Abstract
Background
A number of reasons lead patients to choose to undergo weight loss procedures. Previous studies have demonstrated that patients have unrealistic weight loss goals. However, there is a general paucity of information on a patient’s expectations in regards to comorbidity improvement and resolution. The purpose of this study is to examine the impact a patient’s comorbid conditions have on the motivation to proceed with bariatric surgery. Furthermore, we examined the patient’s expectations regarding postoperative weight loss and comorbidity improvement.
Methods
Forty-five subjects completed a modified Goals and Relative Weights Questionnaire assessment 1 week prior to their anticipated bariatric surgery. The first portion addressed a patient’s personal weight loss goals and factors that influence their procedure selection. The second part assessed the expectations and evaluations of a variety of specifically determined weight loss outcomes.
Results
A total of 45 patients completed the survey (laparoscopic adjustable gastric band (LAGB) 23/45; Roux-en-Y gastric bypass (RNYGB) 22/45). The mean goal percentage of excess weight loss was 85.0% (21–130%). This translated to 80.2% (21–127%) in the LAGB group and 90.5% (37–130%) in the RNYGB group. Of 13 possible reasons, “a desire for change in medical comorbidities” was deemed as most important in choosing a goal weight. Comorbidities with the highest dissatisfaction level included urinary incontinence and hypertension. All patients expected some degree of comorbidity improvement at 1 year postsurgery, with 26% (6/23) expecting a resolution of their diabetes, 36% (10/28) expecting a resolution of hypertension, and 40% (10/25) expecting a resolution of obstructive sleep apnea.
Conclusion
A dissatisfaction with obesity-related comorbidities, most notably hypertension and urinary incontinence, was a motivating factor in choosing to undergo bariatric surgery. Patients expected improvement in their comorbid illnesses; however, they still possessed unrealistic weight loss expectations for their intended weight loss procedure.
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References
World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: The Organization; 2004. Report No.: Technical report series 894.
Wang Y, Beydoun MA, Liang L, et al. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity. 2008;16(10):2323–30.
National Institutes of Health. Clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults. Bethesda: National Institutes of Health; 1998.
Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.
White MA, Masheb RM, Burke-Martindale C, et al. Accuracy of self-reported weight among bariatric surgery candidates: the influence of race and weight cycling. Obesity (Silver Spring). 2007;15(11):2761–8.
Wadden TA, Butryn ML, Sarwer DB, et al. Comparison of psychosocial status in treatment-seeking women with class III vs. class I–II obesity. Surg Obes Relat Dis. 2006;2(2):138–45.
Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16(12):1622–9.
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.
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(1):79–85.
Eadie WT. Statistical methods in experimental physics. St. Louis: Elsevier; 1983.
Munoz DJ, Lal M, Chen EY, et al. Why patients seek bariatric surgery: a qualitative and quantitative analysis of patient motivation. Obes Surg. 2007;17(11):1487–91.
Kaly P, Orellana S, Torrella T, et al. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis. 2008;4(1):6–10.
The Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment program III). JAMA. 2001;285:2486–97.
Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998;15:539–53.
Bump RC, Sugerman HJ, Fantl JA, et al. Obesity and lower urinary tract function in women: effects of surgically induced weight loss. Am J Obstet Gynecol. 1992;167:392–7.
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Karmali, S., Kadikoy, H., Brandt, M.L. et al. What Is My Goal? Expected Weight Loss and Comorbidity Outcomes Among Bariatric Surgery Patients. OBES SURG 21, 595–603 (2011). https://doi.org/10.1007/s11695-009-0060-z
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DOI: https://doi.org/10.1007/s11695-009-0060-z