery was surveyed regarding pre- and post-COVID-19 lifestyle habits. Excess weight loss (EWL) outcomes from a group of pre-COVID surgical patients were compared to that of a group of post-COVID surgical patients. Primary outcome was whether the lockdown changed 1-year weight loss outcomes. Secondary outcome was whether patient lifestyle behaviors were changed during the pandemic.

Results: There was no difference in 1-year EWL between pre- and post-COVID SG patients (51.7% versus 55.9%, p = 0.35), or between pre- and post-COVID RYGB patients (88.9% versus 80.4%, p = 0.42). Pre-stay-at-home order, 91.8% endorsed physical activity compared to 80.3% post-stay-at-home order (p = 0.0025). Mean physical activity decreased from 4.2 h/week to 2.7 h/week after the stay-at-home order (p < 0.0001). Additionally, 41.3% reported worsened dietary habits post-stay-at-home order.

Conclusion: The COVID-19 pandemic has greatly impacted the behaviors of bariatric surgery patients. Despite deterioration of lifestyle habits, 1-year weight loss outcomes after bariatric surgery remained the same before and after the instatement of social distancing measures. In the short term, the biological effect of metabolic procedures may mask the effects of suboptimal diet and physical activity, but more studies are necessary to better assess the impact of COVID-19 on outcomes after bariatric surgery.

Keywords: Bariatric surgery; COVID-19; Coronavirus; Weight loss.

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Conflict of interest statement

Dr. Jacobsen receives a teaching honorarium from Gore Medical. Dr. Grunvald has received consulting honararia for Novo Nordisk, Currax Pharmaceuticals, and Gelesis Inc. Dr. Sandler is a consultant for Intuitive Surgical and Boston Scientific. Dr. Horgan is a consultant for Intuitive Surgical, Alume Biosciences, Stryker Corporation, and Fortimedix Surgical. Drs. Huang, Blitzer, Lee, Broderick, Li, and Cheverie have no relevant conflicts of interest or financial ties to disclose.

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