Patient Perspective in Obesity Surgery: Goals for Weight Loss and Improvement of Body Shape in a Prospective Cohort Study

Objective: Obesity surgery provides sustainable weight loss, improvement of comorbidities, and improved quality of life (QOL). There is few evidence on the patient perspective and goals. This study compared expected and achieved weight loss, body shape, and QOL. Methods: Patients completed the Moorehead-Ardelt QOL questionnaire (MAQOL) and questionnaires on actual and expected weight loss and body shape, comorbidities, and goals of obesity surgery preoperatively and within 24 months postoperatively. Results: 44 patients completed questionnaires pre- and postoperatively. BMI, MAQOL and comorbidities significantly improved postoperatively. Patients’ expected weight loss goal corresponded to a postoperative BMI of 32.6 ± 5.6 kg/m2 and was not different from their achieved BMI within 24 months after surgery (33.9 ± 6.3 kg/m2, p = 0.276). Self-reported body shape improved but did not reach preoperatively expected goals. During the weight loss period, patients adapted their weight loss and body shape goals to higher levels. Patients attributed a higher part of their success in weight loss to surgery postoperatively (79.5 ± 22.0 vs. 89.1 ± 18.4%, p = 0.028). Conclusion: Patients lost as much weight as they had expected and later modified the goals to even greater weight loss. Body shape improved but did not reach expected levels. QOL improved independently from weight loss and body shape. Patients attributed successful weight loss predominantly to surgery.

[1]  A. Elander,et al.  Self-image after bariatric surgery and its relationship to gender, excess skin and health-related quality of life , 2018, Journal of plastic surgery and hand surgery.

[2]  H. Kenngott,et al.  Gastrointestinal Quality of Life Improves Significantly After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—a Prospective Cross-Sectional Study Within a 2-Year Follow-up , 2017, Obesity Surgery.

[3]  M. Büchler,et al.  Influence of bariatric surgery on quality of life, body image, and general self-efficacy within 6 and 24 months-a prospective cohort study. , 2017, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[4]  B. Müller-Stich,et al.  Is there a Reason Why Obese Patients Choose Either Conservative Treatment or Surgery? , 2017, Obesity Surgery.

[5]  H. Kenngott,et al.  Renal Function in Type 2 Diabetes Following Gastric Bypass. , 2016, Deutsches Arzteblatt international.

[6]  M. Büchler,et al.  Combined Non-alcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: Sleeve Gastrectomy or Gastric Bypass?—a Controlled Matched Pair Study of 34 Patients , 2016, Obesity Surgery.

[7]  G. Twig,et al.  Body-Mass Index in 2.3 Million Adolescents and Cardiovascular Death in Adulthood. , 2016, The New England journal of medicine.

[8]  T. Rainis,et al.  Sleeve Gastrectomy in Different Age Groups: a Comparative Study of 5-Year Outcomes , 2016, Obesity Surgery.

[9]  S. Upala,et al.  Bariatric surgery reduces risk of endometrial cancer. , 2015, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[10]  S. Gudbjörnsdottir,et al.  Cardiovascular disease and mortality in patients with type 2 diabetes after bariatric surgery in Sweden: a nationwide, matched, observational cohort study. , 2015, The lancet. Diabetes & endocrinology.

[11]  H. Kenngott,et al.  Surgical versus medical treatment of type 2 diabetes mellitus in nonseverely obese patients: a systematic review and meta-analysis. , 2015, Annals of surgery.

[12]  R. Kolotkin,et al.  Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. , 2015, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[13]  L. Twells,et al.  Body shape expectations and self-ideal body shape discrepancy in women seeking bariatric surgery: a cross-sectional study , 2014, BMC Obesity.

[14]  M. Büchler,et al.  Patient expectations of bariatric surgery are gender specific--a prospective, multicenter cohort study. , 2014, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[15]  K. Flegal,et al.  Prevalence of childhood and adult obesity in the United States, 2011-2012. , 2014, JAMA.

[16]  R. Ceneviva,et al.  [Body perception and bariatric surgery: the ideal and the possible]. , 2013, Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery.

[17]  J. Oppert,et al.  Obesity: The Gateway to Ill Health – an EASO Position Statement on a Rising Public Health, Clinical and Scientific Challenge in Europe , 2013, Obesity Facts.

[18]  H. Buchwald,et al.  Metabolic/Bariatric Surgery Worldwide 2011 , 2013, Obesity Surgery.

[19]  R. Gómez-Huelgas [Bariatric surgery versus conventional medical therapy for type 2 diabetes]. , 2012, Revista clinica espanola.

[20]  H. Kenngott,et al.  Excessive Weight Loss after Sleeve Gastrectomy: A Systematic Review , 2012, Obesity Surgery.

[21]  S. Blair,et al.  Edmonton Obesity Staging System: association with weight history and mortality risk. , 2011, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[22]  S. Ledoux,et al.  The Impact of Bariatric Surgery on Comorbidities and Medication Use Among Obese Patients , 2010, Obesity surgery.

[23]  R. Pasquali,et al.  Obesity and infertility , 2007, Current opinion in endocrinology, diabetes, and obesity.

[24]  L. Gonder-Frederick,et al.  Evaluation of expectations and knowledge in bariatric surgery patients. , 2007, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[25]  E. Mathus-Vliegen,et al.  Long-Term Weight Loss after Bariatric Surgery in Patients Visited at Home Outside the Study Environment , 2006, Obesity surgery.

[26]  Daniel B. Jones,et al.  Understanding Patients' Value of Weight Loss and Expectations for Bariatric Surgery , 2006, Obesity surgery.

[27]  Melodie K. Moorehead,et al.  The Validation of the Moorehead-Ardelt Quality of Life Questionnaire II , 2003, Obesity surgery.

[28]  J. Seidell,et al.  Epidemiology of obesity. , 2002, Seminars in vascular medicine.

[29]  Ronette L. Kolotkin,et al.  Quality of life and obesity , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[30]  NG Martin,et al.  Relating body mass index to figural stimuli: population-based normative data for Caucasians , 2001, International Journal of Obesity.

[31]  J. Melissas,et al.  Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study. , 2015, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.

[32]  N. Bansback,et al.  The incidence of co-morbidities related to obesity and overweight: A systematic review and meta-analysis , 2009, BMC Public Health.

[33]  M. Murr,et al.  Unrealistic weight loss expectations in candidates for bariatric surgery. , 2008, Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery.