Skip to main content
Erschienen in: Obesity Surgery 11/2020

08.07.2020 | Original Contributions

Motivation and Weight Loss Expectations in Bariatric Surgery Candidates: Association with 1- and 2-Year Results After Bariatric Surgery

verfasst von: Caroline M. J. Theunissen, Anne van Vlijmen, Danny J. A. M. Tak, Ivan Nyklíček, Mariska A. C. de Jongh, Barbara S. Langenhoff

Erschienen in: Obesity Surgery | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

There are discrepancies between patients’ expected weight loss and what is considered achievable after bariatric surgery. This study describes the association between patients’ expectations and actual weight loss, 1 and 2 years postoperatively.

Materials and Methods

A prospective observational study was performed. The association between expectations and actual weight loss (% total weight loss) was explored using linear regression analyses, adjusting for baseline demographics, surgery types, and self-esteem (Rosenberg self-esteem scale) and repeated separately per gender. Gender differences in motivations were explored using Chi-square tests.

Results

Of 440 patients at baseline, results on 368 (84%) at 1 year and 341 (78%) patients at 2 years were available. Significant and opposite associations were found when analyzing genders separately. There was a significant negative association between expectations and %TWL in men at 1 year (β − 0.23, p = 0.04) and 2 years postoperatively (β − 0.26, p = 0.03), indicating smaller weight loss for greater expectations. In women, a significant positive association (β 0.24, p < 0.01) was found 2 years postoperatively, indicating greater weight loss for greater expectations. Both genders were mainly motivated by health concerns, but women were also motivated by reduced self-confidence to lose weight.

