Skip to main content
Erschienen in: Obesity Surgery 7/2017

25.01.2017 | Original Contributions

Patients’ Preoperative Estimate of Target Weight and Actual Outcome after Bariatric Surgery

verfasst von: Stephanie C.W. Aelfers, Wendy Schijns, Nadine Ploeger, Ignace M.C. Janssen, Frits J. Berends, Edo O. Aarts

Erschienen in: Obesity Surgery | Ausgabe 7/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

Evidence about the impact of psychological factors on weight loss after bariatric surgery is scarce. This study explores whether patients’ preoperative estimate of target weight influences actual weight loss for different types of bariatric procedures.

Methods

Patients eligible for bariatric surgery were instructed twice on how to calculate their expected target weight. They were divided into three groups based on their percentage excess weight loss (%EWL) and percentage total body weight loss (%TBWL). Weight loss 12 and 24 months after surgery was analyzed for each group and per type of surgery.

Results

Six hundred fifty-six patients participated in this study. Types of surgery performed were the Roux-en-Y gastric bypass (RYGB, 75%), sleeve gastrectomy (SG, 8.1%), REDO-RYGB (12.5%), and laparoscopic adjustable gastric banding (LAGB, 4.4%). Data of 622 and 410 patients were available for analysis at 12 and 24 months, respectively. Surprisingly, 415 patients (63.3%) overestimated their expected weight loss as opposed to our calculation, based on our own historic data. One hundred thirty-four patients (20.4%) estimated their weight loss correctly and 107 patients (16.3%) underestimated their weight loss. There was a significant higher %EWL 12 months after RYGB surgery for patients who overestimated their weight loss compared to those who estimated their weight loss correctly (p = 0.001). After 24 months and for other types of procedures, no statistically significant differences were found between the three groups.

