Page 39 - When surgery alone won’t cut it - Valerie Maureen Monpellier
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Figure 2: Results of meta-analysis on effect of compliance on weight loss in RYGB patients
Study %
ID ES (95% CI) Weight
Compher, 2012
Compher, 2012
Compher, 2012
El Chaar, 2011
Song, 2008
Song, 2008
Gould, 2007
Gould, 2007
Gould, 2007
Shen, 2004
Harper, 2007
Hatoum, 2008
Robinson, 2014
Overall (I-squared = 98.1%, p = 0.000)
NOTE: Weights are from random effects analysis
6.66 (5.01, 8.31) 16.92 (15.27, 18.57) 12.84 (11.19, 14.49) 0.90 (-0.57, 2.37) 4.10 (2.49, 5.71) 8.40 (6.79, 10.01) 5.00 (3.36, 6.64) 13.00 (11.36, 14.64) 10.00 (8.37, 11.63) 1.50 (-0.14, 3.14) 11.00 (9.36, 12.64) -4.15 (-5.70, -2.60) 12.17 (10.52, 13.82) 7.56 (4.29, 10.83)
7.69 7.69 7.69 7.72 7.69 7.69 7.69 7.69 7.69 7.69 7.69 7.70 7.69 100.00
-18.6 0 18.6
Physical activity
There were 21 studies evaluating the association between physical activity (PA) and weight loss 25,27,29-47. Three studies measured PA 36,39,45, in twelve studies PA was as- sessed with questionnaires 27, 29-35, 38,40,44 and in six studies patients were asked about their PA 25,37,41-43,46 (Table 1). In one study PA was assessed prior to RYGB 25, in one study it was assessed both before and after surgery 32; all other studies assessed PA after surgery. Mean BMI prior to surgery ranged from 46.0-54.1 kg/m2, number of patients ranged from 40-303, maximum follow-up was 16 years. In fifteen studies PA and intensity of PA were significant predictors of weight loss and limited PA was associated with less weight loss 25,29-31,33-37,39,40,42,45-47.
There were sufficient data in ten studies with 12 follow-up moments; these data were pooled for meta-analysis (Table 3) 25,27,31,32,34,37,39,42,44,47. A total number of 3,558 patients were included. Active patients had a mean preoperative BMI of 49.6 kg/m2 (±1.3); this was 50.3 kg/m2 (±2.3) in inactive patients. Active patients had a significantly higher EWL, effect size 6.8% (p<0.001, Figure 3).
Subsequently the effect of PA was assessed for different follow-up moments. Three studies reported on weight loss 12 months post-surgery, data of 220 patients were pooled; weight loss was higher in active patients (69.4% in versus 65.6%, p<0.001) 25,32,47. Follow-up was 24 months or longer in seven studies, active patients had EWL
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