Compliance with Surgical After-care following Bariatric Surgery for Morbid Obesity: a Retrospective Study
Abstract
Background Non-compliant patients fail to match their behavior to the clinical prescription. Laparoscopic adjustable gastric banding requires strict compliance with surgical and dietary advice. Failure to attend follow-up appointments and the persistent consumption of calorie-dense liquid foods are associated with poor weight loss and postoperative complications. Prediction of "poor compliers" would enhance candidate selection and enable specific interventions to be targeted.Methods 9 poor compliers were identified and compared with 9 fully compliant controls. Case-notes were analyzed retrospectively.Results Cases were found to graze on foods and eat more in response to negative affects. They were reluctant to undergo psychiatric assessment, viewed the band as responsible for weight loss, and aroused caution in the psychiatric evaluator. Poor compliance was not associated with binge eating, purging, impulsivity or psychiatric illness.Conclusions Unrealistic expectations and anxiety are known to predict non-adherence. Constant negative affects may be self-modulated by grazing. The results are explored in the context of Self-efficacy Theory, a socio-cognitive account of illness behavior.
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Pre-operative grazing is predictive of poorer adherence to dietary recommendations in RYGB and gastric band patients.
“pre‐operative grazing (i.e., picking/nibbling), 33 pre‐operative night‐eating, 30 or a history of combined mood and eating disorder 34 is predictive of poorer adherence to dietary recommendations in RYGB and gastric band patients.”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [33]
Pre-operative emotional eating is predictive of poorer adherence to dietary recommendations in RYGB and gastric band patients.
“pre‐operative emotional eating, 33 pre‐operative grazing (i.e., picking/nibbling), 33 pre‐operative night‐eating, 30 or a history of combined mood and eating disorder 34 is predictive of poorer adherence to dietary recommendations in RYGB and gastric band patients.”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [33]
In that small study, no differences between non-compliers and controls were noted with regard to pre-operative binge eating disorder, bulimia nervosa, mood disorders, alcohol abuse, child sexual abuse history, insight about obesity, and the belief that the band is responsible for weight loss.
“No differences between the groups were noted with regard to pre‐operative binge eating disorder, bulimia nervosa, mood disorders, alcohol abuse, child sexual abuse history, insight about obesity, and the belief that the band is responsible for weight loss”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [33]
In a small study of LAGB patients (N = 18), non-compliers were more likely to report pre-operative emotional eating.
“but non‐compliers were more likely to report pre‐operative emotional eating.”
From Psychological predictors of adherence to lifestyle changes after bariatric surgery: A systematic review (2024) · cites this paper as [33]
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- Authors
- Poole, N. A., Atar, A. A., Kuhanendran, D., Bidlake, L., Fiennes, A., McCluskey, S., Nussey, S., Bano, G., & Morgan, J. F.
- Affiliations
- St George's Hospital (GB)
- Venue
- Obesity Surgery
- Published
- 2005-02
- Volume
- 15
- Issue
- 2
- Pages
- 261-265
- ISSN
- 0960-8923 (ISSN-L)
- 1708-0428
- OpenAlex
- W2016632969
- Cited by
- 115
- References
- 16
- Citations by year
- 2025: 2 · 2024: 7 · 2023: 2 · 2021: 9 · 2020: 5 · 2019: 4 · 2018: 7 · 2017: 6 · 2016: 17 · 2015: 5 · 2014: 7 · 2013: 9 · 2012: 7
- FWCI
- 3.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obesity Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- bariatric surgery, morbid obesity
- MeSH terms
- Adaptation, Physiological, Adaptation, Psychological, Adult, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Patient Compliance, Postoperative Care, Probability, Retrospective Studies, Time Factors, Gastroplasty, Body Mass Index, Incidence, Case-Control Studies, Age Distribution, Sex Distribution, Risk Assessment, Self Efficacy
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