Can a Bariatric Surgery Program Succeed Without Close Patient Proximity? The Experience in a Military Medical Center

Many centers advocate close patient follow-up and a multidisciplinary approach as necessary ingredients for the success of a bariatric surgery program. The military medical environment is not suitable for these conditions. Many patients are referred from great distances to the large regional medical centers, thereby preventing such close follow-up and the ability to create active support groups. A review of the 4-year experience with bariatric surgery at a major military medical center was conducted to determine if the program could be successful, considering that 60% of its patients came from out of state. Hospital records of all 92 patients and the bariatric registry were reviewed. A comprehensive survey to update weight data and assess patient satisfaction was sent to the first 72 patients to undergo surgery. There were no deaths and a perioperative complication rate of 18%. By I year after surgery, 67% of patients lost greater than 50% of their excess weight (mean = 56.6%). Sixty-eight percent of patients responded to the survey; 87% felt they were better off and satisfied with their quality of life since surgery, and 75% reported improved energy levels. If given a chance to rethink their decision, 86% of responders would choose surgery again. A total of 91% were satisfied with their follow-up. Patient proximity to the medical center did not influence weight loss or patient satisfaction. These results suggest that a bariatric surgery program can succeed in a medical environment such as the military where patients are likely to live at great distances from the hospital.