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  • 1.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Possmark, Sofie
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    Ghaderi, Ata
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Näslund, Erik
    Division of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden; Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Thorell, Anders
    Department of Clinical Science at Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Department of Surgery, Ersta Hospital, Stockholm, Sweden.
    Sundbom, Magnus
    Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
    Uddén, Joanna
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Endocrine and Obesity, Capio st Görans Hospital, Stockholm, Sweden.
    Szabo, Eva
    Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, Social Medicin, Stockholm, Sweden.
    A dissonance-based intervention for women post roux-en-Y gastric bypass surgery aiming at improving quality of life and physical activity 24 months after surgery: study protocol for a randomized controlled trial2018In: BMC Surgery, ISSN 1471-2482, E-ISSN 1471-2482, Vol. 18, no 1, article id 25Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Roux-en-Y gastric bypass (RYGB) surgery is the most common bariatric procedure in Sweden and results in substantial weight loss. Approximately one year post-surgery weight regain for these patient are common, followed by a decrease in health related quality of life (HRQoL) and physical activity (PA). Our aim is to investigate the effects of a dissonance-based intervention on HRQoL, PA and other health-related behaviors in female RYGB patients 24 months after surgery. We are not aware of any previous RCT that has investigated the effects of a similar intervention targeting health behaviors after RYGB.

    METHODS: The ongoing RCT, the "WELL-GBP"-trial (wellbeing after gastric bypass), is a dissonance-based intervention for female RYGB patients conducted at five hospitals in Sweden. The participants are randomized to either control group receiving usual follow-up care, or to receive an intervention consisting of four group sessions three months post-surgery during which a modified version of the Stice dissonance-based intervention model is used. The sessions are held at the hospitals, and topics discussed are PA, eating behavior, social and intimate relationships. All participants are asked to complete questionnaires measuring HRQoL and other health-related behaviors and wear an accelerometer for seven days before surgery and at six months, one year and two years after surgery. The intention to treat and per protocol analysis will focus on differences between the intervention and control group from pre-surgery assessments to follow-up assessments at 24 months after RYGB. Patients' baseline characteristics are presented in this protocol paper.

    DISCUSSION: A total of 259 RYGB female patients has been enrolled in the "WELL-GBP"-trial, of which 156 women have been randomized to receive the intervention and 103 women to control group. The trial is conducted within a Swedish health care setting where female RYGB patients from diverse geographical areas are represented. Our results may, therefore, be representative for female RYGB patients in the country as a whole. If the intervention is effective, implementation within the Swedish health care system is possible within the near future.

    TRIAL REGISTRATION: The trial was registered on February 23th 2015 with registration number ISRCTN16417174.

  • 2.
    Sellberg, Fanny
    et al.
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Willmer, Mikaela
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Caring science.
    Tynelius, Per
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden; Centre for Sellberg etal.BMCSurgery (2017) 17:133 Page 6 of 7 Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden.
    Berglind, Daniel
    Department of Public Health Sciences, Karolinska Institutet, K9, Social Medicin, Stockholm, Sweden.
    Four years' follow-up changes of physical activity and sedentary time in women undergoing roux-en-Y gastric bypass surgery and appurtenant children2017In: BMC Surgery, ISSN 1471-2482, E-ISSN 1471-2482, Vol. 17, no 1, article id 133Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Objectively measured levels of physical activity (PA) in patients undergoing Roux-en-Y Gastric Bypass (RYGB) surgery remain essentially unchanged from before to one year after surgery. Effects from RYGB on objectively measured levels of PA among women undergoing RYGB and appurtenant children beyond one year post-surgery are unknown. The aim of the present study was to objectively assess longitudinal changes in PA and sedentary time (ST), among women undergoing RYGB and appurtenant children, from three months before to nine and 48 months after maternal surgery.

    METHODS: Thirty women undergoing RYGB and 40 children provided anthropometric measures during home visits and valid accelerometer assessed (Actigraph GT3X+) PA data, three months before and nine and 48 months after maternal RYGB surgery.

    RESULTS: Women undergoing RYGB decreased time spent in moderate to vigorous PA (MVPA) with 2.0 min/day (p = 0.65) and increased ST with 14.4 min/day (p = 0.35), whereas their children decreased time spent in MVPA with 13.2 min/day (p = 0.04) and increased ST with 110.5 min/day (p < 0.001), from three months before to 48 months after maternal surgery. Twenty, 27 and 33% of women, and 60, 68 and 35% of children reached current PA guidelines three months before and nine and 48 months after maternal RYGB, respectively.

    CONCLUSIONS: Objectively measured PA in women remains unchanged, while appurtenant children decrease time spent in MVPA and increase ST, from three months before through nine and 48 months after maternal RYGB. The majority of both women undergoing RYGB and children are insufficiently active 48 months after maternal RYGB.

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