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A comparison of behavioral and psychological characteristics of patients opting for surgical and conservative treatment for morbid obesity

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      Abstract

      Background

      Little is known about the psychological prerequisites for weight loss maintenance after bariatric surgery. A first step in investigating whether existing knowledge of conservative weight loss treatment is applicable for lifestyle interventions postoperatively is to compare specific psychological characteristics at baseline. The aim of this study was to compare patients scheduled for bariatric surgery with patients receiving conservative treatment for morbid obesity on measures of behavioral and psychosocial characteristics considered predictors of their adoption of and adherence to long-term lifestyle recommendations.

      Methods

      Baseline clinical and questionnaire data from the prospective “Oslo Bariatric Surgery Study” were used to examine potential differences between bariatric surgery patients ( n = 301) and patients receiving conservative weight loss treatment ( n = 261).

      Results

      The surgical group was characterized by their younger age (43.8 vs. 46.2 years, p <0.01), higher percentage of women (79.1 vs. 70.1 %, p <0.05), and higher Body Mass Index (BMI; 45.0 vs. 41.9 kg/m 2, p <0.001). A multiple logistic regression analysis, adjusting for group differences in BMI, gender, and age, showed that the surgical group had higher self-efficacy (Odds ratio; OR = 3.44, 95 % Confidence interval; CI 1.65, 7.14), more positive outcome expectations (OR = 1.53, 95 % CI 1.23, 1.89), and plans that were more explicit for changing their eating behaviors (OR = 1.80, 95 % CI 1.06, 1.93). The surgical patients were also less ready to change physical activity levels (OR = 0.59, 95 % CI 0.48, 0.73), had tried more types of unhealthy weight loss methods in the past (OR = 1.16, 95 % CI 1.01, 1.33), drank soda more frequently (OR = 1.24, 95 % CI 1.02, 1.50), had fewer binge eating episodes (OR = 0.38, 95 % CI 0.20, 0.71), and had more depressive symptoms (OR = 1.19, 95 % CI 1.09, 1.29).

      Conclusions

      Patients opting for bariatric surgery had more positive expectations of the treatment outcomes and stronger beliefs in their ability to achieve these outcomes. Those starting conservative treatment had stronger beliefs in readiness to change physical activity levels. Future studies should explore the effect of interventions for bariatric surgery patients, promoting postoperative physical activity and stress realistic outcome expectations. The potential effects of incorporating this knowledge in intervention strategies remain to be explored.

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      Most cited references 46

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      A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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        International physical activity questionnaire: 12-country reliability and validity.

        Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            Author and article information

            Affiliations
            [ ]Department of Psychology, University of Oslo, PB 1094, Blindern, N-0317 Oslo, Norway
            [ ]Department of Psychology, University of Tromsø, Tromsø, Norway
            [ ]Center for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Postboks 4950, Nydalen, 0424 Oslo, Norway
            [ ]Department for Mental Health and Addiction, Oslo University Hospital, Postboks 4950, Nydalen, 0424 Oslo, Norway
            [ ]Institute of Clinical Medicine, University of Oslo, Oslo, Norway
            Contributors
            ORCID: http://orcid.org/0000-0003-2406-2102, i.l.kvalem@psykologi.uio.no
            irmelin.bergh@psykologi.uio.no
            t.v.soest@psykologi.uio.no
            jan.rosenvinge@uit.no
            tiajoh@ous-hf.no
            e.w.martinsen@medisin.uio.no
            tom.mala@netcom.no
            JOAKRI@ous-hf.no
            Journal
            BMC Obes
            BMC Obes
            BMC obesity
            BioMed Central (London )
            2052-9538
            5 February 2016
            5 February 2016
            2015
            : 3
            26885374
            4743365
            84
            10.1186/s40608-016-0084-6
            © Kvalem et al. 2016

            Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

            Funding
            Funded by: Dep. of Psychology, University of Oslo
            Categories
            Research Article
            Custom metadata
            © The Author(s) 2016

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