Conclusions

Higher expectations were negatively associated with weight loss in men, but positively in women. This may be due to men being motivated by physical complaints, which improve with lower weight-loss. Women are also driven by reduced self-confidence, which may influence weight loss maintenance behaviors. Higher weight loss goals should not be considered as a contra-indication for surgery, but may be utilized to achieve patients’ goals.
Literatur
1.
Zurück zum Zitat Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis United States. 2016;12:731–49.CrossRef Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis United States. 2016;12:731–49.CrossRef
3.
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. Surg Obes Relat Dis. 2013;9:159–91.CrossRef 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. Surg Obes Relat Dis. 2013;9:159–91.CrossRef
5.
Zurück zum Zitat Bauchowitz AU, Gonder-Frederick LA, Olbrisch M-EE, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med. 2005;67:825–32.CrossRef Bauchowitz AU, Gonder-Frederick LA, Olbrisch M-EE, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med. 2005;67:825–32.CrossRef
6.
Zurück zum Zitat Walfish S, Vance D, Fabricatore AN. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg. 2007;17:1578–83.CrossRef Walfish S, Vance D, Fabricatore AN. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg. 2007;17:1578–83.CrossRef
7.
Zurück zum Zitat Homer CV, Tod AM, Thompson AR, et al. Expectations and patients’ experiences of obesity prior to bariatric surgery: a qualitative study. BMJ Open. 2016;6:e009389.CrossRef Homer CV, Tod AM, Thompson AR, et al. Expectations and patients’ experiences of obesity prior to bariatric surgery: a qualitative study. BMJ Open. 2016;6:e009389.CrossRef
8.
Zurück zum Zitat Zijlstra H, Larsen JK, De Ridder DTD, et al. Initiation and maintenance of weight loss after laparoscopic adjustable gastric banding. The role of outcome expectation and satisfaction with the psychosocial outcome. Obes Surg. 2009;19:725–31.CrossRef Zijlstra H, Larsen JK, De Ridder DTD, et al. Initiation and maintenance of weight loss after laparoscopic adjustable gastric banding. The role of outcome expectation and satisfaction with the psychosocial outcome. Obes Surg. 2009;19:725–31.CrossRef
9.
Zurück zum Zitat Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16:1622–9.CrossRef Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16:1622–9.CrossRef
10.
Zurück zum Zitat Wee CC, Jones DB, Davis RB, et al. Understanding patients’ value of weight loss and expectations for bariatric surgery. Obes Surg. 2006;16:496–500.CrossRef Wee CC, Jones DB, Davis RB, et al. Understanding patients’ value of weight loss and expectations for bariatric surgery. Obes Surg. 2006;16:496–500.CrossRef
11.
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;148:264–71.CrossRef 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;148:264–71.CrossRef
12.
Zurück zum Zitat Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4:6–10.CrossRef Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4:6–10.CrossRef
13.
Zurück zum Zitat White MA, Masheb RM, Rothschild BS, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17:74–81.CrossRef White MA, Masheb RM, Rothschild BS, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17:74–81.CrossRef
14.
Zurück zum Zitat Price HI, Gregory DM, Twells LK. Weight loss expectations of laparoscopic sleeve gastrectomy candidates compared to clinically expected weight loss outcomes 1-year post-surgery. Obes Surg. 2013;23:1987–93.CrossRef Price HI, Gregory DM, Twells LK. Weight loss expectations of laparoscopic sleeve gastrectomy candidates compared to clinically expected weight loss outcomes 1-year post-surgery. Obes Surg. 2013;23:1987–93.CrossRef
15.
Zurück zum Zitat Bauchowitz A, Azarbad L, Day K, et al. Evaluation of expectations and knowledge in bariatric surgery patients. Surg Obes Relat Dis. 2007;3:554–8.CrossRef Bauchowitz A, Azarbad L, Day K, et al. Evaluation of expectations and knowledge in bariatric surgery patients. Surg Obes Relat Dis. 2007;3:554–8.CrossRef
16.
Zurück zum Zitat Heinberg LJ, Keating K, Simonelli L. Discrepancy between ideal and realistic goal weights in three bariatric procedures: who is likely to be unrealistic? Obes Surg. 2010;20:148–53.CrossRef Heinberg LJ, Keating K, Simonelli L. Discrepancy between ideal and realistic goal weights in three bariatric procedures: who is likely to be unrealistic? Obes Surg. 2010;20:148–53.CrossRef
17.
Zurück zum Zitat Karmali S, Kadikoy H, Brandt ML, et al. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2011;21:595–603.CrossRef Karmali S, Kadikoy H, Brandt ML, et al. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2011;21:595–603.CrossRef
18.
Zurück zum Zitat Fischer L, Nickel F, Sander J, et al. Patient expectations of bariatric surgery are gender specific - a prospective, multicenter cohort study. Surg Obes Relat Dis. 2014;10:516–23.CrossRef Fischer L, Nickel F, Sander J, et al. Patient expectations of bariatric surgery are gender specific - a prospective, multicenter cohort study. Surg Obes Relat Dis. 2014;10:516–23.CrossRef
19.
