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Carlsson LMS, Carlsson B, Jacobson P, Karlsson C, Andersson-Assarsson JC, Kristensson FM, Ahlin S, Svensson PA, Taube M, Näslund I, Karason K, Peltonen M, Sjöholm K. Life expectancy after bariatric surgery or usual care in patients with or without baseline type 2 diabetes in Swedish Obese Subjects. Int J Obes (Lond) 2023; 47:931-938. [PMID: 37438611 PMCID: PMC10511310 DOI: 10.1038/s41366-023-01332-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/16/2023] [Accepted: 06/21/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES To determine life expectancy and causes of death after bariatric surgery in relation to baseline type 2 diabetes (T2D) in the prospective, Swedish Obese Subjects study. METHODS The study included 2010 patients with obesity who underwent bariatric surgery and 2037 matched controls, eligible for surgery. The surgery group underwent gastric bypass (n = 265), banding (n = 376), or vertical banded gastroplasty (n = 1369). The control group (n = 2037) received usual obesity care. Causes of death were obtained from the Swedish Cause of Death Register, case sheets and autopsy reports, in patients with baseline T2D (n = 392 surgery patients/n = 305 controls) or non-T2D (n = 1609 surgery patients/n = 1726 controls) during a median follow-up 26 years. RESULTS In T2D and non-T2D subgroups, bariatric surgery was associated with increased life expectancy (2.1, 95% confidence interval (95% CI) 0.2-4.0; and 1.6, 0.5-2.7 years, respectively) and reduced overall mortality (adjusted hazard ratio (adjHR) = 0.77, 95% CI: 0.61-0.97; and 0.82, 0.72-0.94, respectively), and the treatment benefit was similar (interaction p = 0.615). Bariatric surgery was associated with reduced cardiovascular mortality in both subgroups (adjHR = 0.65, 95% CI: 0.46-0.91; and 0.70, 0.55-0.88, respectively (interaction p = 0.516)). CONCLUSIONS Bariatric surgery is associated with similar reduction of overall and cardiovascular mortality and increased life expectancy regardless of baseline diabetes status.
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Affiliation(s)
- Lena M S Carlsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Björn Carlsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Research and Early Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | - Peter Jacobson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Cecilia Karlsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Late-Stage Development, Cardiovascular, Renal and Metabolism (CVRM), BioPharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Felipe M Kristensson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sofie Ahlin
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Clinical Physiology, NU Hospital Group, Trollhättan, Sweden
| | - Per-Arne Svensson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Magdalena Taube
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Kristjan Karason
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Kajsa Sjöholm
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Nakanishi H, Teixeira AF, Matar RH, Hage K, Acosta AJ, Abu Dayyeh BK, Pullatt R, Clapp B, Ghanem OM. Impact on Mid-Term Health-Related Quality of Life after Duodenal Switch: a Systematic Review and Meta-Analysis. Obes Surg 2023; 33:769-779. [PMID: 36609744 DOI: 10.1007/s11695-022-06449-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE Metabolic and bariatric surgery (MBS) could improve health-related quality of life (HrQoL) for selected patients with obesity. Although biliopancreatic diversion with duodenal switch (BPD-DS) is regarded as the most effective MBS technique in achieving weight loss, no consensus has been reached on the impact of BPD-DS on HrQoL. The aim of this meta-analysis is to assess the mid-term HrQoL after BPD-DS in the management of patients with obesity. MATERIALS AND METHODS Cochrane, Embase, APA PsycInfo, PubMed, Scopus, and Web of Science were searched for articles from their inception to August 2022 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42022352073). RESULTS From 223 studies screened, twelve studies met the eligibility criteria, with a total of 937 patients with obesity undergoing BPD-DS. Minimal clinically important differences (MCID) were reached for the physical component summary score (PCS) of the 36-Item Short-Form Health Survey (SF-36) (MD = 13.4) and impact of weight on quality of life (IWQOL)-Lite total score (MD = 48.7). Similarly, MCIDs were attained in the Laval questionnaire and SF-36 subscales. CONCLUSION Our meta-analysis demonstrated an improvement in mid-term HrQoL after BPD-DS. Despite the promising trends demonstrated in this meta-analysis, further studies with large sample sizes are needed to evaluate the impact of HrQoL on patients with obesity after BPD-DS.
