Abstract
PurposeSurgery remains the only treatment allowing for a significant and sustainable weight loss in case of severe obesity. Patients undergo a specific multidisciplinary preparation and selection before the operation. This study aims to correlate the psychosocial profile with the likelihood of undergoing bariatric surgery in patients enrolled in the preparation program of a Swiss reference center.MethodsAll patients referred to an obesity center between January 1, 2016, and June 30, 2017, seeking a first bariatric procedure were included. Socio-demographic data, BMI, preoperative psychological and dietary evaluations were collected. Usually, the preoperative process lasts 1 year. Patients who left the preparation or who had not undergone surgery after more than 2 years of follow-up were considered withdrawers. Surgery completion predictors were reviewed with bivariate analysis and socio-demographic clusters established using the K-means method.ResultsOut of a total of 221 patients, 99 (45%) patients had not undergone bariatric surgery 2 years after their first consultation. The patients were divided into four distinct socio-demographic clusters, among which a particularly deprived one. Criteria such as unfavorable psychological (p < 0.001) and dietary (p < 0.001) evaluations, and male gender (p < 0.05) were significantly associated with non-operation, unlike socio-demographic indicators and clusters (p > 0.1).ConclusionAlmost half of the patients starting a bariatric program are not operated on, which is related to an unfavorable psychological or dietary evaluation and to the male gender. This study also demonstrates that a significant share of patients combines several factors of social deprivation, without influencing the likelihood of surgery completion.Level of evidenceLevel V: Descriptive study.
Highlights
Severe obesity is a metabolic disease and a well-known risk factor for multiple other chronic disorders [1]
The aim of the present study is to identify the profile of patients applying to a Swiss referral center for bariatric surgery, as well as factors contributing to attrition
Dietary evaluation focuses on the stability of the present eating disorder, weight stability during the process, a balanced relationship with food, and the implementation of behavior modifications towards the postoperative phase
Summary
Severe obesity is a metabolic disease and a well-known risk factor for multiple other chronic disorders [1]. It presents an important societal dimension, as it is more common among deprived socio-economic subgroups of the population and constitutes a factor of social exclusion in developed countries [2]. Bariatric surgery remains the only effective and longterm treatment of severe obesity [3,4,5,6,7]. Patients must overcome an important psychological stigma before deciding to consult a bariatric center, even though weight loss surgery is highly regulated. In weight loss intervention programs, the most common attrition reasons are practical difficulties, such as family or work problems,
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