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Psychological correlates of obese patients seeking surgical or residential behavioral weight loss treatment

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Abstract

Background

The purpose of this study was to gain a better understanding of the psychological factors related to obese individuals self-selecting for either a residential cognitive-behavioral-based program or surgical treatment program for weight loss.

Methods

Two patient samples with a body mass index of ≥35 kg/m2 were administered a battery of psychological questionnaires, including the Beck Depression Inventory, Binge Eating Scale, and Impact of Weight on Quality of Life-Lite, at the evaluation for entry into either a surgical weight loss treatment program (n = 76) or cognitive-behavioral-based weight loss treatment program (n = 101).

Results

No significant difference was found in the mean body mass index of the 2 samples. No significant difference was found in the self-reported level of depressive symptoms of the 2 samples, with both samples obtaining a mean depressive symptom score in the mild range. Surgical treatment seekers, however, reported significantly greater emotional eating and attributed greater impairment in their quality of life to their weight.

Conclusion

Individuals seeking a surgical approach to weight loss might perceive their weight as having a greater negative impact on their life than those selecting a residential behavioral lifestyle change approach, even when their weight and depressive symptoms are equivalent. Therefore, an individual’s own cognitive appraisal of the negative consequences of their weight might correlate with their treatment choice.

Section snippets

Subjects

Individuals seeking treatment for obesity at either a residential weight loss program with a cognitive-behavioral focus or a hospital-based surgical weight loss program offering both Roux-en-Y gastric bypass and laparoscopic banding procedures were included in this study. All had agreed for their data to be used for research purposes under protocols approved by the Duke University Medical Center Institutional Review Board for Clinical Investigations. All individuals assessed within a designated

Body mass index

The weight loss surgery program included only patients with BMI ≥35 kg/m2; the behavioral group was culled for eligible participants with a BMI in this same range. Thus, no significant difference was present in the mean BMI of the 2 samples. The behavioral treatment group selected for having a BMI ≥35 kg/m2 had a mean BMI of 45.82 ±9.02 kg/m2; the surgical treatment-seeking group had a mean BMI of 47.55 ±6.90 kg/m2.

Gender

The gender composition for the behavioral treatment group (n = 101) was 33% male

Discussion

Although extensive guidelines have been established to assist healthcare providers to make appropriate treatment recommendations for patients with obesity, the ultimate decision for treatment modality selection is made by the patient. Many individuals seeking treatment at behavioral and surgical weight loss centers are self-referred and thus use their own set of criteria in determining a course of action to lose weight. We believe that patients consider cost, access, insurance coverage,

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

Acknowledgments

The authors wish to thank Alexa Connell, Research Coordinator for Structure House, Center for Weight Control and Lifestyle Change for her assistance in the preparation of the manuscript.

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Copyright © 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.