Efficacy of Combined Lifestyle Interventions as a Complement to Bariatric Surgery (ECLIBS): Short Term Outcomes of a Pilot Study.

Purpose: Combined lifestyle interventions (CLI) is a program designed to treat (morbid) obesity and can possibly be an adjunct to bariatric surgery. Bariatric surgery can lead to 25-50% total weight loss (TWL) and up to 71% excess weight loss, yet the longevity of the weight reduction remains variable, primarily attributed to a lack of lifestyle change. This pilot study aims to assess the effect of a 3-year structured CLI program, additional to a 5-year bariatric surgery program in a regional hospital, on the short-term outcome following bariatric surgery.

Materials and methods: A single-center prospective cohort study was performed on patients who underwent bariatric surgery between September 2021 and October 2022 (n=28). A structured CLI program was organized and offered by an official out-of-hospital CLI provider. CLI participants were matched with patients following regular follow-up. Primary outcome was quarterly measured excess weight loss (EWL). Secondary outcomes were TWL, fat measurements, sports participation and comorbidities.

Results: There were significant differences in sports participation after 1 year (92.9% vs. 62.5%; P=0.050), EWL at 21 months (18.3 kg; 95% confidence interval [CI], 0.14-36.4; P=0.049), fat mass at 18 months (-8.7 kg; 95% CI, -14.1, -3.3; P=0.008) and fat percentage at 18 months (-10.0%; 95% CI, -17.9, -2.0; P=0.017) in the CLI group compared to the control group.

Conclusion: Preliminary short-term results show that a structured additional CLI program to bariatric surgery could benefit in terms of weight loss, perhaps due to better sports participation, but long-term results have to be awaited for.