Zurück zum Zitat Diniz MDFHS, Passos VMDA, Barreto SM, et al. Different criteria for assessment of roux-en-y gastric bypass success: does only weight matter? Obes Surg. 2009;19:1384–92.CrossRef Diniz MDFHS, Passos VMDA, Barreto SM, et al. Different criteria for assessment of roux-en-y gastric bypass success: does only weight matter? Obes Surg. 2009;19:1384–92.CrossRef
20.
Zurück zum Zitat Dalle Grave R, Calugi S, Compare A, et al. Weight loss expectations and attrition in treatment-seeking obese women. Obes Facts. 2015;8:311–8.CrossRef Dalle Grave R, Calugi S, Compare A, et al. Weight loss expectations and attrition in treatment-seeking obese women. Obes Facts. 2015;8:311–8.CrossRef
21.
Zurück zum Zitat Dalle Grave R, Calugi S, Molinari E, et al. Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res. 2005;13:1961–9.CrossRef Dalle Grave R, Calugi S, Molinari E, et al. Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res. 2005;13:1961–9.CrossRef
23.
Zurück zum Zitat Vidal P, Ramón JM, Goday A, et al. Lack of adherence to follow-up visits after bariatric surgery: reasons and outcome. Obes Surg. 2014;24:179–83.CrossRef Vidal P, Ramón JM, Goday A, et al. Lack of adherence to follow-up visits after bariatric surgery: reasons and outcome. Obes Surg. 2014;24:179–83.CrossRef
25.
Zurück zum Zitat Durant NH, Joseph RP, Affuso 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;14:532–40.CrossRef Durant NH, Joseph RP, Affuso 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;14:532–40.CrossRef
26.
Zurück zum Zitat Crawford R, Glover L. The impact of pre-treatment weight-loss expectations on weight loss, weight regain, and attrition in people who are overweight and obese: a systematic review of the literature. Br J Health Psychol. 2012;17:609–30.CrossRef Crawford R, Glover L. The impact of pre-treatment weight-loss expectations on weight loss, weight regain, and attrition in people who are overweight and obese: a systematic review of the literature. Br J Health Psychol. 2012;17:609–30.CrossRef
27.
Zurück zum Zitat Aelfers SCW, Schijns W, Ploeger N, et al. Patients’ preoperative estimate of target weight and actual outcome after bariatric surgery. Obes Surg. 2017;27:1729–34.CrossRef Aelfers SCW, Schijns W, Ploeger N, et al. Patients’ preoperative estimate of target weight and actual outcome after bariatric surgery. Obes Surg. 2017;27:1729–34.CrossRef
28.
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;65:79–85.CrossRef 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;65:79–85.CrossRef
29.
Zurück zum Zitat Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14:392–8.CrossRef Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14:392–8.CrossRef
30.
Zurück zum Zitat Gorin AA, Pinto AM, Tate DF, et al. Failure to meet weight loss expectations does not impact maintenance in successful weight losers. Obesity. 2007;15:3086–90.CrossRef Gorin AA, Pinto AM, Tate DF, et al. Failure to meet weight loss expectations does not impact maintenance in successful weight losers. Obesity. 2007;15:3086–90.CrossRef
31.
Zurück zum Zitat Nederlandse Werkgroep Bariatrische Psychologie NOK. Richtlijn Bariatrische Psychologie. 2015 Nederlandse Werkgroep Bariatrische Psychologie NOK. Richtlijn Bariatrische Psychologie. 2015
32.
Zurück zum Zitat Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25:587–606.CrossRef Brethauer SA, Kim J, el Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25:587–606.CrossRef
35.
Zurück zum Zitat Twisk JWR. Inleiding in de toegepaste biostatistiek - Hoofdstuk 7 Multiple regressieanalyse: associatie- en predictiemodellen. 2nd ed. Maarssen: Elsevier Inc.; 2010. Twisk JWR. Inleiding in de toegepaste biostatistiek - Hoofdstuk 7 Multiple regressieanalyse: associatie- en predictiemodellen. 2nd ed. Maarssen: Elsevier Inc.; 2010.
36.
Zurück zum Zitat Price HI, Gregory DM, Twells LK. Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study. BMC Obes. 2014;1:28.CrossRef Price HI, Gregory DM, Twells LK. Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study. BMC Obes. 2014;1:28.CrossRef
37.
Zurück zum Zitat Gourash WF, Lockhart JS, Kalarchian MA, et al. Retention and attrition in bariatric surgery research: an integrative review of the literature. Surg Obes Relat Dis. 2016;12:199–209.CrossRef Gourash WF, Lockhart JS, Kalarchian MA, et al. Retention and attrition in bariatric surgery research: an integrative review of the literature. Surg Obes Relat Dis. 2016;12:199–209.CrossRef
38.
Zurück zum Zitat Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34:1481–6.CrossRef Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34:1481–6.CrossRef
39.
Zurück zum Zitat Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–86.CrossRef Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1677–86.CrossRef
Metadaten
Titel
Motivation and Weight Loss Expectations in Bariatric Surgery Candidates: Association with 1- and 2-Year Results After Bariatric Surgery
verfasst von
Caroline M. J. Theunissen
Anne van Vlijmen
Danny J. A. M. Tak
Ivan Nyklíček
Mariska A. C. de Jongh
Barbara S. Langenhoff
Publikationsdatum
08.07.2020
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 11/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04811-x

Weitere Artikel der Ausgabe 11/2020

Obesity Surgery 11/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.