Low Health Literate State Does Not Negatively Affect Final Weight Loss After a Laparoscopic Gastric Bypass Procedure

Abstract

Weight loss surgery is an effective treatment in patients with morbid obesity, but its benefit depends on self-care management afterwards Self-care management is partly influenced by individual’s health literacy. The level of individual’s health literate state (HLS) could determine the person’s health behavior with a subsequent effect on final weight loss We therefore hypothesized that a low HLS may result in a worse post-bariatric surgery outcome (final weight loss) compared to them with a high HLS. A retrospective study was performed including 78 patients (male vs female: 23% vs 77%, respectively; mean age 43 years (SD 12)) who underwent a laparoscopic gastric bypass (LGB) procedure. All patients were invited to perform in a review in which HLS was estimated using Rapid Estimate of Adult Literacy in Medicine- Dutch (REALM-D) and Newest Vital Sign- Dutch (NVS-D) questionnaires. Anthropometric information, such as weight at 0, 3, 6 9 and 12 months after surgery, was collected. Mean preoperative weight was 128.0 kg (SD 21.1) and patients had an average weight loss of 42.2 kg (SD 12.0) after 12 months. Almost half of the population (49%) was low educated, 38% had medium education and 13% was high educated. Of all patients, 22% had an inadequate HLS, according to the REALM-D. Following the NVS-D, 14% was characterized with an inadequate HLS. Patients with an inadequate HLS had an average weight loss of 40.2 kg (SD 13.8) or 31.5% (SD 8.1), while patients with an adequate HLS had an average weight loss of 42.8 kg (SD 11.4 or 33.3 % (SD 6.6). Following the NVS-D, preoperative weight was 123.6 (SD 20.5) for patients with an inadequate HLS and 128.7 (SD 21.1) for patients with an adequate HLS. Patients with an inadequate HLS had an average weight loss of 39.8 kg (SD 14.2) or 31.5% (SD 8.5), patients with an adequate HLS had an average weight loss of 42.6 kg (SD 11.6) or 33.1 % (SD 6.7). This reduce after 12 months did not significantly differ between patients with an inadequate and adequate HLS according to the REALM-D (B = - 1.806, P = 0.350) and NVS-D (B= -0.357, P = 0.885) after correction for age, gender and preoperative weightWeight reduction did not significantly differ between patients with inadequate or adequate health literacy levels, one year after LGB.