Some Positive Personality Correlates of Adherence to Treatment among Post-Bariatric Surgery Patients

Abstract

According to WHO nearly 1.4 billion people (age > 20) are obese among whom there are 200 million men and 300 million women and nearly 40 million children (age Obesity causes 2.6 million deaths every year (WHO, 2005) India being a poverty ridden country is still considered as a cradle of poverty and malnutrition. However, researches show that low and middle income countries like India are grappling with a dual burden of both under-nutrition and obesity (Grammaticas, 2011). Moreover, the Asian Indian phenotype is characterized by central body obesity which makes Indians predisposed to increased incidences of Diabetes Mellitus and CVD. Thus, it's not a surprise being declared the Diabetes Capital of the World (Mohan, Sandeep, Deepa, Shah, & Varghese, 2007).Bariatric surgeryObesity has become an epidemic that is not only limited to aesthetic problems but affects the physiology as a disease. Obesity is magnet for several co-morbidities which include diabetes mellitus, hypertension, obstructive sleep apnea, joint-pains, infertility, hypothyroidism, poly-cystic ovarian syndrome, dyslipidemia, hypoventilation, fatty liver disease, etc. (Hamdy, et al, 2013). Thus traditional treatments of Obesity are being replaced by Bariatric Surgeries that involve an anatomical modification of the stomach and intestines. These surgeries on the gastro-intestinal tract are becoming increasingly indicated in the Indian population due to the rising prevalence of the Metabolic Syndrome (Ramachandran, Snehalatha, Satyavani, Sivasankari, & Vijay, 2003)Bariatric surgeries however need to be supplemented with behavioural and lifestyle modification. The treatment regimen post-surgery involving diet phases that start from Clear Liquids and gradually wane to Solids is a long-term process and thus adherence is a major concern post bariatric surgeries. Non-Compliance to suggested portion size and related behavioural modifications may lead to Dumping Syndrome, eventual dilation of the pouch and also in relative less weight loss than normally expected. It could also eventually imply low weight loss maintenance.The Indian scenario moreover is strikingly different from the West in relation to nutritional beliefs, staple diet, social environment, and personal characteristics of the individuals. Thus it is necessary to conduct research on the psycho-social aspects of the Indian bariatric patients that may affect their treatment adherence post-surgery.Treatment adherence post bariatric surgeryPontirolli et al. (2007) have concluded that 'adherence to scheduled visits and compliance to the recommended rules' predict success of Laparoscopic Gastric Banding (LAGB) more than personality disorders.Bariatric surgery need to be supplemented with behavioural and lifestyle modification. Patients thus require pre and post-surgery psychological evaluation and support. Treatment adherence to diet and behavioural modifications post bariatric surgery are imperative for effective results (Wadden, et al, 2007). The treatment regimen post-surgery involving diet phases that start from Clear Liquids and gradually wane to Solids is a long-term process and thus adherence is a major concern post bariatric surgeries. NonCompliance to suggested portion size and related behavioural modifications may lead to Dumping Syndrome, eventual dilation of the pouch and also in relative less weight loss than normally expected. It could also eventually imply low weight loss maintenance. Researchers thus hypothesize that prevalence, strength and quality of certain positive personality characteristics such as motivation, self-regulation, competence, optimism and social environment such as social support and autonomy support from healthcare team, are related to the level of adherence to the treatment in bariatric patients. …