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Erschienen in: Obesity Surgery 9/2015

01.09.2015 | Original Contributions

Predictors of Preoperative Weight Loss in Morbidly Obese Adults Waiting for Bariatric Surgery: A Prospective Cohort Study

verfasst von: Irmelin Bergh, Ingela Lundin Kvalem, Hilde Risstad, Linda D. Cameron, Falko F. Sniehotta

Erschienen in: Obesity Surgery | Ausgabe 9/2015

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Abstract

Background

Preoperative weight loss is encouraged before bariatric surgery, as it is associated with improved surgical conditions. It has also been related to better postoperative outcomes, but this relationship is less clear. However, little is known about what predicts weight loss preoperatively, so the aim was to identify psychosocial and clinical predictors of preoperative weight loss.

Methods

Weight was measured at the first visit, the time of surgery approval, and on the day of surgery in 286 bariatric surgery patients (227 women). A questionnaire consisting of multiple psychosocial measures was completed before surgery.

Results

Preoperatively, patients experienced a mean weight loss of 3.8 %. Men lost significantly more weight than women (mean = 5.4, SD = 6.0 vs. mean = 3.4, SD = 5.8, t = −2.3, p < 0.05), and 43.2 % of the patients lost ≥5% of their body weight. A high weight loss goal (β = 0.20, p < 0.001), frequent self-weighing (β = 0.18, p < 0.002), and being close to or at highest lifetime weight when applying for surgery (β = −0.30, p < 0.0001) were identified as predictors of weight loss, after controlling for body mass index (BMI), gender, and length of preoperative time period.

