Eating attitudes, perceptions of body image and patient quality of life before and after bariatric surgery

The relationship of decision regret with quality of life and comfort level in patients undergoing laparoscopic sleeve gastrectomy: a cross-sectional study

BACKGROUND

Laparoscopic sleeve gastrectomy (SG) is one of the effective methods of weight loss. It is essential to determine patients' regret and predictive factors to improve their quality of life and comfort. No study has investigated decision regret and affecting factors in patients undergoing SG in Turkey.

OBJECTIVES

The study aimed to determine the relationship of decision regret with quality of life and comfort level in patients undergoing SG.

SETTING

The research was carried out with patients who had undergone SG in a private hospital in the west of Turkey.

METHODS

The research was conducted as a descriptive, correlational, and cross-sectional study. Data were collected between March and May 2023, and the study was completed with 286 patients. Data were collected using the Personal Information Form, Decision Regret Scale (DRS), Quality of Life Following Obesity Surgery Scale (QoL-OS), and Comfort Scale.

RESULTS

Patients' mean score on the DRS was 5.27 ± 13.41 (0-100), the total mean score on the QoL-OS-Biopsychosocial dimension was 79.57 ± 9.35 (18-90), the mean score on the QoL-OS-Complications dimension was 17.17 ± 4.60 (7-35), and the environmental comfort score average was 8.87 ± 2.23 (0-10). Patients' decision regret was significantly affected by the QoL-OS-Biopsychosocial Area dimension in the first place (Beta = -.516; P < .001), social comfort in the second place (Beta = -.278; P < .001), postoperative weight gain in the third place (Beta = .221; P < .001), and complication development in the fourth place (Beta = .163; P < .001).

CONCLUSIONS

The study revealed that patients' decision regret levels were very low up to 3 years after surgery and found that low postoperative quality of life and social comfort level, postoperative weight gain, and complications affected decision regret.

Influence of mental and behavioral factors on weight loss after bariatric surgery: A systematic review and meta-analysis

INTRODUCTION

Multiple factors are related to lower weight loss after bariatric surgery. This review and meta-analysis evaluates the influence of several mental and behavioral factors on weight loss.

METHOD

Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non-moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow-up moments were analyzed separately.

RESULTS

In total, 75 articles were included in the review; 12 meta-analyses were conducted. Higher postoperative compliance to follow-up was associated with 6.86%-13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24- and 36-month follow-up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms.

CONCLUSION

Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric-metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss.

Factors associated with grazing behavior in candidates for bariatric surgery at a hospital in the Amazon

Blackground

To assess grazing behavior and associated factors in candidates for bariatric surgery monitored at a public hospital that is a reference in the care of people with severe obesity.

Methods

Cross-sectional analytical study, with candidates for bariatric surgery of both genders, treated in a public hospital in the Amazon. To assess grazing behavior, the Repetitive Eating Questionnaire was used, and to investigate patterns of eating behavior, the Three Factor Eating Questionnaire was used, which assesses: Emotional Eating, Cognitive Restriction and Uncontrolled Eating. Sociodemographic information was obtained through self-report and the description of medication use through the medical record. Body mass index (BMI) was also calculated by measuring weight and height. The SPSS program, v. 21.0 was used. The study was approved by the Research Ethics Committee.

Results

A total of 205 participants were evaluated, with a mean age of 37.5 ± 8.6 years, the majority (93.7%) being women and the majority (59.5%) was not also using medication to lose weight. About 66.3% of the participants had compulsive grazing. The factor with the highest score was cognitive restriction (p < 0.001). Individuals who used weight loss drugs had higher scores in the cognitive restriction factor (p = 0.015) and lower scores for uncontrolled eating (p = 0.008), compulsive grazing (p = 0.021) and non-compulsive grazing (p = 0.034).

Conclusion

Linear regression showed that emotional eating and uncontrolled eating were predictors of both compulsive grazing and non-compulsive grazing behavior. It was observed that grazing behavior, cognitive restriction, emotional eating and uncontrolled eating are present and correlated in the studied patients. In addition, the use of weight loss drugs seems to help reduce dysfunctional eating behaviors in patients with severe obesity.

