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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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          In search of how people change. Applications to addictive behaviors.

          How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
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            Is savage's independence axiom a universal rationality principle?

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              Towards a theory of intentional behaviour change: plans, planning, and self-regulation.

              Briefly review the current state of theorizing about volitional behaviour change and identification of challenges and possible solutions for future theory development. Review of the literature and theoretical analysis. Reasoned action theories have made limited contributions to the science of behaviour change as they do not propose means of changing cognitions or account for existing effective behaviour change techniques. Changing beliefs does not guarantee behaviour change. The implementation intentions (IMPs) approach to planning has advanced theorizing but the applications to health behaviours often divert substantially from the IMPs paradigm with regard to interventions, effects, mediators and moderators. Better construct definitions and differentiations are needed to make further progress in integrating theory and understanding behaviour change. Further progress in theorizing can be achieved by (a) disentangling planning constructs to study their independent and joint effects on behaviour, (b) progressing research on moderators and mediators of planning effects outside the laboratory and (c) integrating planning processes within learning theory and self-regulation theory.
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                Author and article information

                Contributors
                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
                : 6
                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
                Author information
                http://orcid.org/0000-0003-2406-2102
                Article
                84
                10.1186/s40608-016-0084-6
                4743365
                26885374
                33c7d022-da6d-4b94-9a07-f64756df8479
                © 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.

                History
                : 29 August 2015
                : 20 January 2016
                Funding
                Funded by: Dep. of Psychology, University of Oslo
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                psychosocial variables,bariatric surgery,weight treatment,behavioral strategies

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