I have worked 20 years as a physician by now, in public as well as private health care. You always try to do good and hopefully your work makes a difference, no matter what clinical setting you are in. But one thing is clear to me: I have never encountered another single treatment giving as many positive health effects as a bariatric operation does. The obesity goes away, as does the type 2 diabetes, high blood pressure, sleep apnea and joint pains. People get a ticket back to working life, and to their own self esteem. So far gastric bypass and sleeve gastrectomy are pure success stories, if you ask me.
But all is not perfect. The health care system has been good at delivering safe, high quality surgery with low complication rates, it has also (in most cases) taken good care of any postoperative complications. The patients get relevant information and are coached to learn new routines the first year, often also the second. But what happens after that?
How well does eating 6 times a day, keeping track of adequate fluid intake, not drinking with meals, taking daily vitamin supplements etc work, after let's say 5-8- 10 years? The surgical procedure is by now quite a long time ago, everyday life has taken over. Maybe you stopped taking the vitamin supplements -nothing happened. You feel fine anyway. You started drinking fluids with meals -that went fine too. This is where the health care system has problems, we lose track of our patients.
In Sweden, a study has looked at patients >10 years after gastric bypass surgery. The aim was to measure how many that were still taking their vitamin supplements as prescribed. Can you guess the percentage? (The accurate answer comes in the next blog entry. Then we will also talk about what happens to the body if you stop taking supplements).
So, how do we improve long term follow up of bariatric patients? Well, in the long perspecitve health care providers need to improve their knowledge of obesity as well as obesity surgery, something that is currently lacking. But this will take time, and many peoples' attitudes need to change along the way
Something that instead happens RIGHT NOW is BariBuddy -our iPhone app tailored to patients undergoing bariatric surgery. BariBuddy will push reminders regarding meals, fluids, vitamin supplements and exercise. Every day. Forever, if you so wish. It will keep track of all the practical details around the surgical procedure, as well as your weight curve afterwards.
The pilot version has been out for testing since June, App Store launch is coming shortly. Follow our website for updates!