Skip to main content
Log in

A Survey of Bariatric Surgery Patients’ Interest in Postoperative Interventions

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

A substantial minority of bariatric surgery patients display clinically significant weight regain and recurrence of obesity-related comorbidities. Although postoperative follow-up and behavioral interventions are associated with better weight loss outcomes, many patients fail to attend or receive these services. More information is needed to better target and increase the probability of sustained treatment in those patients experiencing postoperative weight regain. The purpose of this study was to understand the challenges that patients perceive themselves to be facing and assess their receptivity and preferences for postoperative interventions.

Methods

A survey developed by the authors was sent to patients who received bariatric surgery from a program based in an academic medical center between September 2008 and December 2010 (n = 751).

Results

Data from 154 responders indicate that the vast majority of individuals who have undergone bariatric surgery are satisfied with surgery and their weight losses; however, most reported being on a trajectory of weight regain. Patients endorsed concerns about both current eating behavior and, additional, future weight regain. In addition, these patients expressed strong interest in participating in postoperative programs aimed at stopping and reversing regain.

Conclusions

The results provide novel information about bariatric surgery patients’ receptivity to and preferences for interventions after bariatric surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity. 2013;21:S1–27.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  2. Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord. 1998;22:113–26.

    Article  PubMed  CAS  Google Scholar 

  3. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.

    Article  PubMed  Google Scholar 

  4. Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  5. Adams TD, Davidson LE, Litwin SE, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308:1122–31.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  6. Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.

    PubMed  CAS  PubMed Central  Google Scholar 

  7. Melton GB, Steele KE, Schweitzer MA, et al. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastroinest Surg. 2008;12:250–5.

    Article  Google Scholar 

  8. Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4:640–6.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Sarwer DB, Dilks RJ, West-Smith L. Dietary intake and eating behavior after bariatric surgery: threats to weight loss maintenance and strategies for success. Surg Obes Relat Dis. 2011;7:644–51.

    Article  PubMed  Google Scholar 

  10. Sarwer DB, Moore RH, Spitzer JC, et al. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Surg Obes Relat Dis. 2012;8:561–8.

    Article  PubMed  Google Scholar 

  11. Peacock JC, Zizzi SJ. Survey of bariatric surgery patients’ experiences with behavioral and psychological services. Surg Obes Relat Dis. 2012;8:777–83.

    Article  PubMed  Google Scholar 

  12. Compher CW, Hanlon A, Kang Y, et al. Attendance at clinical visits predicts weight loss after gastric bypass surgery. Obes Surg. 2012;22:927–34.

    Article  PubMed  Google Scholar 

  13. Harper J, Madan AK, Ternovits CA, et al. What happens to patients who do not follow-up after bariatric surgery? Am Surg. 2007;73:181–4.

    PubMed  Google Scholar 

  14. Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2010;76:1139–42.

    PubMed  Google Scholar 

  15. Pontiroli AE, Fossati A, Vedani P, et al. Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients. Obes Surg. 2007;17:1492–7.

    Article  PubMed  Google Scholar 

  16. Shen R, Dugay G, Rajaram K, et al. Impact of patient follow-up on weight loss after bariatric surgery. Obes Surg. 2004;14:514–9.

    Article  PubMed  Google Scholar 

  17. Rudolph A, Hilbert A. Post-operative behavioural management in bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Obes Rev. 2013;14:292–302.

    Article  PubMed  CAS  Google Scholar 

  18. Gould JC, Beverstein G, Reinhardt S, et al. Impact of routine and long-term follow-up on weight loss after laparoscopic gastric bypass. Surg Obes Relat Dis. 2007;3:627–30.

    Article  PubMed  Google Scholar 

  19. Toussi R, Fujioka K, Coleman KJ. Pre- and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obesity. 2009;17:996–1002.

    Article  PubMed  Google Scholar 

  20. Kalarchian MA, Marcus MD, Courcoulas AP, et al. Optimizing long-term weight control after bariatric surgery: a pilot study. Surg Obes Relat Dis. 2012;8:710–5.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Foster GD, Wadden TA, Phelan S, et al. Obese patients’ perceptions of treatment outcomes and the factors that influence them. Arch Intern Med. 2001;161:2133–9.

    Article  PubMed  CAS  Google Scholar 

  22. Lara MD, Baker MT, Larson CJ, et al. Travel distance, age, and sex as factors in follow-up visit compliance in the post-gastric bypass population. Surg Obes Relat Dis. 2005;1:17–21.

    Article  PubMed  Google Scholar 

  23. Thomas JG, Bond DS, Sarwer DB, et al. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis. 2011;7:548–57.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Arem H, Irwin M. A review of web-based weight loss interventions in adults. Obes Rev. 2011;12:e236–43.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Tate DF, Jackvony EH, Wing RR. Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA. 2003;289:1833–6.

    Article  PubMed  Google Scholar 

  26. Wolfe BL, Terry ML. Expectations and outcomes with gastric bypass surgery. Obes Surg. 2006;16:1622–9.

    Article  PubMed  Google Scholar 

  27. Harbottle L. Audit of nutritional and dietary outcomes of bariatric surgery patients. Obes Rev. 2011;12:198–204.

    Article  PubMed  CAS  Google Scholar 

  28. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.

    Article  PubMed  Google Scholar 

  29. Stewart KE, Olbrisch ME, Bean MK. Back on track: confronting post-surgical weight gain. Bariatric Nurs Surg Patient. 2010;5:179–85.

    Article  Google Scholar 

  30. Asch DA, Jedrziewski MK, Christakis NA. Response rates to mail surveys published in medical journals. J Clin Epidemiol. 1997;50:1129–36.

    Article  PubMed  CAS  Google Scholar 

  31. Van Horn PS, Green KE, Martinussen M. Survey response rates and survey administration in counseling and clinical psychology. Educ Psychol Meas. 2009;69:389–403.

    Article  Google Scholar 

  32. Edwards P, Roberts I, Clarke M, et al. Increasing response rates to postal questionnaires: systematic review. BMJ. 2002;324:1183–91.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Christian NJ, King WC, Yanovski SZ, et al. Validity of self-reported weights following bariatric surgery. JAMA. 2013;310:2454–6.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  34. Forman EF, Butryn ML, Juarascio A, et al. The mind your health project: a randomized controlled trial of an innovative behavioral treatment for obesity. Obesity. 2013;21:1119–26.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

Download references

Conflict of Interest

D. B. Sarwer is a consultant for BAROnova, EnteroMedics, and Kythera and has received consulting fees from these organizations. The remaining authors have no commercial associations that might be a conflict of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the University of Pennsylvania.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lauren E. Bradley.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bradley, L.E., Sarwer, D.B., Forman, E.M. et al. A Survey of Bariatric Surgery Patients’ Interest in Postoperative Interventions. OBES SURG 26, 332–338 (2016). https://doi.org/10.1007/s11695-015-1765-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-015-1765-9

Keywords

Navigation