Nurse-led intervention for the management of bariatric surgery patients: A systematic review

The prevalence of obesity has become a global health concern, and severe obesity is associated with various chronic diseases and decreased quality of life. Bariatric surgery has shown success in treating obesity. Nevertheless, some patients experience weight regain and unsatisfactory outcomes. Multidisciplinary interventions have been shown to improve postoperative outcomes. Case managers, often specialized nurses, play a crucial role in patient support and coordination of care. However, the diverse design of case-managing interventions hinders the assessment of their success. Thus, the aim of this review is to identify the most successful structural characteristics of case-managing interventions, with or without the support of e-Health, in the process of perioperative management of bariatric surgery patients. A systematic literature review was conducted following the PRISMA guidelines. PubMed, MEDLINE, EBSCOhost, and CINAHL databases were searched for relevant studies published in the last 10 years. Eligible studies included randomized controlled trials, controlled clinical studies, case studies, or observational studies that evaluated perioperative care in bariatric surgery. The PICO framework was used to frame the search strategy. The initial search yielded 225 articles, of which 10 studies met the inclusion criteria. Nurse-led case-managing interventions with a multidisciplinary approach showed positive results in weight loss, physical activity, and quality of life. Patient-centered care models were found to promote adherence to treatment and patient satisfaction. E-Health technologies improved quality of life but not weight loss. The duration of behavioral interventions and the long-term outcomes after surgery remained unclear. Nurse-led case-management interventions, with a focus on behavioral change and multidisciplinary approaches, show promise in improving outcomes in bariatric surgery patients. Patient-centered care models and longer term interventions may contribute to sustained weight loss and better postoperative outcomes. Further research is needed to determine the optimal duration of interventions and the long-term effects on weight maintenance.

Determinants of Dietary Adherence Among Chinese Patients After Bariatric Surgery Based on the Attitude-Social Influence-Efficacy Model

PURPOSE

To explore main determinants of dietary adherence among Chinese patients after bariatric surgery based on the Attitude-Social influence-Efficacy (ASE) model.

METHODS

A cross-sectional survey was conducted by using convenience sampling method to select 288 participants in a tertiary hospital in Jiangsu, China. General information and disease-related information were collected as well as applying the Dietary Adherence Scale after Bariatric Surgery (DASBS) and Attitude-Social influence-Efficacy Questionnaire after Bariatric Surgery (ASEQBS). Univariate analysis, correlation analysis, and multivariate analysis were used to identify determinants of dietary adherence among patients after bariatric surgery.

RESULTS

A total of 288 questionnaires were effectively collected. The mean DASBS score was 54.90 ± 10.08 among post-bariatric patients. Univariate analysis results showed that education level, time since surgery, smoking, exercise, participation in peer support groups, and participation in nutrition counseling had significant effects on postoperative diet adherence level of patients (P < 0.05). The correlation analysis results showed that the total score of dietary adherence was positively correlated with the total score of intention, attitude, social influence, and self-efficacy, and the correlation coefficients were 0.511, 0.550, 0.460, and 0.484, respectively (P < 0.05). The results of multiple linear regression analysis showed that time since surgery, attitude, intention, social influence, exercise, and self-efficacy entered the regression equation (P < 0.05). The standardized regression coefficients of attitude and intention are 0.237 and 0.196, respectively. The regression model could explain 44.0% of the total variation.

CONCLUSION

The dietary adherence of Chinese post-bariatric patients is at an upper-middle level, which needs to be further improved. Time since surgery, exercise, intention, attitude, social influence, and self-efficacy had significant effects on patients' dietary adherence. Attitude had the greatest effect on dietary adherence, followed by intention. The results shed light on that these factors should be emphasized to take personalized intervention strategy in designing dietary intervention program, in order to improve the patient's dietary adherence and surgical outcomes.

Bariatrik Cerrahi Sonrası Öz-Etkililiğin ve Seçilmiş Faktörlerin Yaşam Kalitesine Etkisi

Giriş: Bariatrik cerrahinin kilo vermede etkili olmasının yanı sıra fizyolojik ve psikososyal sağlık üzerine de önemli etkileri vardır. Bu etkilerden biri de yaşam kalitesi üzerinedir. Amaç: Bariatrik cerrahi sonrası öz-etkililiğin ve seçilmiş faktörlerin yaşam kalitesine etkisini incelemektir. Yöntem: Araştırma kesitsel, tanımlayıcı ve kestirim tipi bir araştırmadır. Araştırma örneklemini bariatrik cerrahi yapılan 103 hasta oluşturmuştur. Veriler Eylül 2018-Temmuz 2019 tarihleri arasında sosyodemografik özellikler formu, Kilonun Yaşam Kalitesine Etkisi Ölçeği ve Öz etkililik Yeterlilik Ölçeği kullanılarak toplanmıştır. Bulgular: Hastaların yaş ortalaması 33.70±8.13 olup ameliyat sonrası geçen süre 9.64±5.22 ay olarak bulunmuştur. Hastaların tamamına sleeve gastrektomi ameliyatı yapılmıştır. Hastaların Kilonun Yaşam Kalitesine Etkisi Ölçeği toplam puan ortalaması 75.12±20.14; Öz etkililik Yeterlik Ölçeği toplam puan ortalaması 51.25±6.57 olarak bulunmuştur. Hastaların yaşam kalitesini etkileyen faktörler incelendiğinde modelin anlamlı olduğu belirlenmiştir. Modele dahil edilen değişkenler hastaların yaşam kalitesinin %52’sini açıklamaktadır. Ameliyat sonrası geçen sürenin (β: -0.653, p = 0.000) anlamlı ve negatif yönde yaşam kalitesini yordadığı saptanmıştır. Sonuç: Hastaların yaşam kalitelerinin orta düzey ve öz-etkililiklerinin düşük düzeyde olduğu bulunmuştur. Hastalarda Öz etkililiğin yaşam kalitesi üzerine etkisi olmadığı bulunmuştur. Hastalarda bariatrik cerrahi sonrası geçen süre arttıkça yaşam kalitesinin düştüğü saptanmıştır. Hastaların ameliyat sonrası yaşam kalitesinin arttırılması için hemşirelerin ve ekip üyelerinin ameliyat sonrası uzun dönem hastaları izlemesi önerilmektedir.

