Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, 9500 Euclid Avenue/M61, Cleveland, OH 44195, USA.
Obes Surg. 2010 Feb;20(2):148-53. doi: 10.1007/s11695-009-9982-8. Epub 2009 Oct 1.
Patients choose to undergo bariatric surgery for a variety of medical and psychosocial reasons. However, the majority of bariatric surgery candidates have unrealistic weight loss goals, and certain subgroups within this population may be more likely to endorse such beliefs. This study examines weight loss expectations in patients undergoing three different weight loss procedures (laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, or laparoscopic sleeve gastrectomy).
Between October 2007 and June 2008, 114 patients (81.6% female) underwent weight loss surgery. At entry into the program, patients identified their postsurgical goal weights. "Realistic" weights were calculated based on patients' presurgical excess weights and expected loss based upon their surgical procedure.
Patient [mean preoperative body mass index (BMI) = 48.89] weight loss discrepancies were quite variable with "realistic" versus "dream" weight discrepancies ranging from 0.34 to 71.11 kg (M = 28.79 kg; SD = 13.21 kg). The mean was equivalent to losing 106% (SD = 0.15%) of excess body weight. Baseline BMI, female gender, younger age, and Caucasian ethnicity accounted for up to 62% of the variance in discrepancy scores. After controlling for initial BMI, there were no differences in discrepancies based upon type of surgery.
Across all three surgery types, women, Caucasians, younger patients, and those with higher initial BMIs were more likely to have unrealistic goals. Informed consent procedures should help patients, particularly those most likely to be unrealistic, understand likely outcomes as part of education on risks and benefits of weight loss surgery.
患者选择接受减重手术有多种医学和心理社会原因。然而，大多数减重手术候选人对减重目标不切实际，且该人群中的某些亚组可能更倾向于抱有此类信念。本研究调查了三种不同减重手术（腹腔镜胃旁路术、腹腔镜可调胃束带术或腹腔镜袖状胃切除术）患者的减重预期。
2007 年 10 月至 2008 年 6 月期间，114 名患者（81.6%为女性）接受了减重手术。在进入该项目时，患者确定了术后目标体重。“现实”体重是根据患者术前超重和预期因手术而减轻的体重计算得出的。
患者的体重减轻差异相当大，“现实”体重与“梦想”体重之间的差异范围为 0.34 至 71.11 公斤（M = 28.79 公斤；SD = 13.21 公斤）。平均值相当于减去 106%（SD = 0.15%）的超重体重。基线 BMI、女性、年轻、白种人种族占差异评分方差的 62%。在控制初始 BMI 后，三种手术类型之间的差异无统计学意义。
在所有三种手术类型中，女性、白种人、年轻患者和初始 BMI 较高的患者更有可能设定不切实际的目标。知情同意程序应帮助患者，尤其是那些最有可能不切实际的患者，了解可能的结果，作为对减重手术风险和益处的教育的一部分。
