Skip to main content
SpringerLink
Log in

Relevance of Self-reported Behavioral Changes Before Bariatric Surgery to Predict Success After Surgery

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

International guidelines emphasize the need for multidisciplinary preparation to improve the safety and effectiveness of bariatric surgery (BS), but whether the patient is ready for surgery is difficult to assess. The objective of this study was to explore whether inquiries on dietary habits and physical activity before surgery are predictive of postoperative weight loss.

Methods

We prospectively assessed in 78 candidates for BS (age, 43 ± 12 years; M/F, 15/63; weight, 122 ± 17 kg; IMC, 44 ± 5 kg/m2) anthropometric parameters, food intake, and physical activity (Baecke questionnaire) at the beginning and the end of a systematized preoperative preparation (7 ± 2 months) including consultations (mean number 7 ± 2) with a nutritionist, dietician, psychologist, and sports coach.

Results

During the preparation, weight change was zero (±5 kg). In contrast, self-reported caloric intake decreased from 2143 ± 640 to 1906 ± 564 kcal/24 h (p < 0.001) and snacking from 68 to 13% during the preparation. Self-reported physical activity increased (p < 0.05). The decrease in reported caloric intake was positively correlated with the mean number of preoperative consultations attended (R = 0.2885, p < 0.05) but not with the changes in preoperative weight. Postsurgical weight loss (recorded at 6 and 12 months) was correlated with preoperative changes in weight and physical activity but not with preoperative dietary changes.

Conclusions

Self-reported improvement of dietary habits is not a good reflection of actual changes in dietary behavior among candidates for bariatric surgery, as illustrated by the absence of weight changes on average during the preoperative preparation. In contrast to dietary inquiry, self-reported changes in physical activity are predictive of postoperative weight loss after bariatric surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Coupaye M, Sabate JM, Castel B, et al. Predictive factors of weight loss 1 year after laparoscopic gastric bypass in obese patients. Obes Surg. 2010;20(12):1671–7.

    Article  PubMed  Google Scholar 

  2. Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.

    Article  PubMed  Google Scholar 

  3. Sun K, Tordjman J, Clément K, et al. Fibrosis and adipose tissue dysfunction. Cell Metab. 2013;18(4):470–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Minami CA, Stulberg JJ, Hungness ES. Partnering behavioral modification with bariatric surgery. JAMA. 2016;316(4):448–9.

    Article  PubMed  Google Scholar 

  6. Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55.

    Article  CAS  PubMed  Google Scholar 

  7. 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 for Metabolic & Bariatric Surgery. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2013;9(2):159–91.

    Article  Google Scholar 

  8. Giusti V, Schwab L, Benoit M. Bariatric surgery: what is the ideal length of the preoperative track? Rev Med Suisse. 2015;11(467):720. 722-725

    CAS  PubMed  Google Scholar 

  9. Brandenburg D, Kotlowski R. Practice makes perfect? Patient response to a prebariatric surgery behavior modification program. Obes Surg. 2005;15(1):125–32.

    Article  PubMed  Google Scholar 

  10. Patel P, Hartland A, Hollis A, et al. Tier 3 multidisciplinary medical weight management improves outcome of Roux-en-Y gastric bypass surgery. The Annals of The Royal College of Surgeons of England. 2015;97(3):235–7.

    Article  CAS  PubMed  Google Scholar 

  11. Mahawar K, Parmar C, Carr WJ, et al. Preoperative interventions for patients being considered for bariatric surgery: separating the fact from fiction. Obes Surg. 2015;25(8):1527–33.

    Article  PubMed  Google Scholar 

  12. Stewart F, Avenell A. Behavioural interventions for severe obesity before and/or after bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2016;26(6):1203–14.

    Article  PubMed  Google Scholar 

  13. Ledoux S, Msika S, Moussa F, et al. Comparison of nutritional consequences of conventional therapy of obesity, adjustable gastric banding, and gastric bypass. Obes Surg. 2006;16(8):1041–9.

    Article  PubMed  Google Scholar 

  14. Coupaye M, Rivière P, Breuil M, et al. Comparison of nutritional status during the first year after sleeve gastrectomy and Roux-en-Y gastric bypass. Obes Surg. 2014;24(2):276–83.

    Article  PubMed  Google Scholar 

  15. Baecke JA, Burema J, Frijters JE. A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr. 1982;36(5):936–42.

    CAS  PubMed  Google Scholar 

  16. Jenkinson C, Wright L, Coulter A. Criterion validity and reliability of the SF-36 in a population sample. Qual Life Res. 1994;3(1):7–12.

