Effect of Telehealth Visits on Weight Loss Outcomes After Endoscopic Bariatric Therapy

Introduction: During the COVID-19 pandemic, many clinic visits were converted to telehealth out of necessity. As pandemic restrictions ease, questions remain about the efficacy of telehealth and the value of continuing clinics in telehealth format. Our aim is to evaluate weight loss outcomes in an exclusively telehealth-based endoscopic bariatric therapies (EBT) practice that offers intragastric balloon (IGB) and endoscopic sleeve gastroplasty (ESG), compared to outcomes in the same practice prior to COVID-19, with exclusively in-person visits. Methods: Retrospective review was conducted on patients who received EBT between 2016-2023 at a single urban facility. After EBT, patients received exclusively in-person follow-up visits between 2016 to early 2020 or virtual follow-up visits after March 2020 until present. All patients received multimodal weight loss counseling from a dietitian, a psychologist, and a bariatric endoscopist. Independent samples t-tests were performed to compare mean total body weight loss (TBWL), % change in mean TBWL, change in body mass index (BMI), % change in BMI, % excess body weight loss (EBWL), and number of follow-up visits at 6 months and 1 year following EBT between the virtual and in-person groups. Results: Fifty-four patients received EBT, with all patients having 6 months of follow-up data (virtual n=18, in-person n=36), and most having 12 months of follow-up data (virtual n=15, in-person n=27). There were no significant differences in baseline age, gender, diabetes, BMI, or EBT modality received between the groups. There were no significant differences in mean TBWL, % change in mean TBWL, change in BMI, % change in BMI, or % EBWL. At 6 months, there was a significantly greater number of visits in the virtual group at 4.44 vs 2.94, (P=0.012). This trend continued at 1 year, with 6.57 virtual visits and 3.61 in-person visits (P=0.001) (Table 1). Conclusion: Telehealth follow-up visits after EBTs show non-inferior weight loss outcomes at 6 months and 1 year when compared to in-person visits. Additionally, there were more visits conducted via telehealth at 6 months and 1 year, which can benefit patients long-term by providing more support in the year following EBT. Thus, the telehealth model for follow-up visits in patients receiving EBTs should be highly considered. Table 1. - Differences in weight loss markers in patients undergoing virtual or in-person follow-up visits at 6 months and 1 year 6 Months 1 Year Virtual n=18Mean In-person n=36Mean P-value Virtual n=15Mean In-person n=27Mean P-value Total Body Weight Loss (lbs) 34.08 28.78 .30 28.07 20.23 .18 Total Body Weight Loss (%) 13.66 11.46 .26 11.34 8.38 .20 BMI Change (kg/m2) 5.50 4.29 .13 4.42 3.24 .20 BMI Change (%) 13.96 11.15 .16 11.27 8.68 .27 Excess Body Weight Loss (%) 40.12 35.21 .43 31.33 27.25 .56