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Affiliation(s)
- Hayato Nakanishi
- St. George's University of London, London, SW17 0RE, UK
- University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus
| | - Andre F Teixeira
- Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando, FL, 32806, USA
| | - Reem H Matar
- St. George's University of London, London, SW17 0RE, UK
- University of Nicosia Medical School, University of Nicosia, 2417, Nicosia, Cyprus
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Karl Hage
- Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Andres J Acosta
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Barham K Abu Dayyeh
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Rana Pullatt
- Department of Surgery, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Benjamin Clapp
- Department of Surgery, Texas Tech HSC Paul Foster School of Medicine, El Paso, TX, 79902, USA
| | - Omar M Ghanem
- Department of Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
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Assessment of motivating and demotivating factors to undergo bariatric surgery in high-risk populations with correlation to generalized anxiety disorder and influence of others: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:140-145. [PMID: 36845774 PMCID: PMC9949805 DOI: 10.1097/ms9.0000000000000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/25/2022] [Indexed: 02/28/2023] Open
Abstract
Very few research have looked at the causes and influences that push individuals into bariatric surgery. Although bariatric surgery is effective in boosting self-esteem, little is known about the precise physical characteristics people want to alter. Methods This study was a descriptive, correlational cross-sectional study to achieve the objectives of the study. All overweight and obese population in Jeddah, Saudi Arabia. Study instrument was designed based on the data present in the latest literature. Study tool consisted of: (1) sociodemographic data, (2) motives of bariatric surgery, (3) concerns about bariatric surgery, (4) people affecting the decision of seeking bariatric surgery, and (5) general anxiety disorder scale. Results The study included 567 participants. More than half of the study participants were females (n=335, 59.1%). The mean age among study participants was 27.88 years. Most of the participants selected themselves as the main person (n=329). In the second place comes "person who had the surgery" (n=72). A family member was prevalent among 59 participants and a friend among 57 participants. The partner has the least frequency. The most common reason was self-esteem among 26% followed by body image among 20%. The most frequent factor was "I am satisfied with my current weight loss method) among 220 participants followed by "I am afraid of any surgery and will avoid it unless absolutely needed" among 51 participants. Conclusion Bariatric surgery patients want to improve their health and live longer. Several people are dissatisfied with their bodies and seek cosmetic surgery. Patients desire bariatric surgery for their own and their loved ones', physicians', and peers' reasons. This study supports emphasizing the reasons why Jeddah, Saudi Arabia residents choose bariatric surgery and the demotivating issues.
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Garcia FK, Verkooijen KT, Veen EJ, Mulder BC, Koelen MA, Hazebroek EJ. Stigma Toward Bariatric Surgery in the Netherlands, France, and the United Kingdom: Protocol for a Cross-cultural Mixed Methods Study. JMIR Res Protoc 2022; 11:e36753. [PMID: 35482364 PMCID: PMC9100527 DOI: 10.2196/36753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 11/16/2022] Open
Abstract
Background Bariatric surgery is an effective procedure for the treatment of obesity. Despite this, only 0.1% to 2% of eligible individuals undergo surgery worldwide. The stigma surrounding surgery might be a reason for this. Thus far, no research has systematically studied the nature and implications of bariatric surgery stigma. The limited studies on bariatric surgery stigma are often conducted from the perspective of the public or health care professions and either use small and nonrepresentative samples or fail to capture the full essence and implications of the stigma altogether, including attitudes toward patients and perpetrators of the stigma. In addition, studies from patients’ perspectives are limited and tend to address bariatric surgery stigma superficially or implicitly. Finally, the extent to which cultural factors shape and facilitate this stigma and the experiences of patients have not yet been researched. Objective This study aimed to explore the perceptions, experiences, and consequences of bariatric surgery stigma from the perspective of the public, health care professionals, and patients before and after bariatric surgery. Furthermore, although the concept of stigma is universal, every society has specific