Relationship between Eating Behavior, Quality of Life and Weight Regain in Women after Bariatric Surgery

Individuals undergoing bariatric Surgery (BS) may have long-term weight regain. There is a need to investigate factors that may be related to this and if they can interfere with Quality of Life (QOL). This study aims to evaluate the relationship between eating behavior, perception of QOL, and weight regain in women after 24 months of bariatric surgery. This was a transversal study with 50 adult women residents in the city of Belém, Brazil. Sociodemographic, anthropometric, eating behavior (Three-Factor Eating Questionnaire—TFEQ-21) and perception of QOL (Item Short Form Healthy Survey—SF-36) data were collected. In 60% (n = 30) there was weight regain (≥15%), with a mean weight regain of 23.3% (±18.4). Emotional eating was the most frequent pattern (p = 0.047). Regarding QOL, the functional capacity and limitation due to physical aspects domains had a better perception (p < 0.0001). Women without weight regain showed a better perception of the functional capacity aspects (p = 0.007), limitation due to physical aspects (p = 0.044), social aspects (p = 0.048), and general physical components (p = 0.016) and also had an inverse association with the perception of QOL in physical components (p = 0.008). Patterns of eating behavior and weight regain can damage the perception of QOL, especially physical capacity. Long-term follow-up is essential to evaluate the behavior of people who have undergone BS in order to prevent weight regain and QOL damage.

Correlation between Anxiety Symptoms and Perception of Quality of Life in Women with More Than 24 Months after Undergoing Bariatric Surgery

Purpose: To analyze the correlation between anxiety symptoms and perceived quality of life in women more than 24 months after undergoing bariatric surgery. Methods: Cross-sectional, descriptive and analytical study, carried out with women who underwent bariatric surgery after at least 24 months. To assess the level of anxiety symptoms, the Beck Inventory was used and to assess the perception of quality of life, the Item Short Form Healthy Survey was applied. Results: Of the 50 participants, 36.0% had reports indicative of moderate symptoms and 64.0% had severe symptoms of anxiety. The domains of quality of life that correlated with better perception were pain (p < 0.001), functional capacity (p = 0.013), general health status (p = 0.018), social aspects (p < 0.001), and mental health (p < 0.001). In linear regression, a significant inverse correlation was found between the general emotional component of quality of life and anxiety score (β = −0.546; CI −1.419; −0.559; p < 0.001) and between the general physical component of quality of life and anxiety score (β = −0.339; CI −0.899; −0.131; p = 0.010), both independent of weight regain and surgery time. Conclusions: It was observed that moderate to severe anxiety symptoms seem to interfere with the perception of quality of life, regardless of weight regain and surgery time.

Meanings attributed to changes occurring after bariatric surgery: an analysis in the light of Grounded Theory

ABSTRACT Objectives: to understand the meanings attributed to the changes experienced after bariatric surgery by people with obesity. Methods: this is a study with a qualitative approach, with a theoretical framework in Symbolic Interactionism; and methodological, in the Grounded Theory. There were 12 participants who underwent bariatric surgery in two health services (bariatric surgery clinic; general hospital). Data collection took place between July and October 2020, through an intensive interview. Testimonies were recorded using an electronic device and transcribed in full. Data were coded in the MAXQDA 2020 software and analyzed considering the adopted theoretical framework. Results: two categories emerged: Rebuilding a social life; and Rediscovering self-esteem. From the articulation of these categories, the phenomenon “Re-signifying life after bariatric surgery” was constructed. Final Considerations: bariatric surgery contributed to significant changes in the daily lives of participants, and Symbolic Interactionism allowed the understanding of how participants interpreted their meanings.