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Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

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Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

Auteurs : Kevin O. Hwang ; Joseph H. Childs ; G. Ken Goodrick ; Wael A. Aboughali ; Eric J. Thomas ; Craig W. Johnson ; Sherman C. Yu ; Elmer V. Bernstam

Source :

Obesity surgery [ 0960-8923 ] ; 2008.

RBID : PMC:3063089

Abstract

Background

Our objective was to analyze subjective explanations for unsuccessful weight loss among bariatric surgery candidates.

Methods

This was a retrospective analysis of 909 bariatric surgery candidates (78.2% female, average body mass index [BMI] 47.3) at a university center from 2001 to April 2007 who answered an open-ended question about why they were unable to lose weight. We generated a coding scheme for answers to the question and established inter-rater reliability of the coding process. Associations with demographic parameters and initial BMI were tested.

Results

The most common categories of answers were nonspecific explanations related to diet (25.3%), physical activity (21.0%), or motivation (19.7%), followed by diet-related motivation (12.7%) and medical conditions or medications affecting physical activity (12.7%). Categories related to time, financial cost, social support, physical environment, and knowledge occurred in less than 4% each. Men were more likely than women to cite a medical condition or medication affecting physical activity (19.2% vs 10.8%, P=0.002, odds ratio [OR]=1.96, 95% confidence interval [CI]=1.28–2.99) but less likely to cite diet-related motivation (7.1% vs 14.2%, P=0.008, OR=0.46, 95% CI=0.26–0.82).

Conclusions

Our findings suggest that addressing diet, physical activity, and motivation in a comprehensive approach would meet the stated needs of obese patients. Raising patient awareness of under-recognized barriers to weight loss, such as the physical environment and lack of social support, should also be considered. Lastly, anticipating gender-specific attributions may facilitate tailoring of interventions.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063089

DOI: 10.1007/s11695-008-9573-0
PubMed: 18542846
PubMed Central: 3063089

Affiliations:

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Le document en format XML

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<author><name sortKey="Hwang, Kevin O" sort="Hwang, Kevin O" uniqKey="Hwang K" first="Kevin O." last="Hwang">Kevin O. Hwang</name>
</author>
<author><name sortKey="Childs, Joseph H" sort="Childs, Joseph H" uniqKey="Childs J" first="Joseph H." last="Childs">Joseph H. Childs</name>
</author>
<author><name sortKey="Goodrick, G Ken" sort="Goodrick, G Ken" uniqKey="Goodrick G" first="G. Ken" last="Goodrick">G. Ken Goodrick</name>
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<author><name sortKey="Aboughali, Wael A" sort="Aboughali, Wael A" uniqKey="Aboughali W" first="Wael A." last="Aboughali">Wael A. Aboughali</name>
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<author><name sortKey="Thomas, Eric J" sort="Thomas, Eric J" uniqKey="Thomas E" first="Eric J." last="Thomas">Eric J. Thomas</name>
</author>
<author><name sortKey="Johnson, Craig W" sort="Johnson, Craig W" uniqKey="Johnson C" first="Craig W." last="Johnson">Craig W. Johnson</name>
</author>
<author><name sortKey="Yu, Sherman C" sort="Yu, Sherman C" uniqKey="Yu S" first="Sherman C." last="Yu">Sherman C. Yu</name>
</author>
<author><name sortKey="Bernstam, Elmer V" sort="Bernstam, Elmer V" uniqKey="Bernstam E" first="Elmer V." last="Bernstam">Elmer V. Bernstam</name>
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<author><name sortKey="Yu, Sherman C" sort="Yu, Sherman C" uniqKey="Yu S" first="Sherman C." last="Yu">Sherman C. Yu</name>
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<author><name sortKey="Bernstam, Elmer V" sort="Bernstam, Elmer V" uniqKey="Bernstam E" first="Elmer V." last="Bernstam">Elmer V. Bernstam</name>
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<series><title level="j">Obesity surgery</title>
<idno type="ISSN">0960-8923</idno>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Our objective was to analyze subjective explanations for unsuccessful weight loss among bariatric surgery candidates.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">This was a retrospective analysis of 909 bariatric surgery candidates (78.2% female, average body mass index [BMI] 47.3) at a university center from 2001 to April 2007 who answered an open-ended question about why they were unable to lose weight. We generated a coding scheme for answers to the question and established inter-rater reliability of the coding process. Associations with demographic parameters and initial BMI were tested.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The most common categories of answers were nonspecific explanations related to diet (25.3%), physical activity (21.0%), or motivation (19.7%), followed by diet-related motivation (12.7%) and medical conditions or medications affecting physical activity (12.7%). Categories related to time, financial cost, social support, physical environment, and knowledge occurred in less than 4% each. Men were more likely than women to cite a medical condition or medication affecting physical activity (19.2% vs 10.8%, <italic>P</italic>
=0.002, odds ratio [OR]=1.96, 95% confidence interval [CI]=1.28–2.99) but less likely to cite diet-related motivation (7.1% vs 14.2%, <italic>P</italic>
=0.008, OR=0.46, 95% CI=0.26–0.82).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our findings suggest that addressing diet, physical activity, and motivation in a comprehensive approach would meet the stated needs of obese patients. Raising patient awareness of under-recognized barriers to weight loss, such as the physical environment and lack of social support, should also be considered. Lastly, anticipating gender-specific attributions may facilitate tailoring of interventions.</p>
</sec>
</div>
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  <front><journal-meta><journal-id journal-id-type="nlm-journal-id">9106714</journal-id>
<journal-id journal-id-type="pubmed-jr-id">20877</journal-id>
<journal-id journal-id-type="nlm-ta">Obes Surg</journal-id>
<journal-title>Obesity surgery</journal-title>
<issn pub-type="ppub">0960-8923</issn>
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<article-id pub-id-type="manuscript">NIHMS199291</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Hwang</surname>
<given-names>Kevin O.</given-names>
</name>
<aff id="A1">Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, USA</aff>
<email>Kevin.O.Hwang@uth.tmc.edu</email>
</contrib>
<contrib contrib-type="author"><name><surname>Childs</surname>
<given-names>Joseph H.</given-names>
</name>
<aff id="A2">The University of Texas Medical School at Houston, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Goodrick</surname>
<given-names>G. Ken</given-names>
</name>
<aff id="A3">Department of Cardiothoracic and Vascular Surgery, UT Physicians, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Aboughali</surname>
<given-names>Wael A.</given-names>
</name>
<aff id="A4">Department of Family and Community Medicine, The University of Texas Medical School at Houston, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Thomas</surname>
<given-names>Eric J.</given-names>
</name>
<aff id="A5">Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Johnson</surname>
<given-names>Craig W.</given-names>
</name>
<aff id="A6">The University of Texas School of Health Information Sciences at Houston, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Yu</surname>
<given-names>Sherman C.</given-names>
</name>
<aff id="A7">Department of Surgery, The University of Texas Medical School at Houston, Houston, TX, USA</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Bernstam</surname>
<given-names>Elmer V.</given-names>
</name>
<aff id="A8">Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX, USA</aff>
<aff id="A9">The University of Texas School of Health Information Sciences at Houston, Houston, TX, USA</aff>
</contrib>
</contrib-group>
<pub-date pub-type="nihms-submitted"><day>7</day>
<month>5</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>6</month>
<year>2008</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>23</day>
<month>3</month>
<year>2011</year>
</pub-date>
<volume>19</volume>
<issue>10</issue>
<fpage>1377</fpage>
<lpage>1383</lpage>
<permissions><copyright-statement>© Springer Science + Business Media, LLC 2008</copyright-statement>
<copyright-year>2008</copyright-year>
</permissions>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Our objective was to analyze subjective explanations for unsuccessful weight loss among bariatric surgery candidates.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">This was a retrospective analysis of 909 bariatric surgery candidates (78.2% female, average body mass index [BMI] 47.3) at a university center from 2001 to April 2007 who answered an open-ended question about why they were unable to lose weight. We generated a coding scheme for answers to the question and established inter-rater reliability of the coding process. Associations with demographic parameters and initial BMI were tested.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">The most common categories of answers were nonspecific explanations related to diet (25.3%), physical activity (21.0%), or motivation (19.7%), followed by diet-related motivation (12.7%) and medical conditions or medications affecting physical activity (12.7%). Categories related to time, financial cost, social support, physical environment, and knowledge occurred in less than 4% each. Men were more likely than women to cite a medical condition or medication affecting physical activity (19.2% vs 10.8%, <italic>P</italic>
=0.002, odds ratio [OR]=1.96, 95% confidence interval [CI]=1.28–2.99) but less likely to cite diet-related motivation (7.1% vs 14.2%, <italic>P</italic>
=0.008, OR=0.46, 95% CI=0.26–0.82).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Our findings suggest that addressing diet, physical activity, and motivation in a comprehensive approach would meet the stated needs of obese patients. Raising patient awareness of under-recognized barriers to weight loss, such as the physical environment and lack of social support, should also be considered. Lastly, anticipating gender-specific attributions may facilitate tailoring of interventions.</p>
</sec>
</abstract>
<kwd-group><kwd>Morbid obesity</kwd>
<kwd>Bariatric surgery</kwd>
<kwd>Barriers</kwd>
</kwd-group>
<contract-num rid="DK1">T35 DK007676-15
				||DK</contract-num>
<contract-sponsor id="DK1">National Institute of Diabetes and Digestive and Kidney Diseases  : NIDDK</contract-sponsor>
</article-meta>
</front>
</pmc>
<affiliations><list></list>
<tree><noCountry><name sortKey="Aboughali, Wael A" sort="Aboughali, Wael A" uniqKey="Aboughali W" first="Wael A." last="Aboughali">Wael A. Aboughali</name>
<name sortKey="Bernstam, Elmer V" sort="Bernstam, Elmer V" uniqKey="Bernstam E" first="Elmer V." last="Bernstam">Elmer V. Bernstam</name>
<name sortKey="Childs, Joseph H" sort="Childs, Joseph H" uniqKey="Childs J" first="Joseph H." last="Childs">Joseph H. Childs</name>
<name sortKey="Goodrick, G Ken" sort="Goodrick, G Ken" uniqKey="Goodrick G" first="G. Ken" last="Goodrick">G. Ken Goodrick</name>
<name sortKey="Hwang, Kevin O" sort="Hwang, Kevin O" uniqKey="Hwang K" first="Kevin O." last="Hwang">Kevin O. Hwang</name>
<name sortKey="Johnson, Craig W" sort="Johnson, Craig W" uniqKey="Johnson C" first="Craig W." last="Johnson">Craig W. Johnson</name>
<name sortKey="Thomas, Eric J" sort="Thomas, Eric J" uniqKey="Thomas E" first="Eric J." last="Thomas">Eric J. Thomas</name>
<name sortKey="Yu, Sherman C" sort="Yu, Sherman C" uniqKey="Yu S" first="Sherman C." last="Yu">Sherman C. Yu</name>
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Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

Explanations for Unsuccessful Weight Loss Among Bariatric Surgery Candidates

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Abstract

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