cultural norms and values that define acceptable attributes and behaviors for its members. Therefore, this study also aimed to explore the extent to which cultural factors influence bariatric surgery stigma by comparing the Netherlands, France, and the United Kingdom. Methods This paper describes the protocol for a multiphase mixed methods research design. In the first part, we will conduct a scoping review to determine the current knowledge on bariatric surgery stigma and identify knowledge gaps. In the second part, semistructured interviews among patients before and after bariatric surgery will be conducted to explore their experiences and consequences of bariatric surgery stigma. In the third part, surveys will be conducted among both the public and health care professionals to determine the prevalence, nature, and impact of bariatric surgery stigma. Surveys and interviews will be conducted in the Netherlands, France, and the United Kingdom. Finally, data integration will be conducted at the interpretation and reporting levels. Results The study began in September 2020 and will continue through September 2025. With the results of the review, we will create an overview of the current knowledge regarding bariatric surgery stigma from patients’ perspectives. Qualitative data will provide insights into patients’ experiences with bariatric surgery stigma. Quantitative data will provide information related to the prevalence and nature of bariatric surgery stigma from the perspective of the public and health care professionals. Both qualitative and quantitative data will be compared for each country. Conclusions The findings from this study will lead to new insights that can be used to develop strategies to reduce bariatric surgery stigma and improve access, use, and outcomes of bariatric surgery. International Registered Report Identifier (IRRID) PRR1-10.2196/36753
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Affiliation(s)
- Franshelis K Garcia
- Health and Society, Department of Social Sciences, Wageningen University, Wageningen, Netherlands
| | - Kirsten T Verkooijen
- Health and Society, Department of Social Sciences, Wageningen University, Wageningen, Netherlands
| | - Esther J Veen
- Rural Sociology, Department of Social Sciences, Wageningen University, Wageningen, Netherlands.,Almere University of Applied Sciences, Almere, Netherlands
| | - Bob C Mulder
- Strategic Communication, Department of Social Sciences, Wageningen University, Wageningen, Netherlands
| | - Maria A Koelen
- Health and Society, Department of Social Sciences, Wageningen University, Wageningen, Netherlands
| | - Eric J Hazebroek
- Human Nutrition and Health, Department of Agrotechnology and Food Sciences, Wageningen University, Wageningen, Netherlands.,Department of Bariatric Surgery, Vitalys, Rijnstate Hospital, Arnhem, Netherlands
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Keeton J, Ofori A, Booker Q, Schneider B, McAdams C, Messiah SE. Psychosocial Factors that Inform the Decision to Have Metabolic and Bariatric Surgery Utilization in Ethnically Diverse Patients. Obes Surg 2021; 30:2233-2242. [PMID: 32060853 DOI: 10.1007/s11695-020-04454-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) is currently the only clinically proven method of weight loss that is effective in treating severe obesity and its related comorbidities. However, only about 36% of MBS-eligible patients complete MBS. This qualitative study used the psychosocial framework to identify barriers and facilitators to MBS utilization among patients who had been referred to, or were considering MBS, but had not completed it. METHODS A combination of focus groups and in-depth interviews were utilized (Spring 2019) among ethnically diverse patients (N = 29, 82% female, 62% non-Hispanic Black, 10% Hispanic) who were considering MBS. All data was audio recorded, transcribed, and coded. Interview questions were grouped by the four psychosocial model domains (intrapersonal, interpersonal, organization/clinical interaction, societal/environmental) within the context of why patients would/would not follow through with MBS. The analysis included a combination of deductive and inductive approaches to generate the final codebook. Then, each code was input into Dedoose to identify overarching themes and sub-themes. RESULTS A total of 9 themes and 17 subthemes were found. Two major intrapersonal themes and four subthemes were identified as facilitators to MBS utilization and included a desire for improvement in existing comorbidities, mobility, and anticipated changes in physical appearance. Primary barriers to MBS completion included concerns about potential change in dietary behaviors post-MBS and safety of procedure. CONCLUSIONS Providing educational materials to address MBS common fears and misconceptions may increase utilization rates. Providing community-based pre- and post-support groups for this patient population may also increase MBS completion rates.