Conclusions

A relatively low proportion of patients lost the recommended weight preoperatively. Our results indicate that patients benefit from monitoring weight preoperatively and that allowing patients to keep their high weight loss goals may contribute to higher weight loss. Further investigation of these predictors could provide valuable knowledge regarding how to support and motivate patients to lose weight preoperatively.
Literatur
1.
Zurück zum Zitat Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7(6):760–7.PubMedCrossRef Cassie S, Menezes C, Birch DW, et al. Effect of preoperative weight loss in bariatric surgical patients: a systematic review. Surg Obes Relat Dis. 2011;7(6):760–7.PubMedCrossRef
2.
Zurück zum Zitat Weinstein A, Marascalchi B, Spiegel M, Saunders J, Fagerlin A, Parikh M. Patient Preferences and Bariatric Surgery Procedure Selection; the Need for Shared Decision-Making. OBES SURG. 2014 2014/05/01:1–7. English. Weinstein A, Marascalchi B, Spiegel M, Saunders J, Fagerlin A, Parikh M. Patient Preferences and Bariatric Surgery Procedure Selection; the Need for Shared Decision-Making. OBES SURG. 2014 2014/05/01:1–7. English.
3.
Zurück zum Zitat Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5.PubMedCrossRef Alami RS, Morton JM, Schuster R, et al. Is there a benefit to preoperative weight loss in gastric bypass patients? A prospective randomized trial. Surg Obes Relat Dis. 2007;3(2):141–5.PubMedCrossRef
4.
Zurück zum Zitat Lewis M, Phillips M, Slavotinek J, et al. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg. 2006;16(6):697–701.PubMedCrossRef Lewis M, Phillips M, Slavotinek J, et al. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg. 2006;16(6):697–701.PubMedCrossRef
5.
Zurück zum Zitat Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142(10):994–8.PubMedCrossRef Still CD, Benotti P, Wood GC, et al. Outcomes of preoperative weight loss in high-risk patients undergoing gastric bypass surgery. Arch Surg. 2007;142(10):994–8.PubMedCrossRef
6.
Zurück zum Zitat Kadeli DK, Sczepaniak JP, Kumar K, et al. The effect of preoperative weight loss before gastric bypass: a systematic review. J Obes. 2012;2012:7.CrossRef Kadeli DK, Sczepaniak JP, Kumar K, et al. The effect of preoperative weight loss before gastric bypass: a systematic review. J Obes. 2012;2012:7.CrossRef
7.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.PubMedCrossRef Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.PubMedCrossRef
8.
Zurück zum Zitat Alger-Mayer S, Polimeni J, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18(7):772–5.PubMedCrossRef Alger-Mayer S, Polimeni J, Malone M. Preoperative weight loss as a predictor of long-term success following Roux-en-Y gastric bypass. Obes Surg. 2008;18(7):772–5.PubMedCrossRef
9.
10.
Zurück zum Zitat Livhits M, Mercado C, Yermilov I, et al. preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.PubMedCrossRef Livhits M, Mercado C, Yermilov I, et al. preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89.PubMedCrossRef
11.
Zurück zum Zitat Owers CE, Abbas Y, Ackroyd R, et al. Perioperative optimization of patients undergoing bariatric surgery. J Obes. 2012;2012:6.CrossRef Owers CE, Abbas Y, Ackroyd R, et al. Perioperative optimization of patients undergoing bariatric surgery. J Obes. 2012;2012:6.CrossRef
12.
Zurück zum Zitat Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic &amp; Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–91.PubMedCrossRef Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic &amp; Bariatric Surgery. Surg Obes Relat Dis. 2013;9(2):159–91.PubMedCrossRef
13.
Zurück zum Zitat Ochner CN, Dambkowski CL, Yeomans BL, Teixeira J, Xavier Pi-Sunyer F. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes. 2012 Ochner CN, Dambkowski CL, Yeomans BL, Teixeira J, Xavier Pi-Sunyer F. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes. 2012
14.
Zurück zum Zitat Gibbons LM, Sarwer DB, Crerand CE, et al. Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery? Surg Obes Relat Dis. 2006;2(2):159–64.PubMedCrossRef Gibbons LM, Sarwer DB, Crerand CE, et al. Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery? Surg Obes Relat Dis. 2006;2(2):159–64.PubMedCrossRef
