Measuring Knowledge, Attitudes, and Barriers to Medication Adherence in Potential Bariatric Surgery Patients

Abstract

Background Bariatric surgery is an effective treatment for the obesity epidemic, but the poor attendance and adherence rates of post-surgery recommendations threaten treatment effectiveness and health outcomes. Preoperatively, we investigated the unique contributions of clinical (e.g., medical and psychiatric comorbidities), sociodemographic (e.g., sex, age, and educational level), and psychopathological variables (e.g., binge eating severity, the general level of psychopathological distress, and alexithymia traits) on differing dimensions of adherence in a group of patients seeking bariatric surgery. Methods The final sample consisted of 501 patients (346 women). All participants underwent a full psychiatric interview. Self-report questionnaires were used to assess psychopathology, binge eating severity, alexithymia, and three aspects of adherence: knowledge, attitude, and barriers to medical recommendations. Results Attitude to adherence was associated with alexithymia (β = ˗2.228; p < 0.001) and binge eating disorder (β = 0.103; p = 0.047). The knowledge subscale was related to medical comorbidity (β = 0.113; p = 0.012) and alexithymia (β = −2.256; p < 0.001); with age (β = 0.161; p = 0.002) and psychiatric comorbidity (β =0.107; p = 0.021) manifesting in the barrier subscale. Conclusion We demonstrated that alexithymia and psychiatric and eating disorders impaired adherence reducing attitude and knowledge of treatment and increasing the barriers. Both patient and doctor can benefit from measuring adherence prior to surgery, with a qualitative approach shedding light on the status of adherence prior to the postsurgical phase when the damage regarding adherence is, already, done.

Impact of Bariatric Surgery on the Healthy Eating Index, Binge Eating Behavior and Food Craving in a Middle Eastern Population: A Lebanese Experience

“…These findings highlight that behavioral evaluation and treatment is a vital component of any obesity-treatment program [56,57]. Psychiatric and behavioral problems have been shown to affect adherence to the advised interventions and to shape BS outcomes [58]. This justifies why BS guidelines promote the integration of mental health professionals in the multidisciplinary care team to support patients in adjusting to the psychological, social and food-behavioral changes experienced in the postoperative phase [59,60].…”

“…Moreover, participants were interviewed by licensed dietitians who were trained to administer 24-h recall reporting and had insight into diets following BS. Finally, diet recall was changed into indices such as HEI and BES that are used globally, allowing for a wider range of comparison [54,55,57,58].…”

Laparoscopic Banded One Anastomosis Gastric Bypass: A Single-Center Series

“…One anastomosis gastric bypass is, basically, a malabsorptive procedure, but restriction plays a role, mainly in the first year. Some degree of weight regain is reported, and it could be related to increased eating attitudes in the long term [ 50 , 51 ].…”

The Complicated Relationship between Dieting, Dietary Restraint, Caloric Restriction, and Eating Disorders: Is a Shift in Public Health Messaging Warranted?

“…The small number of potential patients presenting excludable conditions may be the result of a skewed voluntary sample. For example, patients without psychiatric disorders may be more adherent to dietary restriction and may have more realistic goals compared to those screened out for psychiatric symptoms [ 62 ]. Further, excluding psychiatric disorders such as anxiety was important to screen out those at higher risk from developing an eating disorder from caloric restriction, as anxiety often precedes subclinical and full eating disorder diagnoses.…”