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Affiliation(s)
- Juang Keeton
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Ashley Ofori
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Quiera Booker
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, USA
| | - Benjamin Schneider
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Carrie McAdams
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sarah E Messiah
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, TX, USA. .,Paul M. Bass Administrative and Clinical Center, University of Texas Southwestern Medical Center, 6363 Forest Park Road, BL10.204, Dallas, TX, 75390, USA.
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Carlsson LMS, Sjöholm K, Jacobson P, Andersson-Assarsson JC, Svensson PA, Taube M, Carlsson B, Peltonen M. Life Expectancy after Bariatric Surgery in the Swedish Obese Subjects Study. N Engl J Med 2020; 383:1535-1543. [PMID: 33053284 PMCID: PMC7580786 DOI: 10.1056/nejmoa2002449] [Citation(s) in RCA: 223] [Impact Index Per Article: 55.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Obesity shortens life expectancy. Bariatric surgery is known to reduce the long-term relative risk of death, but its effect on life expectancy is unclear. METHODS We used the Gompertz proportional hazards regression model to compare mortality and life expectancy among patients treated with either bariatric surgery (surgery group) or usual obesity care (control group) in the prospective, controlled Swedish Obese Subjects (SOS) study and participants in the SOS reference study (reference cohort), a random sample from the general population. RESULTS In total, 2007 and 2040 patients were included in the surgery group and the control group, respectively, and 1135 participants were included in the reference cohort. At the time of the analysis (December 31, 2018), the median duration of follow-up for mortality was 24 years (interquartile range, 22 to 27) in the surgery group and 22 years (interquartile range, 21 to 27) in the control group; data on mortality were available for 99.9% of patients in the study. In the SOS reference cohort, the median duration of follow-up was 20 years (interquartile range, 19 to 21), and data on mortality were available for 100% of participants. In total, 457 patients (22.8%) in the surgery group and 539 patients (26.4%) in the control group died (hazard ratio, 0.77; 95% confidence interval [CI], 0.68 to 0.87; P<0.001). The corresponding hazard ratio was 0.70 (95% CI, 0.57 to 0.85) for death from cardiovascular disease and 0.77 (95% CI, 0.61 to 0.96) for death from cancer. The adjusted median life expectancy in the surgery group was 3.0 years (95% CI, 1.8 to 4.2) longer than in the control group but 5.5 years shorter than in the general population. The 90-day postoperative mortality was 0.2%, and 2.9% of the patients in the surgery group underwent repeat surgery. CONCLUSIONS Among patients with obesity, bariatric surgery was associated with longer life expectancy than usual obesity care. Mortality remained higher in both groups than in the general population. (Funded by the Swedish Research Council and others; SOS ClinicalTrials.gov number, NCT01479452.).
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Affiliation(s)
- Lena M S Carlsson
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Kajsa Sjöholm
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Peter Jacobson
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Johanna C Andersson-Assarsson
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Per-Arne Svensson
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Magdalena Taube
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Björn Carlsson
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
| | - Markku Peltonen
- From the Institutes of Medicine (L.M.S.C., K.S., P.J., J.C.A.-A., P.-A.S., M.T., B.C.) and Health and Care Sciences (P.-A.S.), Sahlgrenska Academy at the University of Gothenburg, and Early Cardiovascular, Renal, and Metabolism (CVRM), Biopharmaceuticals Research and Development, AstraZeneca (B.C.), Gothenburg, and the Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna (M.P.) - both in Sweden; and the Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki (M.P.)
