Obesity Surgery

, Volume 18, Issue 5, pp 517–524 | Cite as

Physical Activity Predicts Weight Loss Following Gastric Bypass Surgery: Findings from a Support Group Survey

  • Garry Welch
  • Cheryl Wesolowski
  • Bernadette Piepul
  • Jay Kuhn
  • John Romanelli
  • Jane Garb
Research Article

Abstract

Background

Patient adherence to recommended eating and physical activity behaviors is considered important to weight loss outcomes following gastric bypass surgery, but there has been little systematic research in this area to investigate behavioral predictors of weight loss.

Method

We developed a measure of postsurgical behaviors, the bariatric surgery self-management questionnaire (BSSQ). A survey was conducted of 200 patients attending postsurgical support groups (mean time since surgery 14 months, mean age 40 years, 85% female, presurgical weight 150 kg). Patients completed the BSSQ and measures of treatment regimen distress, perceived benefits of weight loss, and weight-related physical symptoms.

Results

Mean BSSQ adherence was in the 70% range, with subscale scores varying considerably. Distress levels associated with the new lifestyle were consistently low (≈20%) and perceived benefits of weight loss were high early on and maintained consistently (70–90%). A final predictive model showed premorbid weight, time since surgery, and BSSQ physical activity subscale were significant predictors of weight loss, accounting for 73% of variance.

Conclusions

Physical activity adherence was the sole significant behavioral predictor of weight loss, although maladaptive dietary habits and patient selection issues were identified for future research. It will be important to replicate the current study in prospective, longitudinal studies with representative patient cohorts. A challenge for researchers will be to develop novel, intensive recruiting and retention strategies to allow closer examination of these issues.

Keywords

RYGB Bariatric surgery Self management behaviors Distress Weight loss Benefits 

References

  1. 1.
    Wing R, Marinilli Pinto A, Niemeier H. Maintenance: the ultimate goal. In: Apovian CM, Lenders CM, editors. A clinical guide for management of overweight and obese children and adults. London: CRC Press; 2007.Google Scholar
  2. 2.
    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.PubMedCrossRefGoogle Scholar
  3. 3.
    Andrews G, LeMont D, Myers S. Caring for the surgical weight loss patient. Sierra Madre: Wheat Field Publishers; 2003.Google Scholar
  4. 4.
    McMahon M, Sarr M, Clark M, et al. Clinical management after bariatric surgery: value of a multidisciplinary team. Mayo Clin Proc. 2006;81:S34–45.PubMedGoogle Scholar
  5. 5.
    Colles S, Dixon J. Night eating syndrome: impact on bariatric surgery. Obes Surg. 2006;16:811–20.PubMedCrossRefGoogle Scholar
  6. 6.
    Saunders R. Grazing: a high risk behavior. Obes Surg. 2004;14:98–102.PubMedCrossRefGoogle Scholar
  7. 7.
    Elkins G, Whitfield P, Marcus J. Non-compliance with behavioral recommendations following bariatric surgery. Obes Surg. 2005;15.Google Scholar
  8. 8.
    Ware J, Kosinski M. SF-36 Physical and mental health summary scales: a manual for users of version 1. Lincoln: Quality Metric; 2001.Google Scholar
  9. 9.
    Patrick D, Bushnell D, Rothman M. Performance of two self-report measures for evaluating obesity and weight loss. Obes Res. 2004;12:48–57.PubMedCrossRefGoogle Scholar
  10. 10.
    Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.CrossRefGoogle Scholar
  11. 11.
    Streiner D, Norman G. Health measurement scales: a practical guide to their development and use. Oxford: Oxford University Press; 1989.Google Scholar
  12. 12.
    Kincaid J, Fishburne R, Rogers R. Derivation of new readability formulas (Automated Readability Index, Fog Count and Flesch Reading Ease Formula) for Navy enlisted personnel. Memphis: Naval Technical Training, U. S. Naval Air Station; 1975.Google Scholar
  13. 13.
    Snedecor G, Cochran W. Multiple linear regression. Statistical methods. 8th ed. Ames: Iowa State University Press; 1989.Google Scholar
  14. 14.
    SPSS. Statistical Package for the Social Sciences. 10.0 version. Chicago: SPSS; 1999.Google Scholar
  15. 15.
    Kuczmarski M, Kuczmarski R, Najjar M. Effects of age on validity of self-reported height, weight, and body mass index: findings from the Third National Health and Nurtition Examination Survey 1988–1994. J Am Diet Assoc. 2001;101:28–34.PubMedCrossRefGoogle Scholar
  16. 16.
    Nyholm M, Gullberg B, Merio J. The validity of obesity based on self-reported weight and height: implications for populations studies. Obesity. 2007;15:197–208.PubMedCrossRefGoogle Scholar
  17. 17.
    Renquist K, Jeng G, Mason E. Calculating follow-up rates. Obes Surg. 1992;2:361–7.PubMedCrossRefGoogle Scholar
  18. 18.
    Monteforte J, Turkelson C. Bariatric surgery for morbid obesity. Obes Surg. 2000;10:391–401.PubMedCrossRefGoogle Scholar
  19. 19.
    Christou N, Look D, Maclean L. Weight gain after short and long term limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.PubMedCrossRefGoogle Scholar
  20. 20.
    Courcoulas A, Flum D. Filling in the gaps in bariatric surgery research. JAMA. 2005;294:1957–60.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V. 2008

Authors and Affiliations

  • Garry Welch
    • 1
  • Cheryl Wesolowski
    • 2
  • Bernadette Piepul
    • 2
  • Jay Kuhn
    • 2
  • John Romanelli
    • 2
  • Jane Garb
    • 3
  1. 1.Behavioral Medicine ResearchBaystate Medical CenterSpringfieldUSA
  2. 2.Weight Loss Surgery ProgramBaystate Medical CenterSpringfieldUSA
  3. 3.Department of SurgeryBaystate Medical CenterSpringfieldUSA

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