    Article  CAS  PubMed  Google Scholar 

  17. Rudolph A, Hilbert A. Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2013;14(4):292–302.

    Article  CAS  PubMed  Google Scholar 

  18. Madan A, Dhawan N, Coday M, et al. Patients who are delayed from undergoing bariatric surgery do not have improved weight loss. Obes Surg. 2008;18(3):278–81.

    Article  PubMed  Google Scholar 

  19. El Chaar M, McDeavitt K, Richardson S, et al. Does patient compliance with preoperative bariatric office visits affect postoperative excess weight loss? Surg Obes Relat Dis. 2011;7(6):743–8.

    Article  PubMed  Google Scholar 

  20. Orth W, Madan A, Ternovits C, et al. Effect of preoperative knowledge on weight loss after laparoscopic gastric bypass. Obes Surg. 2008;18(7):768–71.

    Article  PubMed  Google Scholar 

  21. Ashton K, Heinberg L, Windover A, et al. Positive response to binge eating intervention enhances postoperative weight loss. Surg Obes Relat Dis. 2011;7(3):315–20.

    Article  PubMed  Google Scholar 

  22. Heber D, Greenway FL, Kaplan LM, et al. Endocrine and nutritional management of the post-bariatric surgery patient: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 2010;95(11):4823–43.

    Article  CAS  Google Scholar 

  23. Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.

    Article  PubMed  Google Scholar 

  24. Ochner CN, Dambkowski CL, Yeomans BL, et al. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes. 2012;36(11):1380–7.

    Article  CAS  Google Scholar 

  25. Altieri MS, Tuppo C, Telem DA, et al. Predictors of a successful medical weight loss program. Surg Obes Relat Dis. 2015;11(2):431–5.

    Article  PubMed  Google Scholar 

  26. Jamal MK, DeMaria EJ, Johnson JM, et al. Insurance-mandated preoperative dietary counseling does not improve outcome and increases dropout rates in patients considering gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2008;2(2):122–7.

    Article  Google Scholar 

  27. Ali MR, Baucom-Pro S, Broderick-Villa GA, et al. Weight loss before gastric bypass: feasibility and effect on postoperative weight loss and weight loss maintenance. Surg Obes Relat Dis. 2006;3(5):515–20.

    Article  Google Scholar 

  28. King WC, Belle SH, Eid GM, et al. Physical activity levels of patients undergoing bariatric surgery in the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2008;4(6):721–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Baillot A, Mampuya WM, Comeau E, et al. Feasibility and impacts of supervised exercise training in subjects with obesity awaiting bariatric surgery: a pilot study. Obes Surg. 2013;23(7):882–91.

    Article  CAS  PubMed  Google Scholar 

  30. Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after Roux-en-Y gastric bypass. Obesity. 2009;17(1):92–9.

    Article  PubMed  Google Scholar 

  31. Berglind D, Willmer M, Tynelius P, et al. Accelerometer-measured versus self-reported physical activity levels and sedentary behavior in women before and 9 months after Roux-en-Y gastric bypass. Obes Surg. 2016;26(7):1463–70.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank the staff of the obesity center of Hôpital Louis Mourier for their assistance and Isaure Larger and Cyprien Larger for computing the questionnaires.

Author information

Authors and Affiliations

  1. Explorations Fonctionnelles, Centre de Référence de l’Obésité, Hôpital Louis Mourier (AP-HP), 92700 Colombes and Université Denis Diderot, PRES Sorbonne Paris cité, Paris, France

    Séverine Ledoux, Ouidad Sami, Marie-Christine Breuil, Marie Delapierre & Muriel Coupaye

  2. Service de Chirurgie, Centre de référence de l’Obésité, Hôpital Louis Mourier (AP-HP), 92700 Colombes and Université Denis Diderot, PRES Sorbonne Paris cité, Paris, France

    Daniela Calabrese & Simon Msika

Authors
  1. Séverine Ledoux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ouidad Sami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marie-Christine Breuil
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie Delapierre
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniela Calabrese
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Simon Msika
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Muriel Coupaye
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Séverine Ledoux.

Ethics declarations

Funding

No funding

Conflict of Interest

The authors declare that they have no competing interests.

Electronic Supplementary Material

ESM 1

(DOCX 27 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ledoux, S., Sami, O., Breuil, MC. et al. Relevance of Self-reported Behavioral Changes Before Bariatric Surgery to Predict Success After Surgery. OBES SURG 27, 1453–1459 (2017). https://doi.org/10.1007/s11695-016-2496-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-016-2496-2

Keywords

Search

Navigation