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Selby LV, Ejaz A, Brethauer SA, Pawlik TM. Fatty liver disease and primary liver cancer: disease mechanisms, emerging therapies and the role of bariatric surgery. Expert Opin Investig Drugs 2020; 29:107-110. [PMID: 31986920 DOI: 10.1080/13543784.2020.1721457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Luke V Selby
- Department of Surgery, Divisions of Surgical Oncology and GI/General Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Aslam Ejaz
- Department of Surgery, Divisions of Surgical Oncology and GI/General Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Stacy A Brethauer
- Department of Surgery, Divisions of Surgical Oncology and GI/General Surgery, The Ohio State University Medical Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, Divisions of Surgical Oncology and GI/General Surgery, The Ohio State University Medical Center, Columbus, OH, USA
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Jolles SA, Alagoz E, Liu N, Voils CI, Shea G, Funk LM. Motivations of Males with Severe Obesity, Who Pursue Medical Weight Management or Bariatric Surgery. J Laparoendosc Adv Surg Tech A 2019; 29:730-740. [PMID: 31017517 DOI: 10.1089/lap.2019.0219] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background: Both medical weight management (MWM) and bariatric surgery are significantly underutilized by patients with severe obesity, particularly males. Less than 30% of participants in MWM programs are male, and only 20% of patients undergoing bariatric surgery are men. Objectives: To identify motivations of males who pursue either MWM or bariatric surgery. Setting: Interviews with males with severe obesity (body mass index ≥35 kg/m2), who participated in a Veteran Affairs weight loss program in the Midwest. Materials and Methods: Participants were asked to describe their experiences with MWM and bariatric surgery. Interviews were audio-recorded, transcribed, and uploaded to NVivo for data management and analysis. Five coders iteratively developed a codebook using inductive content analysis to identify relevant themes. We utilized theme matrices organized by type of motivation and treatment pathway to generate higher-level analysis and generate themes. Results: Twenty-five males participated. Participants were 58.7 (standard deviation 8.6) years old on average, and 24% were non-white. Motivations for pursuing MWM or surgery included a desire to improve physical or psychological health and to enhance quality of life. Patients seeking bariatric surgery were motivated by the fear of death and felt that they had exhausted all other weight loss options. MWM patients believed they had more time to pursue other weight loss options. Conclusion: The opportunity to improve health, optimize quality of life, and lengthen lifespan motivates males with severe obesity to pursue weight loss treatments. These factors should be considered when providers educate patients about obesity treatment options and outcomes.
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Affiliation(s)
- Sally A Jolles
- 1 Department of Surgery, William S. Middleton Memorial VA, Madison, Wisconsin.,3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
| | - Esra Alagoz
- 3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
| | - Natalie Liu
- 3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
| | - Corrine I Voils
- 2 Research Service, William S. Middleton Memorial VA, Madison, Wisconsin.,3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
| | - Grace Shea
- 3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
| | - Luke M Funk
- 1 Department of Surgery, William S. Middleton Memorial VA, Madison, Wisconsin.,3 Department of Surgery, Wisconsin Surgical Outcomes Research Group (WiSOR), University of Wisconsin-Madison, Madison, Wisconsin
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Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surg Obes Relat Dis 2019; 15:636-642. [PMID: 30803880 DOI: 10.1016/j.soard.2019.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/19/2018] [Accepted: 01/21/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the motivating factors and people that lead patients to seek bariatric surgery. Bariatric surgery helps to improve body image, but little is known about patients' desired changes in the appearance of specific body parts. OBJECTIVES To identify key factors and people motivating patients' decision to seek bariatric surgery, and to assess body dissatisfaction and desire for surgery to change the appearance of specific body parts. SETTING U.S. university-based hospital clinic. METHODS Patients seeking bariatric surgery (N = 208, 78.4% women, 52.4% black, mean age = 42.0 ± 12.3 yr, mean body mass index = 46.7 ± 8.5 kg/m2) completed the Reasons for Bariatric Surgery questionnaire before their preoperative Psychosocial-behavioral evaluation. Participants rated (1-10) the importance of 15 potential reasons and 7 potential people motivating their decision to seek bariatric surgery. Participants also rated their dissatisfaction and desire for surgery to change the appearance of 11 body parts. RESULTS Mean scores of motivating factors were highest for Physical Health (9.9 ± .4), followed by Longevity (9.7 ± .9). Patients reported high body dissatisfaction and desire for surgery to change the appearance of several body parts, including stomach and thighs. "Myself" was the highest-rated motivating person, followed by healthcare providers, family, and someone who had undergone bariatric surgery. CONCLUSIONS Health is the primary reason reported by patients for seeking bariatric surgery. Patients also report a strong desire for surgery to change the appearance of their body. Patients are self-driven to pursue surgery but are also influenced by healthcare providers, family, and people who have undergone surgery. (Surg Obes Relat Dis 2019;X:XXX-XXX.) © 2019 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kaylah Walton
