Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery
Factors contributing to adolescents’ non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery.
The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery (“completers”) or withdrew from treatment (“non-completers”).
Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital.
A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions.
Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p < .05), and there was a trend towards non-completion for older adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion.
These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.
KeywordsAdolescent bariatric surgery Predictors of surgery non-completion Caregiver weight loss surgery Attrition
We acknowledge Linda Kollar, RN, MSN, CBN, Cassandra McDaniel, BA, Kathy Hrovat, MS, RD, LD, and Taylor Howarth, BA, for their contributions to this work.
Compliance with Ethical Standards
The current study received Institutional Review Board approval.
Conflict of Interest
The authors declare that they have no conflict of interest.
Formal consent is not required for data collection as part of routine clinical practice.
Statement of Human and Animal Rights
This study received institutional review board approval. All procedures performed were in accordance with institutional and national ethical standards of studies involving human participants.
The first author was supported by a training grant from the National Institutes of Health (T32DK063929).
- 1.Kelly AS, Barlow SE, Rao G, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches. A scientific statement from the American Heart Association. Circulation. 2013;128:1689–712. https://doi.org/10.1161/CIR.0b013e3182a5cfb3.CrossRefGoogle Scholar
- 15.Schor EL. Family pediatrics: report of the task force on the family. Pediatrics. 2003;111:1541–71.Google Scholar
- 19.Gundersen, C, Mahatmya D, Garasky S, Lohman, B. Linking psychosocial stressors and childhood obesity. Obes Rev 2010; 12: e54-e63. https://doi.org/10.1111/j.1467-789x.2010.00813.x.
- 20.American Psychiatric Association. Diagnostic and statistical manual of mental disorders, revised. 4th ed.Washington DC: American Psychiatric Association; 2000. https://doi.org/10.1007/springerreference_179660.
- 21.Statistics IS SPSS version 21.0 for Microsoft windows platform. SPSS Inc.: Chicago, IL, USA, 2012.Google Scholar
- 22.Muthén LK, Muthén BO. Mplus version 7: Los Angeles, Muthén & Muthén; 1998-2014.Google Scholar
- 26.Tudiver F, Talbot Y. Why don’t men seek help? Family physicians’ perspective on help-seeking behavior in men. J Family Pract. 1999;48:47–52.Google Scholar