title: Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery?
abstract: OBJECTIVE
  To describe the dieting histories of bariatric surgery candidates.
  
  
  METHODS
  One hundred seventy-seven individuals with extreme obesity who sought bariatric surgery completed the Weight and Lifestyle Inventory, a self-report instrument that assesses several variables, including weight and dieting history. Patients' dieting histories were further explored with an aided recall during a preoperative behavioral/psychological evaluation performed by a mental health professional.
  
  
  RESULTS
  Participants who completed the Weight and Lifestyle Inventory reported an average of 4.7 +/- 2.9 successful dieting attempts, defined as those that resulted in a loss of 10 lbs (4.5 kg) or more. These individuals reported a mean total lifetime weight loss of 61.1 +/- 41.3 kg. Despite these efforts, their weight increased from 89.4 +/- 27.4 kg at the time of their first diet (age 21.2 +/- 10.1 years) to 144.5 +/- 30.8 kg at the time they underwent their behavioral/psychological evaluation (age 43.0 +/- 11.0 years). Results of the aided recall revealed that participants had made numerous other efforts to lose weight that were unsuccessful. Self-directed diets and commercial programs were used more frequently.
  
  
  CONCLUSIONS
  Individuals who sought bariatric surgery reported an extensive history of dieting, beginning in adolescence, that was not successful in halting progressive weight gain. Thus, the recommendation often made by insurance companies that patients delay surgery to attempt more conservative treatment options may be unwarranted, particularly in the presence of significant obesity-related comorbidities. Weight loss histories should be routinely examined during a behavioral evaluation to determine whether additional attempts at non-surgical weight loss are advisable. Future studies also are needed to explore the potential relationship between dieting history and postoperative outcome.
authors.affiliation: Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, 3535 Market Street, Suite 3029, Philadelphia, PA 19104, USA.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Gibbons
authors.forename: David B
authors.initials: DB
authors.lastname: Sarwer
authors.forename: Canice E
authors.initials: CE
authors.lastname: Crerand
authors.forename: Anthony N
authors.initials: AN
authors.lastname: Fabricatore
authors.forename: Robert H
authors.initials: RH
authors.lastname: Kuehnel
authors.forename: Patti E
authors.initials: PE
authors.lastname: Lipschutz
authors.forename: Steven E
authors.initials: SE
authors.lastname: Raper
authors.forename: Noel N
authors.initials: NN
authors.lastname: Williams
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Wadden
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000523:psychology / Q000601:surgery*; D010555:Personality Inventory; D012737:Sex Factors; D011795:Surveys and Questionnaires; D015431:Weight Loss