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Predictors of Preoperative Weight Loss in Morbidly Obese Adults Waiting for Bariatric Surgery: A Prospective Cohort Study

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Abstract

Background

Preoperative weight loss is encouraged before bariatric surgery, as it is associated with improved surgical conditions. It has also been related to better postoperative outcomes, but this relationship is less clear. However, little is known about what predicts weight loss preoperatively, so the aim was to identify psychosocial and clinical predictors of preoperative weight loss.

Methods

Weight was measured at the first visit, the time of surgery approval, and on the day of surgery in 286 bariatric surgery patients (227 women). A questionnaire consisting of multiple psychosocial measures was completed before surgery.

Results

Preoperatively, patients experienced a mean weight loss of 3.8 %. Men lost significantly more weight than women (mean = 5.4, SD = 6.0 vs. mean = 3.4, SD = 5.8, t = −2.3, p < 0.05), and 43.2 % of the patients lost ≥5% of their body weight. A high weight loss goal (β = 0.20, p < 0.001), frequent self-weighing (β = 0.18, p < 0.002), and being close to or at highest lifetime weight when applying for surgery (β = −0.30, p < 0.0001) were identified as predictors of weight loss, after controlling for body mass index (BMI), gender, and length of preoperative time period.

Conclusions

A relatively low proportion of patients lost the recommended weight preoperatively. Our results indicate that patients benefit from monitoring weight preoperatively and that allowing patients to keep their high weight loss goals may contribute to higher weight loss. Further investigation of these predictors could provide valuable knowledge regarding how to support and motivate patients to lose weight preoperatively.

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Acknowledgments

Falko F. Sniehotta is funded by Fuse, the Centre for Translational Research in Public Health, a UK Clinical Research Collaboration Public Health Research Centre of Excellence based on funding from the British Heart Foundation, Cancer Research United Kingdom, Economic and Social Research Council, Medical Research Council, and the National Institute for Health

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Psychology, University of Oslo, P.O. Box 1094 Blindern, N-0317, Oslo, Norway

    Irmelin Bergh & Ingela Lundin Kvalem

  2. Centre of Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway

    Hilde Risstad

  3. Psychological Sciences, University of California, Merced, 5200 North Lake Road, Merced, CA, 95343, USA

    Linda D. Cameron

  4. Institute of Health & Society, Newcastle University, Newcastle, NE2 4AX, UK

    Falko F. Sniehotta

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  1. Irmelin Bergh
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Correspondence to Irmelin Bergh.

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Bergh, I., Kvalem, I.L., Risstad, H. et al. Predictors of Preoperative Weight Loss in Morbidly Obese Adults Waiting for Bariatric Surgery: A Prospective Cohort Study. OBES SURG 25, 1610–1617 (2015). https://doi.org/10.1007/s11695-015-1569-y

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