How to prevent patients from gaining weight after a bariatric surgery ? The French and Francophone Society for Obesity Surgery (SOFFCO), the Academy of Surgery and the National Collective of Obese Associations (CNAO) worked together to carry out a White Bookcontaining 13 proposals for better patient follow-up after obesity surgery. The Haute Autorité de Santé (HAS) will use this text to issue its next recommendations. For the 47,000 operations carried out in France each year, considered as “the only effective treatment for obesity“, one of the priorities is to optimize postoperative follow-up, for example by creating obesity centers.
A risk of late complications
The CNAO in fact identifies the postoperative patient follow-up operated as the “Achilles heel” of this procedure, since two years later, one in two patients leaves the follow-up process. At issue: a lack of professionals, a perception of weight gain as a personal failure, the absence of a system forcing the patient to follow-up, a growing number of operations but also generally inadequate information on the procedure and the complications. A worrying finding since “this follow-up must be ensured for life, obesity being a chronic disease and due to the risk of late complications (surgical or nutritional, some of which can lead to serious neurological damage)“HAS already specified in the recommendations it issued in 2009.
Multidisciplinary labeled obesity centers
To improve this monitoring and therefore the success of bariatric operations, the main proposal of the White Paper is based on the creation of obesity centers labeled for “promote multidisciplinary patient monitoring on a single platform bringing together all the necessary skills“. These structures would bring together surgeons, doctors, nutritionists, psychiatrists, psychologists and nurse coordinators in one”friendly place to live, outside the traditional codes of the medical world“, underlines the working group. These houses would make it possible to combine therapeutic education and medical follow-up, as specified in the White Paper:”it is recommended that this day hospital structure be able to deliver an individualized follow-up adapted to the needs of the patient, notably through the organization of collective workshops (cooking classes, discussion groups) which, beyond their objective of Therapeutic education, will allow patients to focus their attention on subjects other than their weight.“
Obesity causes 10 to 13% of deaths
In 2014, 47,000 French people opted for bariatric surgery, compared to only 12,000 10 years ago. 58% of patients have a body mass index (BMI) between 40 and 49 (morbid obesity), and 10% greater than or equal to 50.
According to the World Health Organization (WHO), the world has 1.9 billion overweight people, including 600 million suffering fromobesity severe. This disease is thought to be responsible for 10 to 13% of deaths.
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