Application and Effectiveness of eHealth Strategies for Metabolic and Bariatric Surgery Patients: A Systematic Review
Sarah E. Messiah, Paulina M. Sacher, Jonathan Yudkin, Amos Ofori, Faisal G. Qureshi, Benjamin Schneider, Deanna M. Hoelscher, Nestor de la Cruz-Muñoz, Sarah E. Barlow
- This review examined whether digital health tools including telehealth, apps, wearables, and online support programs help bariatric surgery patients achieve better outcomes and stay engaged in care.
- Up to 50-70% of bariatric surgery patients stop attending follow-up appointments within 2 years. Digital tools can help bridge this gap.
- The COVID-19 pandemic accelerated telehealth adoption; this review provided evidence bariatric programs needed to confidently integrate virtual care.
- Dr. de la Cruz-Muñoz's team has studied both sides: a 2015 study on follow-up attrition risk factors and this 2020 review on digital tools to keep patients engaged.
- For patients, this shows commitment to using modern technology to support the full weight loss journey, not just the surgery itself.
This systematic review published in Digital Health examined the application and effectiveness of eHealth strategies, including telehealth, mobile apps, wearable devices, remote monitoring, and digital behavioral support tools, for patients undergoing metabolic and bariatric surgery. This review assessed evidence on whether these tools can improve outcomes across the bariatric surgery care continuum from preoperative preparation through long-term follow-up. Dr. de la Cruz-Muñoz is a co-author.
Why This Review Was Needed
Many bariatric patients stop coming to follow-up within a few years of surgery, and follow-up is linked to better long-term results. Digital tools such as telemedicine, apps, text messaging and online programs could help patients stay engaged, but no one had systematically reviewed whether they work.
How the Review Was Done
The team searched five databases (PubMed, EMBASE, CINAHL, PsycNET and SCOPUS) and found 38 studies from 2011 to 2019 on eHealth strategies for bariatric patients. Studies were evaluated using the RE-AIM framework, which looks at reach, effectiveness, adoption, implementation and maintenance.
What the Review Found
- Studies ranged from qualitative interviews to randomized trials and used tools from telemedicine to blog content, before or after surgery.
- Some reported that digital interventions improved weight loss and other outcomes.
- Most were pilot studies with design limitations.
- No studies included adolescents, and very few reported participants’ race or ethnicity.
What This Means for Patients
Virtual visits and digital support can make follow-up easier, especially if you live far away or have a busy schedule. They work best as part of a structured program. Our Out-of-Town Patient Guide explains how we care for patients remotely, and Lifelong Follow-Up explains why staying connected matters.
Clinical Pearls
- Digital health tools show promise for supporting bariatric patients before and after surgery.
- The evidence base is early, with mostly small pilot studies.
- Adolescents and ethnic minority patients are missing from this research.
Strengths and Limitations
The review used five databases and a recognized implementation framework. The variety of tools and study designs made it impossible to pool results.
Expert Commentary
Patients travel to see me from across Florida and the country, and staying connected after surgery is a real challenge. This review gave us a map of what digital tools can do and where the evidence is still thin. Virtual follow-up is now a normal part of how we care for patients who live far away.
— Dr. Nestor de la Cruz-Muñoz
Related Research
Messiah SE, Sacher PM, Yudkin J, Ofori A, Qureshi FG, Schneider B, Hoelscher DM, de la Cruz-Muñoz N, Barlow SE. Application and effectiveness of eHealth strategies for metabolic and bariatric surgery patients: A systematic review. Digital Health. 2020;6. doi:10.1177/2055207619898987.
