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Randomized Controlled Trial
. 2025 Apr;35(4):1285-1296.
doi: 10.1007/s11695-025-07732-9. Epub 2025 Mar 12.

The Effect of Adding a Smartphone-Based Platform to the Metabolic Bariatric Surgery Nutritional Preparation Process: A Randomized Controlled Trial

Yafit Kessler  1   2   3 , Mona Boaz  1 , Limor Mardy-Tilbor  2 , Asnat Raziel  3   4 , Nasser Sakran  3   4   5   6 , David Goitein  3   4   7   8 , Andrei Keidar  4   7   9 , Hasan Kais  4   7   10 , Bella Azaria  11 , Shiri Sherf-Dagan  12   13
Affiliations
Randomized Controlled Trial

The Effect of Adding a Smartphone-Based Platform to the Metabolic Bariatric Surgery Nutritional Preparation Process: A Randomized Controlled Trial

Yafit Kessler et al. Obes Surg. 2025 Apr.

Abstract

Background: Metabolic bariatric surgery (MBS) candidates undergo a comprehensive nutritional preparation process by a registered dietitian (RD). The effect of eHealth interventions on the MBS preparation process is unknown.

Objectives: To assess the impact of adding an application to the nutritional preparation process on pre-surgery nutritional knowledge, physical, and behavioral parameters among MBS candidates.

Methods: An open-label randomized controlled trial among MBS candidates. All participants received 3-6 meetings with an RD and the intervention group also received access to an application containing information modules and a communication platform. Data was collected at baseline and end of preparation.

Results: Forty participants were recruited, of them 67.5% women, with a mean age and body mass index of 34 ± 10.1 years and 43.5 ± 6.0 kg/m2, respectively. Nutritional knowledge, anthropometrics, functionality, adherence to most behavioral recommendations, and subjective state of health improved in both groups (P Time ≤ 0.044). Physical activity initiation (i.e., beginning of regular exercise engagement) was higher among the intervention group (40% at baseline and 68% at end of preparation vs 35% at baseline and 32% at end of preparation for interventions and controls, respectively, P Time × Group = 0.026). The application was rated as providing added value (8.2 on a scale of 1 (no added value) to 10 (meaningful added value)).

Conclusions: Nutrition preparation process with an RD improved MBS knowledge, adherence to behavioral recommendations, subjective state of health, and modestly enhanced weight and functionality outcomes among MBS candidates. Although rated as having an added value, incorporating an application had only a minimal impact on these outcomes.

Keywords: EHealth; Health education; Metabolic bariatric surgery; Mobile application; Preparation process; Registered dietitian.

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Conflict of interest statement

Declarations. Ethics Approval and Consent to Participate: The study protocol was approved by the ethics committee of the institutional review board of Assuta Medical Centers (#0018–20-ASMC). Informed consent was obtained from all individual participants included in the study. The study was preregistered on the NIH registration website (TRIAL no. NCT04451499). Competing Interests: The authors declare no competing interests. Conflict of interest: SSD received research funding from Novo Nordisk, which had no role in the preparation or submission of this manuscript. All other authors declare no conflicts of interest.

Figures

Fig. 1
Fig. 1
Study application modules
Fig. 2
Fig. 2
A flow chart of the study’s participants
Fig. 3
Fig. 3
Differences in eating behaviors pre- and post-preparation in the intervention group (a) and in the control group (b)1,2
Fig. 4
Fig. 4
Nutritional supplementation usage pre- and post-preparation in the intervention group (a) and in the control group (b)1
See this image and copyright information in PMC

References

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