Top

Obesity Surgery

Published in:

01-09-2018 | Original Contributions

Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery

Authors: Cassie Brode, Megan Ratcliff, Jennifer Reiter-Purtill, Sanita Hunsaker, Michael Helmrath, Meg Zeller

Published in: Obesity Surgery | Issue 9/2018

Abstract

Background

Factors contributing to adolescents’ non-completion of bariatric surgery, defined as self-withdrawal during the preoperative phase of care, independent of program or insurance denial, are largely unknown. Recent adolescent and adult bariatric surgery literature indicate that psychological factors and treatment withdrawal play a role; however, for adolescents, additional age-salient (family/caregiver) variables might also influence progression to surgery.

Objectives

The present study examined demographic, psychological, and family/caregiver variables as predictors of whether adolescents completed surgery (“completers”) or withdrew from treatment (“non-completers”).

Setting

Adolescents were from a bariatric surgery program within a pediatric tertiary care hospital.

Methods

A retrospective chart review was conducted of consecutive patients who completed bariatric surgery psychological intake evaluations from September 2009 to April 2013. Data involving completer (n = 61) versus non-completer (n = 65) status were analyzed using two-tailed independent t tests, Chi-squared tests, and logistic regressions.

Results

Forty-three percent of adolescents completed surgery, similar to adult bariatric samples. Significantly more males were non-completers (p < .05), and there was a trend towards non-completion for older adolescents (p = 0.06). No other demographic, psychological, or caregiver/family variables were significant predictors of non-completion.

Conclusions

These findings indicate that demographic variables, rather than psychological or family factors, were associated with the progression to or withdrawal from surgery. Further assessment is needed to determine specific reasons for completing or withdrawing from treatment, particularly for males and older adolescents, to improve clinical care and reduce attrition.

Kelly AS, Barlow SE, Rao G, et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches. A scientific statement from the American Heart Association. Circulation. 2013;128:1689–712. https://doi.org/10.1161/CIR.0b013e3182a5cfb3.CrossRef

Skinner AC, Perrin EM, Skelton JA. Prevalence of obesity and severe obesity in US children, 1999-2014. Obesity. 2016;24(5):1116–23. https://doi.org/10.1002/oby.21497.CrossRef

Inge TH, Boyce TW, Lee M, et al. Access to care for adolescents seeking weight loss surgery. Obesity. 2014;22:2593–7. https://doi.org/10.1002/oby.20898.CrossRef

Woolford SJ, Clark SJ, Sallinen BJ, et al. Bariatric surgery decision making challenges: the stability of teens’ decisions and the treatment failure paradox. PediatrSurgInt. 2012;28:455–60. https://doi.org/10.1007/s00383-012-3069-7.CrossRef

Martin M, Beekley A, Kjorstad R, et al. Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. SurgObesRelat Dis. 2010;6:8–15. https://doi.org/10.1016/j.soard.2009.07.003.CrossRef

Sockalingam S, Cassin S, Crawford SA, et al. Psychiatric predictors of surgery non-completion following suitability assessment for bariatric surgery. ObesSurg. 2013;23:205–11. https://doi.org/10.1007/s11695-012-0762-5.CrossRef

Merrell J, Ashton K, Windover A, et al. Psychological risk may influence drop-out prior to bariatric surgery. SurgObesRelat Dis. 2012;8:463–9. https://doi.org/10.1016/j.soard.2012.01.018.CrossRef

Grave R, Calugi S, Molinari E, et al. Weight loss expectations in obese patients and treatment attrition: an observational multicenter study. Obes Res. 2005;13:1961–9. https://doi.org/10.1038/oby.2005.241.CrossRef

Grossi E, Dalle Grave R, Mannucci, et al. Complexity of attrition in the treatment of obesity: clues from a structured telephone interview. Int J Obesity. 2006;30:1132–7. https://doi.org/10.1038/sj.ijo.0803244.CrossRef

10.

Moroshko I, Brennan L, O'Brien P. Predictors of dropout in weight loss interventions: a systematic review of the literature. Obes Rev. 2011;12:912–34. https://doi.org/10.1111/j.1467-789x.2011.00915.x.CrossRef

11.

Zeller M, Kirk S, Claytor R, et al. Predictors of attrition from a pediatric weight management program. J Pediatr. 2004;144:466–70. https://doi.org/10.1016/j.jpeds.2003.12.031.CrossRef

12.

Cohen MJ, Curran JL, Phan TT, et al. Psychological contributors to noncompletion of an adolescent preoperative bariatric surgery program. SurgObesRelat Dis. 2017;13(1):58–64. https://doi.org/10.1016/j.soard.2016.08.020.CrossRef

13.

Zeller MH, Reiter-Purtill J. Psychosocial issues in adolescent bariatric surgery. In: The ASMBS Textbook of Bariatric Surgery. New York: Springer; 2014. p. 65–73. https://doi.org/10.1007/978-1-4939-1197-4_8.CrossRef

14.

Skelton JA, Goff DC, IP E, et al. Attrition in a multidisciplinary pediatric weight management clinic. Childhood Obesity. 2011;7(3):185–93. https://doi.org/10.1089/chi.2011.0010.CrossRef

15.

Schor EL. Family pediatrics: report of the task force on the family. Pediatrics. 2003;111:1541–71.

