Predictors of Preoperative Weight Loss in Morbidly Obese Adults Waiting for Bariatric Surgery: A Prospective Cohort Study
- 542 Downloads
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.
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.
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.
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.
KeywordsBariatric surgery Preoperative weight loss Morbidly obese Psychosocial
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.
- 2.Weinstein A, Marascalchi B, Spiegel M, Saunders J, Fagerlin A, Parikh M. Patient Preferences and Bariatric Surgery Procedure Selection; the Need for Shared Decision-Making. OBES SURG. 2014 2014/05/01:1–7. English.Google Scholar
- 12.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. Surg Obes Relat Dis. 2013;9(2):159–91.PubMedCrossRefGoogle Scholar
- 13.Ochner CN, Dambkowski CL, Yeomans BL, Teixeira J, Xavier Pi-Sunyer F. Pre-bariatric surgery weight loss requirements and the effect of preoperative weight loss on postoperative outcome. Int J Obes. 2012Google Scholar
- 22.National Institutes of Health Consensus Development Conference Statement. Gastrointestinal surgery for severe obesity. Am J Clin Nutr. 1992;55(2):615S–9S.Google Scholar
- 27.Schwarzer R, Born A. Optimistic self-beliefs: assessment of general perceived self-efficacy in thirteen cultures. World Psychol. 1997;3:177–90.Google Scholar
- 29.Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press; 1965.Google Scholar
- 30.Tambs K. Valg av sporsmal til kortversjoner av etablerte psykometriske instrumenter. Forslag til fremgangsmate og noen eksempler. Ubevisst sjeleliv og bevisst samfunnsliv Psykisk helse i en sammenheng Festskrift til Tom Sorensens 60 ars jubileum. 2004:29–48.Google Scholar
- 35.Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale, N. J: Laurence Erlbaum; 1988.Google Scholar
- 37.Adams ST, Salhab M, Hussain ZI, Miller GV, Leveson SH. Roux-en-Y gastric bypass for morbid obesity: what are the preoperative predictors of weight loss? Postgrad Med J. 2013 Mar 7. PubMed PMID: 23472004. Epub 2013/03/09. EngGoogle Scholar