Researchers: Naomi Schreuer¹, Rachel Kizony^1,2, Ronit Endevelt¹, Moaad Farraj^3,4

Background: Metabolic and bariatric surgery (MBS) achieves substantial weight loss, yet long-term outcomes remain challenging when postoperative follow-up and self-management are limited. Israeli Ministry of Health guidelines emphasize proactive, continuous multidisciplinary follow-up; Current follow-up is primarily medically oriented, with limited attention to self-management and participation in daily life.

Objectives: To identify factors relevant to post-MBS outcomes (weight loss, quality of life and self-management), evaluate an occupation-based telehealth follow-up program, and formulate policy recommendations for strengthening long-term post-MBS services.

Method: The study included a cross-sectional analysis of 96 adults at 6 or 12 months post-MBS and a single-blind randomized controlled trial of 66 participants comparing one-year telehealth plus standard follow-up with standard follow-up alone. Outcomes included excess weight loss (%EWL), quality of life, self-management, participation, eating self-efficacy, cognition, mobility, physical activity, and depression.

Findings: Excess weight loss was high overall. At 12 months, participation was indirectly associated with %EWL through self-management and social eating self-efficacy, while cognition and depression were linked to self-management through participation. In the RCT, telehealth follow-up did not affect %EWL, QOL, or cognitive outcomes, but produced significantly greater improvement in participation and maintenance of self-management by the final assessment, versus standard care. Participants emphasized unmet needs for continuous multidisciplinary support and assistance integrating recommendations into daily routines.

Conclusions: Postoperative success should be understood as a multidimensional process extending beyond weight loss, incorporating patients’ capacity to manage health behaviors and participate effectively in everyday life.

Recommendations: Post-MBS policy should move toward a participatory, client-centered follow-up model built on proactive continuous care, multidisciplinary integration, hybrid accessibility, personalized goals, long-term self-management support, and family/peer engagement within bariatric and community services. Embedding these principles across bariatric centers and community services may strengthen continuity and accessibility of care and support implementation of
postoperative recommendations in everyday life.

Research end date: 09/2026