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Erschienen in: Obesity Surgery 5/2019

22.02.2019 | Original Contributions

Decision Regret up to 4 Years After Gastric Bypass and Gastric Banding

verfasst von: Christina C. Wee, Aaron Fleishman, Ashley C. McCarthy, Donald T. Hess, Caroline Apovian, Daniel B. Jones

Erschienen in: Obesity Surgery | Ausgabe 5/2019

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Abstract

Background

Weight loss surgery (WLS) is neither risk-free nor universally effective. Few studies have examined what proportion of patients regret having undergone WLS.

Methods

We interviewed patients at two WLS centers before and after WLS about weight loss, quality of life/QOL (Impact of Weight on QOL-lite), and decision regret (modified Brehaut Regret scale, range 0–100). We conducted separate multivariable logistic regression models to examine the association between weight loss and ∆QOL scores and having decision regret (score > 50).

Results

Of 205 RYGB patients, only 2.2% (year 1) to 5.1% (year 4, n = 134) reported regret scores > 50 over 4 years; 2.0–4.5% did not think they made the right decision; 2.0–4.5% would not undergo WLS again. In contrast, of 188 gastric banding patients (n = 123 at year 4), 8.2–20.3% had regret scores > 50; 5.9–19.5% did not think they made the right decision; 7.1–19.5% would not undergo WLS again. Weight loss and ∆QOL scores were significant correlates of decision regret after banding although weight loss was a stronger correlate with lower model quasi-likelihood under the independence model criterion score. Four years after banding, mean weight loss for patients with regret scores > 50 was 7.4% vs. 21.1% for those with scores < 50; the AOR for regret score > 50 was 0.90 (95% CI 0.87–0.94) for every 1% greater weight loss. Poor sexual function, but not weight loss or other QOL factors, was significantly correlated with decision regret after RYGB.