Conclusion

Despite instructions on how to calculate target weight, the majority of patients overestimated their weight loss. Actual %EWL 12 months after RYGB surgery might be influenced by setting a low target weight.
Literatur
1.
Zurück zum Zitat Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. The Cochrane database of systematic reviews. 2014;8:Cd003641. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. The Cochrane database of systematic reviews. 2014;8:Cd003641.
2.
Zurück zum Zitat Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedPubMedCentral Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedPubMedCentral
3.
Zurück zum Zitat Dogan K, Gadiot RP, Aarts EO, et al. Effectiveness and safety of sleeve gastrectomy, gastric bypass, and adjustable gastric banding in morbidly obese patients: a multicenter, retrospective. Matched Cohort Study Obesity surgery. 2015;25(7):1110–8.CrossRefPubMed Dogan K, Gadiot RP, Aarts EO, et al. Effectiveness and safety of sleeve gastrectomy, gastric bypass, and adjustable gastric banding in morbidly obese patients: a multicenter, retrospective. Matched Cohort Study Obesity surgery. 2015;25(7):1110–8.CrossRefPubMed
4.
Zurück zum Zitat van de Laar A. Bariatric outcomes longitudinal database (BOLD) suggests excess weight loss and excess BMI loss to be inappropriate outcome measures, demonstrating better alternatives. Obes Surg. 2012;22(12):1843–7.CrossRefPubMed van de Laar A. Bariatric outcomes longitudinal database (BOLD) suggests excess weight loss and excess BMI loss to be inappropriate outcome measures, demonstrating better alternatives. Obes Surg. 2012;22(12):1843–7.CrossRefPubMed
5.
Zurück zum Zitat Parri A, Benaiges D, Schroder H, et al. Preoperative predictors of weight loss at 4 years following bariatric surgery. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2015;30(3):420–4.CrossRef Parri A, Benaiges D, Schroder H, et al. Preoperative predictors of weight loss at 4 years following bariatric surgery. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition. 2015;30(3):420–4.CrossRef
6.
Zurück zum Zitat Palmisano S, Silvestri M, Giuricin M, et al. Preoperative predictive factors of successful weight loss and glycaemic control 1 year after gastric bypass for morbid obesity. Obes Surg. 2015;25(11):2040–6.CrossRefPubMed Palmisano S, Silvestri M, Giuricin M, et al. Preoperative predictive factors of successful weight loss and glycaemic control 1 year after gastric bypass for morbid obesity. Obes Surg. 2015;25(11):2040–6.CrossRefPubMed
7.
Zurück zum Zitat Ortega E, Morinigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26(6):1744–50.CrossRefPubMed Ortega E, Morinigo R, Flores L, et al. Predictive factors of excess body weight loss 1 year after laparoscopic bariatric surgery. Surg Endosc. 2012;26(6):1744–50.CrossRefPubMed
8.
Zurück zum Zitat Courcoulas AP, Christian NJ, O'Rourke RW, et al. Preoperative factors and 3-year weight change in the longitudinal assessment of bariatric surgery (LABS) consortium. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery. 2015;11(5):1109–18.CrossRef Courcoulas AP, Christian NJ, O'Rourke RW, et al. Preoperative factors and 3-year weight change in the longitudinal assessment of bariatric surgery (LABS) consortium. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery. 2015;11(5):1109–18.CrossRef
9.
Zurück zum Zitat Dixon JB, Laurie CP, Anderson ML, et al. Motivation, readiness to change, and weight loss following adjustable gastric band surgery. Obesity (Silver Spring, Md). 2009;17(4):698–705.CrossRef Dixon JB, Laurie CP, Anderson ML, et al. Motivation, readiness to change, and weight loss following adjustable gastric band surgery. Obesity (Silver Spring, Md). 2009;17(4):698–705.CrossRef
10.
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(3):392–8.CrossRefPubMed Libeton M, Dixon JB, Laurie C, et al. Patient motivation for bariatric surgery: characteristics and impact on outcomes. Obes Surg. 2004;14(3):392–8.CrossRefPubMed
11.
Zurück zum Zitat Figura A, Ahnis A, Stengel A, et al. Determinants of weight loss following laparoscopic sleeve gastrectomy: the role of psychological burden, coping style, and motivation to undergo surgery. J Obes. 2015;2015:626010.CrossRefPubMedPubMedCentral Figura A, Ahnis A, Stengel A, et al. Determinants of weight loss following laparoscopic sleeve gastrectomy: the role of psychological burden, coping style, and motivation to undergo surgery. J Obes. 2015;2015:626010.CrossRefPubMedPubMedCentral
12.
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(4):496–500.CrossRefPubMed Wee CC, Jones DB, Davis RB, et al. Understanding patients’ value of weight loss and expectations for bariatric surgery. Obes Surg. 2006;16(4):496–500.CrossRefPubMed
13.
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 surgery. 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 surgery. 2013;148(3):264–71.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2008;4(1):6–10.CrossRef Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2008;4(1):6–10.CrossRef
15.
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(1):74–81.CrossRefPubMed White MA, Masheb RM, Rothschild BS, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery? Obes Surg. 2007;17(1):74–81.CrossRefPubMed
16.
Zurück zum Zitat Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55.CrossRefPubMed Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55.CrossRefPubMed
17.
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(12):1987–93.CrossRefPubMed 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(12):1987–93.CrossRefPubMed
18.
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(5):595–603.CrossRefPubMed 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(5):595–603.CrossRefPubMed
19.
Zurück zum Zitat van de Laar A, de Caluwe L, Dillemans B. Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic roux-en-Y gastric bypass patients. Obes Surg. 2011;21(6):763–7.CrossRefPubMed van de Laar A, de Caluwe L, Dillemans B. Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic roux-en-Y gastric bypass patients. Obes Surg. 2011;21(6):763–7.CrossRefPubMed
Metadaten
Titel
Patients’ Preoperative Estimate of Target Weight and Actual Outcome after Bariatric Surgery
verfasst von
Stephanie C.W. Aelfers
Wendy Schijns
Nadine Ploeger
Ignace M.C. Janssen
Frits J. Berends
Edo O. Aarts
Publikationsdatum
25.01.2017
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 7/2017
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2556-2

Weitere Artikel der Ausgabe 7/2017

Obesity Surgery 7/2017 Zur Ausgabe

Update Chirurgie

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

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

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“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar 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“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

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.