Obesity is a chronic and growing disease defined by weighing 20% or more than the ideal, or having a body mass index (BMI) of 30 kg/m2 or more. While natural weight loss is available, many patients are choosing weight loss surgery (i.e., bariatric surgery) as an alternative to lose weight and reduce their risks for comorbidities such as diabetes, heart disease, and sleep apnea. Tools and resources for post-surgical support in the bariatric surgery community have been limited and, in the past, most tools and resources for weight loss have focused on non-surgical weight loss communities; as such, analysis methods for measuring success in this population have not been clearly developed and tested. This research proposes and evaluates analysis methods that may be used in such studies. These analysis methods are evaluated using data from the Weight and Exercise Lifestyle Support study at Baystate Medical Center in Springfield, MA. In this study, a group of participants (n = 6) approved for bariatric surgery were followed by the research team starting roughly one month before surgery through three months after surgery. Participants received pedometers and weight scales, and access to an online patient portal where they could review their physical activity levels, and receive support from others in the study and an exercise consultant. Data collected included pre- and post-study dietary and exercise self-efficacy levels, self-reported and objective physical activity measures, self-reported dietary adherence, device usage, and usability and satisfaction with the program. This research evaluates whether the proposed measures can help determine the presence and nature of the relationships between the aforementioned variables. If these measures prove to be useful, they can be used in future interventions that use technology to support post-surgical weight loss communities.

Introduction: Routine drain placement is still widely used in both sleeve gastrectomy (SG) and Roux en Y gastric bypass (REYGB). There is mounting evidence that drains may increase complication risk without preventing reoperation or other complications. Methods: Data from 2017 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use File was evaluated for drain use during laparoscopic REYGB and SG. Primary outcomes were superficial and deep surgical site infections (SSI), reintervention/reoperation, and readmission. Preoperative patient risk factors were also compared to evaluate for association with drain placement. Results: A total of 148 260 patients fit the inclusion criteria. Drains were used in 23 190 (15.6%) cases and not used in 125 070 (84.4%). Drain placement during surgery was associated with increased odds of superficial SSI, deep incisional SSI, and organ space SSI. Patients with drains were found to have increased odds of requiring at least 1 reoperation or intervention within 30 days of surgery. Preoperative risk factors associated with drain placement included diabetes mellitus, a history of chronic obstructive pulmonary disease, and oxygen dependence. Smokers were slightly less likely to have a drain placed. There was no significant association with chronic steroid and immunosuppressant usage. Conclusion: There is mounting data against drain placement during bariatric surgery. Prior studies using MBSAQIP data have shown an increased complication rate with drains, and our data set supports the idea that drains may increase complications after surgery. While no randomized prospective trials have been performed looking at drain usage in bariatric surgery, the growing retrospective data certainly inform against the regular use of drains.

Obesity is a worldwide public health epidemic with no sign of yet abating. Although previous studies have examined the impact of obesity on walking, little is known about the effects of practice on walking patterns in individuals with obesity. The purpose of this current study was to evaluate whether an obstacle-crossing task may detect walking deficits in a group of adults electing to undergo bariatric surgery. With a cross-sectional design, we collected walking parameters as 24 adults (M age= 46.19, SD= 12.90) with obese body mass index (BMI) scores (M BMI= 41.68, SD= 5.80) and 26 adults (M age= 21.88, SD= 3.48) with normal BMI scores (M BMI= 23.09, SD= 4.47) walked in 5 conditions for 5 trials each: on flat ground, crossing over low, medium, and high obstacles, and again on flat ground. The timing and distance of participants' steps were collected with a mechanized gait carpet (GAITRite, Inc.). We conducted 5 (condition) repeated measures (RM) ANOVAs on our main dependent variables, which measured how fast (velocity) and long (step length) participants' steps were and how much time they spent with one (single limb support time) versus two (double limb support time) feet on the ground. The results showed within session improvements in participants' walking patterns. Comparisons of the first and last trials on flat ground showed that participants took longer, faster steps by increasing step length and velocity (ps<.01). They also spent more time with one versus two feet on the ground via increased single limb support time and decreased double limb support time (ps<.001). Our findings suggest that an obstacle-crossing task may help spur improvements in walking patterns even before adults elect to undergo bariatric surgery.

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