Previous weight loss experiences of bariatric surgery candidates: how much have patients dieted prior to surgery?
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.
Gibbons
Lauren M
LM
Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Sarwer
David B
DB
Crerand
Canice E
CE
Fabricatore
Anthony N
AN
Kuehnel
Robert H
RH
Lipschutz
Patti E
PE
Raper
Steven E
SE
Williams
Noel N
NN
Wadden
Thomas A
TA
D000704:Analysis of Variance; D050110:Bariatric Surgery / Q000523:psychology*; D016009:Chi-Square Distribution; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall; D009767:Obesity, Morbid / Q000178:diet therapy* / Q000523:psychology* / Q000601:surgery; D011795:Surveys and Questionnaires; D015431:Weight Loss