The Department of Surgery, Elisabeth-Tweesteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, The Netherlands.
The Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands.
Obes Surg. 2020 Nov;30(11):4411-4421. doi: 10.1007/s11695-020-04811-x. Epub 2020 Jul 8.
There are discrepancies between patients' expected weight loss and what is considered achievable after bariatric surgery. This study describes the association between patients' expectations and actual weight loss, 1 and 2 years postoperatively.
A prospective observational study was performed. The association between expectations and actual weight loss (% total weight loss) was explored using linear regression analyses, adjusting for baseline demographics, surgery types, and self-esteem (Rosenberg self-esteem scale) and repeated separately per gender. Gender differences in motivations were explored using Chi-square tests.
Of 440 patients at baseline, results on 368 (84%) at 1 year and 341 (78%) patients at 2 years were available. Significant and opposite associations were found when analyzing genders separately. There was a significant negative association between expectations and %TWL in men at 1 year (β - 0.23, p = 0.04) and 2 years postoperatively (β - 0.26, p = 0.03), indicating smaller weight loss for greater expectations. In women, a significant positive association (β 0.24, p < 0.01) was found 2 years postoperatively, indicating greater weight loss for greater expectations. Both genders were mainly motivated by health concerns, but women were also motivated by reduced self-confidence to lose weight.
Higher expectations were negatively associated with weight loss in men, but positively in women. This may be due to men being motivated by physical complaints, which improve with lower weight-loss. Women are also driven by reduced self-confidence, which may influence weight loss maintenance behaviors. Higher weight loss goals should not be considered as a contra-indication for surgery, but may be utilized to achieve patients' goals.
患者对减重手术后预期的减重效果与实际减重效果之间存在差异。本研究描述了患者预期与术后 1 年和 2 年实际体重减轻之间的关联。
进行了一项前瞻性观察研究。使用线性回归分析，根据基线人口统计学、手术类型以及自尊（罗森伯格自尊量表），对预期与实际体重减轻（%总体重减轻）之间的关联进行了调整，并分别按性别进行了重复分析。使用卡方检验探讨了性别之间动机的差异。
在基线时的 440 例患者中，有 368 例（84%）患者在 1 年后和 341 例（78%）患者在 2 年后有结果。当按性别分别分析时，发现了显著的相反关联。在男性中，1 年（β-0.23，p=0.04）和 2 年（β-0.26，p=0.03）术后，期望与%TWL 之间存在显著的负相关，表明期望越高，体重减轻越小。在女性中，2 年后（β 0.24，p<0.01）发现了显著的正相关，表明期望越高，体重减轻越大。两种性别主要受健康问题的驱动，但女性也因自信心下降而减肥。
男性的较高期望与体重减轻呈负相关，但女性则呈正相关。这可能是因为男性的动机是身体抱怨，体重减轻可以改善这些抱怨。女性也受到自信心下降的驱动，这可能会影响减肥维持行为。较高的减肥目标不应被视为手术的禁忌症，而可以利用这些目标来实现患者的目标。