16.

Skelton JA, Buehler C, Irby MB, et al. Where are family theories in family-based obesity treatment?: conceptualizing the study of families in pediatric weight management. Int J Obes. 2012;36(7):891–900. https://doi.org/10.1038/ijo.2012.56.CrossRef

17.

Zeller MH, Hunsaker S, Mikhail C, et al. Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes. Obesity. 2016;24:2562–9. https://doi.org/10.1002/oby.21676.CrossRef

18.

Skelton J, Beech B. Attrition in pediatric weight management: a review of the literature and new directions. Obes Rev. 2011;12:e273–81. https://doi.org/10.1111/j.1467-789x.2010.00803.x.CrossRef

19.

Gundersen, C, Mahatmya D, Garasky S, Lohman, B. Linking psychosocial stressors and childhood obesity. Obes Rev 2010; 12: e54-e63. https://doi.org/10.1111/j.1467-789x.2010.00813.x.

20.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, revised. 4^th ed.Washington DC: American Psychiatric Association; 2000. https://doi.org/10.1007/springerreference_179660.

21.

Statistics IS SPSS version 21.0 for Microsoft windows platform. SPSS Inc.: Chicago, IL, USA, 2012.

22.

Muthén LK, Muthén BO. Mplus version 7: Los Angeles, Muthén & Muthén; 1998-2014.

23.

Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294:1909–17. https://doi.org/10.1001/jama.294.15.1909 CrossRef

24.

Wee CC, Hamel MB, Apovian CM, et al. Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. JAMA Surg. 2013;148(3):264–71. https://doi.org/10.1001/jamasurg.2013.1048 CrossRef

25.

VerbruggeLM SRP. Physician treatment of men and women patients: sex bias or appropriate care? Med Care. 1981;19:609–32. https://doi.org/10.1097/00005650-198106000-00005 CrossRef

26.

Tudiver F, Talbot Y. Why don’t men seek help? Family physicians’ perspective on help-seeking behavior in men. J Family Pract. 1999;48:47–52.

27.

McQuaid EL, Kopel SJ, Klein RB, et al. Medication adherence in pediatric asthma: reasoning, responsibility, and behavior. J Pediatr Psychol. 2003;28:323–33. https://doi.org/10.1093/jpepsy/jsg022 CrossRef

28.

Slotman GJ. Gastric bypass: a family affair—41 families in which multiple members underwent bariatric surgery. SurgObesRelat Dis. 2011;7:592–8. https://doi.org/10.1016/j.soard.2011.04.230

29.

Zeller MH, Guilfoyle SM, Reiter-Purtil J, et al. Adolescent bariatric surgery: caregiver and family functioning across the first postoperative year. SurgObesRelat Dis. 2011;7:145–50. https://doi.org/10.1016/j.soard.2010.07.004

30.

Inge TH, Zeller MH, Harmon CM, et al. Teen-longitudinal assessment of bariatric surgery: methodological features of the first prospective multicenter study of adolescent bariatric surgery. J PediatrSurg. 2007;42:1969–71. https://doi.org/10.1016/j.jpedsurg.2007.08.010

31.

Sawhney P, Modi AC, Jenkins TM, et al. Predictors and outcomes of adolescent bariatric support group attendance. SurgObesRelat Dis. 2013;9:773–9. https://doi.org/10.1016/j.soard.2013.03.016

32.

Cote MP, Byczkowski T, Kotagal U, et al. Service quality and attrition: an examination of a pediatric obesity program. Int J Qual Health Care. 2004;16(2):165–73. https://doi.org/10.1093/intqhc/mzh015 CrossRef

33.

Kitscha CE, Brunet K, Farmer A, et al. Reasons for non-return to a pediatric weight management program. Can J Diet Prac Res. 2009;70(2):89–94. https://doi.org/10.3148/70.2.2009.89.CrossRef

34.

Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. SurgObesRelat Dis. 2016;12(4):731–49. https://doi.org/10.1016/j.soard.2016.02.008

35.

Kizy S et al. National trends in bariatric surgery 2012–2015: demographics, procedure selection, readmissions, and cost. Obes Surg. 2017;27(11):2933–9. https://doi.org/10.1007/s11695-017-2719-1.CrossRef

Title: Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery
Authors: Cassie Brode
Megan Ratcliff
Jennifer Reiter-Purtill
Sanita Hunsaker
Michael Helmrath
Meg Zeller
Publication date: 01-09-2018
Publisher: Springer US
Published in: Obesity Surgery / Issue 9/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-018-3261-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predictors of Preoperative Program Non-Completion in Adolescents Referred for Bariatric Surgery

Abstract

Background

Objectives

Setting

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objectives

Setting

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2018

Practices Concerning Revisional Bariatric Surgery: a Survey of 460 Surgeons

From the Editor’s Desk

Factors Influence the Acceptance of Surgical Treatment in Chinese Bariatric Surgery Candidates

Correction to: Incidence and Risk Factors for Mortality Following Bariatric Surgery: a Nationwide Registry Study

Managing a Positive Air-Leak Test During a Gastrojejunostomy Revision

Lack of Diagnosis of Pneumoperitoneum in Perforated Duodenal Ulcer After RYGB: a Short Case Series and Review of the Literature