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jena Shaw Tronieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Edward KL, Hii MW, Giandinoto JA, Hennessy J, Thompson L. Personal Descriptions of Life Before and After Bariatric Surgery From Overweight or Obese Men. Am J Mens Health 2016; 12:265-273. [PMID: 26846405 DOI: 10.1177/1557988316630770] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Bariatric surgery is now a common weight loss solution for morbidly obese men where meaningful weight reduction and improvements in quality of life have been identified postsurgery. As the majority of surgical candidates are female, there exists a paucity of literature relating to the experience of males undergoing bariatric surgery. In this study, a qualitative descriptive-exploratory design was used to explore body image descriptions, adaptation of a new lifestyle, new boundaries postsurgery, and any barriers seeking consultation for surgery. Six males who had undergone bariatric surgery were recruited in Australia. Data were collected and analyzed using NVivo between May and October 2014. The themes emerging from the data included living in an obese body, life before surgery, decision making for surgery, and life after surgery. The participants collectively reported that life before surgery was challenging. They described the changes the surgery had made in their lives including positive changes to their health, body image, social lives, and self-esteem. Some participants preferred not to tell others their intentions for surgery due to perceived stigma. The men in this study also described a lack of information available to them depicting male perspectives, a possible barrier for men seeking weight loss surgery options. Implications for practice highlighted in these results relate to a greater need for accessible information specific to men based on real-life experiences.
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Affiliation(s)
- Karen-Leigh Edward
- 1 Australian Catholic University, Melbourne, Victoria, Australia.,2 St Vincent's Private Hospital Melbourne, Victoria, Australia
| | - Michael W Hii
- 3 St Vincent's Hospital, Melbourne, Victoria, Australia.,4 University of Melbourne, Victoria, Australia.,5 Melbourne Gastro Oesophageal Surgery, Melbourne, Victoria, Australia
| | - Jo-Ann Giandinoto
- 1 Australian Catholic University, Melbourne, Victoria, Australia.,2 St Vincent's Private Hospital Melbourne, Victoria, Australia
| | - Julie Hennessy
- 5 Melbourne Gastro Oesophageal Surgery, Melbourne, Victoria, Australia
| | - Lisa Thompson
- 1 Australian Catholic University, Melbourne, Victoria, Australia.,2 St Vincent's Private Hospital Melbourne, Victoria, Australia
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Fung M, Wharton S, Macpherson A, Kuk JL. Receptivity to Bariatric Surgery in Qualified Patients. J Obes 2016; 2016:5372190. [PMID: 27516900 PMCID: PMC4969542 DOI: 10.1155/2016/5372190] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 06/30/2016] [Indexed: 01/06/2023] Open
Abstract
Objectives. Bariatric surgery has been shown to be an effective intervention for weight loss and diabetes management. Despite this, many patients qualified for bariatric surgery are not interested in undergoing the procedure. The objective of this study is to determine the factors influencing receptivity to bariatric surgery among those who qualify for the procedure. Methods. Patients attending a publicly funded weight management clinic who qualified for bariatric surgery were asked to complete an elective questionnaire between February 2013 and April 2014. Results. A total of 371 patients (72% female) completed the questionnaire. Only 87 of 371 (23%) participants were interested in bariatric surgery. Individuals interested in bariatric surgery had a higher BMI (48.0 versus 46.2 kg/m(2), P = 0.03) and believed that they would lose more weight with surgery (51 versus 44 kg, P = 0.0069). Those who scored highly on past weight loss success and financial concerns were less likely to be interested in bariatric surgery, whereas those who scored highly on high receptivity to surgery and positive social support were more likely to be interested in bariatric surgery. Conclusion. Although participants overestimated the effect of bariatric surgery on weight loss, most were still not interested in bariatric surgery.
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Affiliation(s)
- Michael Fung
- School of Kinesiology, York University, Toronto, ON, Canada M3J 1P3
| | - Sean Wharton
- School of Kinesiology, York University, Toronto, ON, Canada M3J 1P3
- The Wharton Medical Clinic, Hamilton, ON, Canada L8L 5G8
| | | | - Jennifer L. Kuk
- School of Kinesiology, York University, Toronto, ON, Canada M3J 1P3
- *Jennifer L. Kuk:
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