15.
Zurück zum Zitat Jamal MK, DeMaria EJ, Johnson JM, et al. Insurance-mandated preoperative dietary counseling does not improve outcome and increases dropout rates in patients considering gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2006;2(2):122–7.PubMedCrossRef Jamal MK, DeMaria EJ, Johnson JM, et al. Insurance-mandated preoperative dietary counseling does not improve outcome and increases dropout rates in patients considering gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2006;2(2):122–7.PubMedCrossRef
16.
Zurück zum Zitat Ochner CN, Puma LM, Raevuori A, et al. Effectiveness of a prebariatric surgery insurance-required weight loss regimen and relation to postsurgical weight loss. Obesity. 2009;18(2):287–92.PubMedCentralPubMedCrossRef Ochner CN, Puma LM, Raevuori A, et al. Effectiveness of a prebariatric surgery insurance-required weight loss regimen and relation to postsurgical weight loss. Obesity. 2009;18(2):287–92.PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Baumeister RF, Vohs KD. Self-regulation, ego depletion, and motivation. Soc Personal Psychol Compass. 2007;1(1):115–28.CrossRef Baumeister RF, Vohs KD. Self-regulation, ego depletion, and motivation. Soc Personal Psychol Compass. 2007;1(1):115–28.CrossRef
18.
Zurück zum Zitat Verplanken B, Orbell S. Reflections on past behavior: a self-report index of habit strength1. J Appl Soc Psychol. 2003;33(6):1313–30.CrossRef Verplanken B, Orbell S. Reflections on past behavior: a self-report index of habit strength1. J Appl Soc Psychol. 2003;33(6):1313–30.CrossRef
19.
Zurück zum Zitat Hall PA, Fong GT. Temporal self-regulation theory: a model for individual health behavior. Health Psychol Rev. 2007;1(1):6–52.CrossRef Hall PA, Fong GT. Temporal self-regulation theory: a model for individual health behavior. Health Psychol Rev. 2007;1(1):6–52.CrossRef
20.
Zurück zum Zitat Muraven M, Baumeister RF. Self-regulation and depletion of limited resources: does self-control resemble a muscle? Psychol Bull. 2000;126(2):247–59.PubMedCrossRef Muraven M, Baumeister RF. Self-regulation and depletion of limited resources: does self-control resemble a muscle? Psychol Bull. 2000;126(2):247–59.PubMedCrossRef
21.
Zurück zum Zitat Finkel EJ, Campbell WK, Brunell AB, et al. High-maintenance interaction: inefficient social coordination impairs self-regulation. J Pers Soc Psychol. 2006;91(3):456–75.PubMedCrossRef Finkel EJ, Campbell WK, Brunell AB, et al. High-maintenance interaction: inefficient social coordination impairs self-regulation. J Pers Soc Psychol. 2006;91(3):456–75.PubMedCrossRef
22.
Zurück zum Zitat National Institutes of Health Consensus Development Conference Statement. Gastrointestinal surgery for severe obesity. Am J Clin Nutr. 1992;55(2):615S–9S. National Institutes of Health Consensus Development Conference Statement. Gastrointestinal surgery for severe obesity. Am J Clin Nutr. 1992;55(2):615S–9S.
23.
Zurück zum Zitat Foster GD, Wadden TA, Vogt RA, et al. What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65(1):79–85.PubMedCrossRef Foster GD, Wadden TA, Vogt RA, et al. What is a reasonable weight loss? Patients' expectations and evaluations of obesity treatment outcomes. J Consult Clin Psychol. 1997;65(1):79–85.PubMedCrossRef
24.
Zurück zum Zitat Ghaderi A, Scott B. The preliminary reliability and validity of the Survey for Eating Disorders (SEDs): a self-report questionnaire for diagnosing eating disorders. Eur Eat Disord Rev. 2002;10:61–76.CrossRef Ghaderi A, Scott B. The preliminary reliability and validity of the Survey for Eating Disorders (SEDs): a self-report questionnaire for diagnosing eating disorders. Eur Eat Disord Rev. 2002;10:61–76.CrossRef
25.
Zurück zum Zitat Wadden TA, Foster GD. Weight and Lifestyle Inventory (WALI). Obesity. 2006;14(S3):99S–118S.PubMedCrossRef Wadden TA, Foster GD. Weight and Lifestyle Inventory (WALI). Obesity. 2006;14(S3):99S–118S.PubMedCrossRef
26.
Zurück zum Zitat Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.PubMedCrossRef Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35:1381–95.PubMedCrossRef
27.
