A comparison of behavioral and psychological characteristics of patients opting for surgical and conservative treatment for morbid obesity

Abstract

BackgroundLittle is known about the psychological prerequisites for weight loss maintenance after bariatric surgery. A first step in investigating whether existing knowledge of conservative weight loss treatment is applicable for lifestyle interventions postoperatively is to compare specific psychological characteristics at baseline. The aim of this study was to compare patients scheduled for bariatric surgery with patients receiving conservative treatment for morbid obesity on measures of behavioral and psychosocial characteristics considered predictors of their adoption of and adherence to long-term lifestyle recommendations.MethodsBaseline clinical and questionnaire data from the prospective “Oslo Bariatric Surgery Study” were used to examine potential differences between bariatric surgery patients (n = 301) and patients receiving conservative weight loss treatment (n = 261).ResultsThe surgical group was characterized by their younger age (43.8 vs. 46.2 years, p <0.01), higher percentage of women (79.1 vs. 70.1 %, p <0.05), and higher Body Mass Index (BMI; 45.0 vs. 41.9 kg/m2, p <0.001). A multiple logistic regression analysis, adjusting for group differences in BMI, gender, and age, showed that the surgical group had higher self-efficacy (Odds ratio; OR = 3.44, 95 % Confidence interval; CI 1.65, 7.14), more positive outcome expectations (OR = 1.53, 95 % CI 1.23, 1.89), and plans that were more explicit for changing their eating behaviors (OR = 1.80, 95 % CI 1.06, 1.93). The surgical patients were also less ready to change physical activity levels (OR = 0.59, 95 % CI 0.48, 0.73), had tried more types of unhealthy weight loss methods in the past (OR = 1.16, 95 % CI 1.01, 1.33), drank soda more frequently (OR = 1.24, 95 % CI 1.02, 1.50), had fewer binge eating episodes (OR = 0.38, 95 % CI 0.20, 0.71), and had more depressive symptoms (OR = 1.19, 95 % CI 1.09, 1.29).ConclusionsPatients opting for bariatric surgery had more positive expectations of the treatment outcomes and stronger beliefs in their ability to achieve these outcomes. Those starting conservative treatment had stronger beliefs in readiness to change physical activity levels. Future studies should explore the effect of interventions for bariatric surgery patients, promoting postoperative physical activity and stress realistic outcome expectations. The potential effects of incorporating this knowledge in intervention strategies remain to be explored.

Attitude Matters! How Attitude towards Bariatric Surgery Influences the Effects of Behavioural Weight Loss Treatment

“…As hypothesized (i), baseline characteristics indicated differences between participants of the NEG and POS groups. Overall, the POS group strongly resembled baseline characteristics reported for patients before bariatric surgery [30][31][32], with POS participants being younger and having a higher depression score with a lower score in quality of life. The POS participants also tended to be less well educated and were more likely to be foreign and have a higher smoking rate.…”

“…These evidence-based guidelines help with the decision of the ap-propriate treatment pathway, taking into account body mass index (BMI), body fat distribution, and the patient's comorbidities [29]. Patients undergoing bariatric surgery are generally younger, less well educated, have a higher BMI, and suffer more often from depression in comparison to patients participating in BWL treatments [30][31][32].…”

Associations between perceived somatic symptoms and mental health after Roux-en-Y gastric bypass: a 3-year prospective cohort study

“…Dumping usually levels off following the first year, while symptoms like abdominal pain and fatigue tend to last longer (1,4,15) . Gastrointestinal symptoms, pain, and fatigue are often ambiguous, and thus more susceptible to psychological influences and previous illness experiences (9,16) . Knowing whether somatic symptom impact is related to changes in patients' distress levels can help clinicians to focus their efforts and resources in post-surgical consultations.…”

Psychosocial characteristics associated with symptom perception 1 year after gastric bypass surgery—a prospective study

“…Data were utilized from the Oslo Bariatric Surgery Study (17) , with questionnaires completed after being approved for surgery and one year after surgery. Participants were recruited at the Center for Morbid Obesity and Bariatric Surgery at Oslo University Hospital between February 2011 and September 2013 (17) . Of 506 eligible study participants, 302 (59.6%) consented and completed a set of questionnaires preoperatively.…”