A TELEHEALTH INNOVATION TO SUPPORT WEIGHT LOSS SURGERY

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DESCRIPTION (provided by applicant): For such life-changing impact that bariatric surgery represents for obesity, this popular procedure is noted for its poor post- operative follow-up rates and outcomes tracking. Laparoscopic Gastric Bypass (LGB) has emerged as one of the most popular surgical procedures in the U.S. and an effective treatment for morbid obesity (MO). Close to a quarter-million surgeries are performed annually in the U.S. Post-surgical patients can see dramatic weight loss due to mal-absorption of food through bypassing sections of the small intestine limits food intake. However, mal-absorption also results in loss of nutrients, which appears to persist or worsen over time, often resulting in dangerous nutritional deficiencies. Assuring that these nutrients are added to the diet in the form of appropriate supplements is critical. Yet, no systematic and scalable program exists currently for weight loss surgery clinics to provide ongoing nutritional education and management. Further, physical activity is fundamental to maintaining smart weight loss and body composition. However, specific exercise prescriptions and professional support for activity plans are rarely offered by surgery clinics. Bariatric surgery is not a "magic bullet" and should be regarded as an adjunctive tool that helps the patient initiate and sustain new dietary and physical activity behaviors that will support weight loss. Unfortunately, a huge gap exists in tools to aid patients in initiating and sustaining these behaviors. There have emerged few individualized, scalable programs for patients to avoid behavioral pitfalls that accompany rapid weight loss following such revolutionary surgery. Because the current postoperative pattern is all-too-often self-managed with less-than-optimal provider support, a guided self-care program is much-needed to assure smart weight management, supplemented by remotely-delivered professional support. In order to facilitate systematic follow-up and to improve adherence to post-operative protocols, we propose an evidence-based, structured, tele-health guided program for self-managing behaviors that will sustain healthy weight loss. This multi-disciplinary package provides a patient-centered, scalable, fitness promotion and monitoring system to improve: 1) adherence to nutritional supplements, 2) sustained physical activity at goal levels, and 3) frequent weighing. Because these activities are electronically monitored, the program furnishes accurate patient behavior profiles to allow professionals to better tailor the patient's plan. In addition, gaps will be filled for surgeons, as certification of weight loss clinics is trending toward greater outcomes reporting requirements - a difficult production when clinics maintain little post-surgical follow-up data. PUBLIC HEALTH RELEVANCE: Obesity represents the largest public health crisis in the US. Gastric Bypass Surgery has emerged as a highly effective treatment for morbid obesity and cure for obesity-related diseases, such as diabetes, that once were considered incurable. Inadequate postoperative self-care, however, creates serious complications. Two primary behavioral pitfalls are nutritional mismanagement and insufficient physical activity. Consistent with NIH's mission to promote innovative approaches to combat obesity, we propose a scalable tele-health program to improve adherence, promote smart behavior, and assure healthy weight loss management.