Zurück zum Zitat Schwarzer R, Born A. Optimistic self-beliefs: assessment of general perceived self-efficacy in thirteen cultures. World Psychol. 1997;3:177–90. Schwarzer R, Born A. Optimistic self-beliefs: assessment of general perceived self-efficacy in thirteen cultures. World Psychol. 1997;3:177–90.
28.
Zurück zum Zitat Scholz U, Doña BG, Sud S, et al. Is general self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess. 2002;18(3):242–51.CrossRef Scholz U, Doña BG, Sud S, et al. Is general self-efficacy a universal construct? Psychometric findings from 25 countries. Eur J Psychol Assess. 2002;18(3):242–51.CrossRef
29.
Zurück zum Zitat Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965.
30.
Zurück zum Zitat Tambs K. Valg av sporsmal til kortversjoner av etablerte psykometriske instrumenter. Forslag til fremgangsmate og noen eksempler. Ubevisst sjeleliv og bevisst samfunnsliv Psykisk helse i en sammenheng Festskrift til Tom Sorensens 60 ars jubileum. 2004:29–48. Tambs K. Valg av sporsmal til kortversjoner av etablerte psykometriske instrumenter. Forslag til fremgangsmate og noen eksempler. Ubevisst sjeleliv og bevisst samfunnsliv Psykisk helse i en sammenheng Festskrift til Tom Sorensens 60 ars jubileum. 2004:29–48.
31.
Zurück zum Zitat Gross JJ. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003;85(2):348.PubMedCrossRef Gross JJ. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. J Pers Soc Psychol. 2003;85(2):348.PubMedCrossRef
32.
Zurück zum Zitat Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361–70.PubMedCrossRef Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand. 1983;67:361–70.PubMedCrossRef
33.
Zurück zum Zitat Hendrick S. A generic measure of relationship satisfaction. J Marriage Fam. 1988;50:93–8.CrossRef Hendrick S. A generic measure of relationship satisfaction. J Marriage Fam. 1988;50:93–8.CrossRef
34.
Zurück zum Zitat Friborg O, Martinussen M, Rosenvinge JH. Likert-based vs. semantic differential-based scorings of positive psychological constructs: a psychometric comparison of two versions of a scale measuring resilience. Personal Individ Differ. 2006;40:873–84.CrossRef Friborg O, Martinussen M, Rosenvinge JH. Likert-based vs. semantic differential-based scorings of positive psychological constructs: a psychometric comparison of two versions of a scale measuring resilience. Personal Individ Differ. 2006;40:873–84.CrossRef
35.
Zurück zum Zitat Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N. J: Laurence Erlbaum; 1988. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N. J: Laurence Erlbaum; 1988.
36.
Zurück zum Zitat Mrad BA, Johnson Stoklossa C, Birch DW. Does preoperative weight loss predict success following surgery for morbid obesity? Am J Surg. 2008;195(5):570–4.PubMedCrossRef Mrad BA, Johnson Stoklossa C, Birch DW. Does preoperative weight loss predict success following surgery for morbid obesity? Am J Surg. 2008;195(5):570–4.PubMedCrossRef
37.
Zurück zum Zitat Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013 Mar 7. PubMed PMID: 23472004. Epub 2013/03/09. Eng Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013 Mar 7. PubMed PMID: 23472004. Epub 2013/03/09. Eng
38.
Zurück zum Zitat Eldredge KL, Agras WS, Arnow B. The last supper: emotional determinants of pretreatment weight fluctuation in obese binge eaters. Int J Eat Disord. 1994;16(1):83–8.PubMedCrossRef Eldredge KL, Agras WS, Arnow B. The last supper: emotional determinants of pretreatment weight fluctuation in obese binge eaters. Int J Eat Disord. 1994;16(1):83–8.PubMedCrossRef
39.
Zurück zum Zitat Urbszat D. Eat, drink, and be merry, for tomorrow we diet: effects of anticipated deprivation on food intake in restrained and unrestrained eaters. J Abnorm Psychol. 2002;111(2):396.PubMedCrossRef Urbszat D. Eat, drink, and be merry, for tomorrow we diet: effects of anticipated deprivation on food intake in restrained and unrestrained eaters. J Abnorm Psychol. 2002;111(2):396.PubMedCrossRef
40.
Zurück zum Zitat Durant NH, Durant RP, Joseph OH, et al. Empirical evidence does not support an association between less ambitious pre-treatment goals and better treatment outcomes: a meta-analysis. Obes Rev. 2013;14(7):532–40.PubMedCentralPubMedCrossRef Durant NH, Durant RP, Joseph OH, et al. Empirical evidence does not support an association between less ambitious pre-treatment goals and better treatment outcomes: a meta-analysis. Obes Rev. 2013;14(7):532–40.PubMedCentralPubMedCrossRef
