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Published in: Obesity Surgery 7/2017

01-07-2017 | Original Contributions

Is there a Reason Why Obese Patients Choose Either Conservative Treatment or Surgery?

Authors: Lars Fischer, Anna-Laura Wekerle, Johannes Sander, Felix Nickel, Adrian T. Billeter, Ulrike Zech, Thomas Bruckner, Beat P. Müller-Stich

Published in: Obesity Surgery | Issue 7/2017

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Abstract

Background

The effects of bariatric surgery on excess weight loss (EWL) and comorbidities are proven. Still, a significant number of patients prefer conservative therapy (ConsP).

Objectives

The goal of this study was to examine why ConsP and patients awaiting bariatric surgery (SurgP) choose which therapy, and to define the differences in their expectations.

Setting

Prospective study, 1 university hospital, 1 general hospital, Germany.

Methods

ConsP and SurgP were asked to complete a questionnaire. Statistical analysis including all patients and a BMI-matched cohort was performed using the chi-square and Wilcoxon rank-sum test.

Results

Overall, 151 patients participated in this study (50 ConsP, 101 SurgP, 69.4% females). The mean age was 41.1 years (SD ± 12.2 years). ConsP had a significant lower body mass index (BMI, 44.7 kg/m2 vs. 49.3 kg/m2, p < 0.01). The educational level was significantly higher in ConsP. SurgP suffered significantly more often from depression (21.6% vs. 36.6%, p = 0.02) and joint pain (45.1% vs. 68.7%, p = 0.02). ConsP completed significantly more diets that were supervised by physicians or considered well-structured (56.3% vs. 31.0%, p = 0.04). SurgP considered their chosen therapy a last resort significantly more often (p < 0.01). A BMI-matched analysis between ConsP and SurgP revealed no significant differences in the prevalence of comorbidities but showed that fear of surgery plays a major role in the decision-making processes of obese patients.

Conclusion

A higher BMI and a greater prevalence of comorbidities had driven patients to seek a more radical solution for their obesity, i.e., surgery. The BMI-matched analysis suggests that fear of surgery is a relevant factor in why obese patients do not decide to undergo bariatric surgery lightly.
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Metadata
Title
Is there a Reason Why Obese Patients Choose Either Conservative Treatment or Surgery?
Authors
Lars Fischer
Anna-Laura Wekerle
Johannes Sander
Felix Nickel
Adrian T. Billeter
Ulrike Zech
Thomas Bruckner
Beat P. Müller-Stich
Publication date
01-07-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 7/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2534-0

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