Patient-Related Predictors for Seeking and Receiving Obesity Surgery

Sonja Elisabeth Sauerbrey; Ricarda Schmidt; Haiko Schlögl; Matthias Blüher; Arne Dietrich; Anja Hilbert

doi:10.1159/000531353

Patient-Related Predictors for Seeking and Receiving Obesity Surgery

Obes Facts. 2023;16(5):447-456. doi: 10.1159/000531353. Epub 2023 Jun 3.

Authors

Sonja Elisabeth Sauerbrey¹, Ricarda Schmidt², Haiko Schlögl^{3

4}, Matthias Blüher⁴, Arne Dietrich⁵, Anja Hilbert²

Affiliations

¹ Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany, Sonja.Sauerbrey@medizin.uni-leipzig.de.
² Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany.
³ Department of Medicine, University Hospital Leipzig, Leipzig, Germany.
⁴ Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Zentrum München, University of Leipzig, Leipzig, Germany.
⁵ Department of Visceral, Transplant, Thoracic and Vascular Surgery, Bariatric Surgery Section, University Hospital Leipzig, Leipzig, Germany.

Abstract

Introduction: The decision for obesity surgery (OS) is complex and strongly driven by patients' preference. This study aimed to examine patients' preference for OS before and after behavioral weight loss treatment (BWLT), associated patient characteristics, its role in predicting the receipt of OS after BWLT, and potential mediators.

Methods: Data of N = 431 adults with obesity starting a 1-year routine care obesity BWLT were analyzed. Patients were interviewed before (pre-BWLT) and after BWLT (post-BWLT) regarding their preference for OS, and anthropometric, medical, and psychological data were collected.

Results: Only a minority of patients (11.6%) had an explicit preference for OS pre-BWLT. Post-BWLT, the number of patients preferring OS significantly increased (27.4%). Patients with a constant or emerging preference for OS showed less favorable anthropometric, psychological, and medical characteristics than patients without or with a vanishing preference for OS. Patients' pre-BWLT preference for OS significantly predicted receiving OS post-BWLT. This association was mediated by higher body mass index pre- and post-BWLT, but not by less percentage total body weight loss (%TBWL) through BWLT.

Conclusion: Although the preference for OS pre-BWLT predicted the receipt of OS post-BWLT, it was not associated with %TBWL during BWLT. Further prospective studies with multiple assessment time points during BWLT may help understand when and why patients' attitude toward OS changes, and identify possible mediators on the association between the preference and receipt of OS.

Keywords: Bariatric surgery; Behavioral weight loss treatment; Obesity surgery; Preference; Serial mediation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Bariatric Surgery*
Behavior Therapy
Body Mass Index
Humans
Obesity / psychology
Obesity / surgery
Obesity, Morbid* / surgery
Prospective Studies
Treatment Outcome

Grants and funding

This research was funded by the Federal Ministry of Education and Research (BMBF), Germany, Grant No. 01EO1501, and the Open Access Publishing Fund of the University of Leipzig supported by the German Research Foundation within the program Open Access Publication Funding. These sources played no role in the collection, analysis and reporting of data, and preparation of the manuscript.