41.
Zurück zum Zitat Gelinas B, Gelinas C, Delparte R, et al. Unrealistic weight loss goals and expectations among bariatric surgery candidates: the impact on pre- and postsurgical weight outcomes. Bariatric Surg Practice Patient Care. 2013;8(1):12–7.CrossRef Gelinas B, Gelinas C, Delparte R, et al. Unrealistic weight loss goals and expectations among bariatric surgery candidates: the impact on pre- and postsurgical weight outcomes. Bariatric Surg Practice Patient Care. 2013;8(1):12–7.CrossRef
42.
Zurück zum Zitat Walfish S, Walfish D, Fabricatore VA. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg. 2007;17(12):1578–83.PubMedCrossRef Walfish S, Walfish D, Fabricatore VA. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg. 2007;17(12):1578–83.PubMedCrossRef
43.
Zurück zum Zitat Fabricatore A, Fabricatore C, Crerand T, et al. How do mental health professionals evaluate candidates for bariatric surgery? Survey results. Obes Surg. 2006;16(5):567–73.PubMedCrossRef Fabricatore A, Fabricatore C, Crerand T, et al. How do mental health professionals evaluate candidates for bariatric surgery? Survey results. Obes Surg. 2006;16(5):567–73.PubMedCrossRef
44.
Zurück zum Zitat White M, Masheb R, Rothschild B, Burke-Martindale C, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17(1):74–81.PubMedCrossRef White M, Masheb R, Rothschild B, Burke-Martindale C, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17(1):74–81.PubMedCrossRef
45.
Zurück zum Zitat Wing R, Wing D, Tate A, et al. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355(15):1563–71.PubMedCrossRef Wing R, Wing D, Tate A, et al. A self-regulation program for maintenance of weight loss. N Engl J Med. 2006;355(15):1563–71.PubMedCrossRef
46.
Zurück zum Zitat Odom J, Odom K, Zalesin T, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef Odom J, Odom K, Zalesin T, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.PubMedCrossRef
47.
Zurück zum Zitat Linde J, Linde R, Jeffery S, et al. Self-weighing in weight gain prevention and weight loss trials. Ann Behav Med. 2005;30(3):210–6.PubMedCrossRef Linde J, Linde R, Jeffery S, et al. Self-weighing in weight gain prevention and weight loss trials. Ann Behav Med. 2005;30(3):210–6.PubMedCrossRef
48.
Zurück zum Zitat Butryn ML, Phelan S, Hill JO, et al. Consistent self-monitoring of weight: a key component of successful weight loss maintenance. Obesity. 2007;15(12):3091–6.PubMedCrossRef Butryn ML, Phelan S, Hill JO, et al. Consistent self-monitoring of weight: a key component of successful weight loss maintenance. Obesity. 2007;15(12):3091–6.PubMedCrossRef
49.
Zurück zum Zitat Ochner CN, Barrios DM, Lee CD, et al. Biological mechanisms that promote weight regain following weight loss in obese humans. Physiol Behav. 2013;120(0):106–13.PubMedCrossRef Ochner CN, Barrios DM, Lee CD, et al. Biological mechanisms that promote weight regain following weight loss in obese humans. Physiol Behav. 2013;120(0):106–13.PubMedCrossRef
50.
Zurück zum Zitat Schwartz A, Doucet É. Relative changes in resting energy expenditure during weight loss: a systematic review. Obes Rev. 2010;11(7):531–47.PubMedCrossRef Schwartz A, Doucet É. Relative changes in resting energy expenditure during weight loss: a systematic review. Obes Rev. 2010;11(7):531–47.PubMedCrossRef
51.
Zurück zum Zitat Franz M, Franz J, VanWormer AL, et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007;107(10):1755–67.PubMedCrossRef Franz M, Franz J, VanWormer AL, et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc. 2007;107(10):1755–67.PubMedCrossRef
Metadaten
Titel
Predictors of Preoperative Weight Loss in Morbidly Obese Adults Waiting for Bariatric Surgery: A Prospective Cohort Study
verfasst von
Irmelin Bergh
Ingela Lundin Kvalem
Hilde Risstad
Linda D. Cameron
Falko F. Sniehotta
Publikationsdatum
01.09.2015
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 9/2015
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-015-1569-y

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