Conclusion

Few patients regret undergoing RYGB but 20% regret undergoing gastric banding with weight loss being a major driver.
Literatur
1.
Zurück zum Zitat Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed
2.
Zurück zum Zitat Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.CrossRefPubMed Sjostrom L, Peltonen M, Jacobson P, et al. Bariatric surgery and long-term cardiovascular events. JAMA. 2012;307(1):56–65.CrossRefPubMed
3.
Zurück zum Zitat Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153(5):427–34.CrossRefPubMed Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153(5):427–34.CrossRefPubMed
4.
Zurück zum Zitat Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.CrossRefPubMed Flum DR, Belle SH, King WC, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.CrossRefPubMed
5.
Zurück zum Zitat Nguyen NT, Masoomi H, Laugenour K, et al. Predictive factors of mortality in bariatric surgery: data from the Nationwide Inpatient Sample. Surgery. 2011;150(2):347–51.CrossRefPubMed Nguyen NT, Masoomi H, Laugenour K, et al. Predictive factors of mortality in bariatric surgery: data from the Nationwide Inpatient Sample. Surgery. 2011;150(2):347–51.CrossRefPubMed
6.
Zurück zum Zitat Wee CC. A 52-year-old woman with obesity: review of bariatric surgery. JAMA. 2009;302(10):1097–104.CrossRefPubMed Wee CC. A 52-year-old woman with obesity: review of bariatric surgery. JAMA. 2009;302(10):1097–104.CrossRefPubMed
7.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.CrossRefPubMed
8.
Zurück zum Zitat Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763–78.CrossRefPubMed Adams KF, Schatzkin A, Harris TB, et al. Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old. N Engl J Med. 2006;355(8):763–78.CrossRefPubMed
9.
Zurück zum Zitat King WCCJ, Courcoulas AP, Dakin GF, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis. 2017;13(8):1392–402.CrossRefPubMedPubMedCentral King WCCJ, Courcoulas AP, Dakin GF, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis. 2017;13(8):1392–402.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Peterhansel C, Petroff D, Klinitzke G, et al. Risk of completed suicide after bariatric surgery: a systematic review. Obes Rev. 2013;14(5):369–82.CrossRefPubMed Peterhansel C, Petroff D, Klinitzke G, et al. Risk of completed suicide after bariatric surgery: a systematic review. Obes Rev. 2013;14(5):369–82.CrossRefPubMed
11.
Zurück zum Zitat Mesureur L, Arvanitakis M. Metabolic and nutritional complications of bariatric surgery: a review. Acta Gastroenterol Belg. 2017;80(4):515–25.PubMed Mesureur L, Arvanitakis M. Metabolic and nutritional complications of bariatric surgery: a review. Acta Gastroenterol Belg. 2017;80(4):515–25.PubMed
12.
Zurück zum Zitat Coleman KJ, Brookey J. Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors. Obes Surg. 2014;24(10):1729–36.CrossRefPubMed Coleman KJ, Brookey J. Gender and racial/ethnic background predict weight loss after Roux-en-Y gastric bypass independent of health and lifestyle behaviors. Obes Surg. 2014;24(10):1729–36.CrossRefPubMed
13.
Zurück zum Zitat Wee CCJD, Apovian C, Hess DT, et al. Weight loss after bariatric surgery: do clinical and behavioral factors explain racial differences? Obes Surg. 2017;27(11):2873–84.CrossRefPubMed Wee CCJD, Apovian C, Hess DT, et al. Weight loss after bariatric surgery: do clinical and behavioral factors explain racial differences? Obes Surg. 2017;27(11):2873–84.CrossRefPubMed
14.
Zurück zum Zitat Wee CC, Apovian CM, Blackburn GL, et al. Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. Arch Surg. 2012; Wee CC, Apovian CM, Blackburn GL, et al. Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. Arch Surg. 2012;
15.
Zurück zum Zitat Wee CC, Davis RB, Huskey KW, et al. Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status. J Gen Intern Med. 2013;28(2):231–8.CrossRefPubMed Wee CC, Davis RB, Huskey KW, et al. Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status. J Gen Intern Med. 2013;28(2):231–8.CrossRefPubMed
16.
Zurück zum Zitat Wee CCDR, Jones DB, Apovian CA, et al. Sex, race, and the quality of life factors most important to patients’ well-being among those seeking bariatric surgery. Obes Surg. 2016;26(6):1308–16.CrossRefPubMedPubMedCentral Wee CCDR, Jones DB, Apovian CA, et al. Sex, race, and the quality of life factors most important to patients’ well-being among those seeking bariatric surgery. Obes Surg. 2016;26(6):1308–16.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Wee CC, Hamel MB, Apovian CM, et al. Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. JAMA Surg. 2013;148(3):264–71.CrossRefPubMedPubMedCentral Wee CC, Hamel MB, Apovian CM, et al. Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. JAMA Surg. 2013;148(3):264–71.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Brehaut JC, O’Connor AM, Wood TJ, et al. Validation of a decision regret scale. Med Decis Mak. 2003;23(4):281–92.CrossRef Brehaut JC, O’Connor AM, Wood TJ, et al. Validation of a decision regret scale. Med Decis Mak. 2003;23(4):281–92.CrossRef
19.
Zurück zum Zitat Kolotkin RL, Crosby RD, Kosloski KD, et al. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9(2):102–11.CrossRefPubMed Kolotkin RL, Crosby RD, Kosloski KD, et al. Development of a brief measure to assess quality of life in obesity. Obes Res. 2001;9(2):102–11.CrossRefPubMed
20.
Zurück zum Zitat Kolotkin RL, Crosby RD. Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-lite) in a community sample. Qual Life Res. 2002;11(2):157–71.CrossRefPubMed Kolotkin RL, Crosby RD. Psychometric evaluation of the impact of weight on quality of life-lite questionnaire (IWQOL-lite) in a community sample. Qual Life Res. 2002;11(2):157–71.CrossRefPubMed
21.
Zurück zum Zitat Coulman KDMF, Blazeby JM, Owen-Smith A. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obes Rev. 2017;18(May):547–59.CrossRefPubMedPubMedCentral Coulman KDMF, Blazeby JM, Owen-Smith A. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obes Rev. 2017;18(May):547–59.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Turrentine FLMJ, Mehaffey RL, Mullen MG, et al. Patient reported outcomes 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27:2253–7.CrossRefPubMed Turrentine FLMJ, Mehaffey RL, Mullen MG, et al. Patient reported outcomes 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27:2253–7.CrossRefPubMed
23.
Zurück zum Zitat Wee CCHM, Huskey KW, Davis RB. The value of health and weight loss among primary care patients with moderate to severe obesity: do quality of life factors have a larger influence than comorbidities? Obes Res Clin Pract. 2017;11(1):123–6.CrossRefPubMed Wee CCHM, Huskey KW, Davis RB. The value of health and weight loss among primary care patients with moderate to severe obesity: do quality of life factors have a larger influence than comorbidities? Obes Res Clin Pract. 2017;11(1):123–6.CrossRefPubMed
Metadaten
Titel
Decision Regret up to 4 Years After Gastric Bypass and Gastric Banding
verfasst von
Christina C. Wee
Aaron Fleishman
Ashley C. McCarthy
Donald T. Hess
Caroline Apovian
Daniel B. Jones
Publikationsdatum
22.02.2019
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 5/2019
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-03772-0

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