Behavioral weight management interventions in metabolic and bariatric surgery: A systematic review and meta‐analysis investigating optimal delivery timing
Bibliographic record
Abstract
Summary Metabolic and bariatric surgery (MBS) yields unprecedented clinical outcomes, though variability is high in weight change and health benefits. Behavioral weight management (BWM) interventions may optimize MBS outcomes. However, there is a lack of an evidence base to inform their use in practice, particularly regarding optimal delivery timing. This paper evaluated the efficacy of BWM conducted pre‐ versus post‐ versus pre‐ and post‐MBS. The review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement and included pre‐ and/or post‐operative BWM interventions in adults reporting anthropometric and/or body composition data. Thirty‐six studies (2,919 participants) were included. Post‐operative BWM yielded greater decreases in weight (standardized mean difference [SMD] = −0.41; 95% confidence interval [CI]: −0.766 to −0.049, p < 0.05; I 2 = 93.5%) and body mass index (SMD = −0.60; 95% CI: −0.913 to −0.289, p < 0.001; I 2 = 87.8%) relative to comparators. There was no effect of BWM delivered pre ‐ or joint pre‐ and post‐operatively. The risk of selection and performance bias was generally high. Delivering BWM after MBS appears to confer the most benefits on weight, though there was high variability in study characteristics and risk of bias across trials. This provides insight into the type of support that should be considered post‐operatively.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.023 | 0.007 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".