title: Motivation, readiness to change, and weight loss following adjustable gastric band surgery.
abstract: High levels of readiness to change (RTC) are considered critical to the long-term success of weight management programs including bariatric surgery. However, there are no data to support this assertion. We hypothesize that RTC level will not influence weight outcomes following surgery. In 227 consecutive patients undergoing adjustable gastric banding surgery, we recorded reasons for seeking surgery, and RTC measured with the University of Rhode Island Change Assessment. Scores were blinded until study completion. The primary outcome measure was percentage of excess BMI loss at 2 years (%EBMIL-2); others included compliance and surgical complications. Of 227 subjects, 204 (90%) had weight measurement at 2 years. There was no significant correlation between RTC score and %EBMIL-2 (r = 0.047, P = 0.5). Using the median split for RTC score the lowest 102 subjects mean %EBMIL-2 was 52.9 +/- 26.9% and the highest 52.2 +/- 28.3%, P = 0.869. There was no weight loss difference between highest and lowest quartiles, or a nonlinear relationship between weight loss and RTC score. There was no significant relationship between RCT score and compliance, or likelihood of complications. Those motivated by appearance were more likely to be younger women who lost more weight at 2 years. Poor attendance at follow-up visits was associated with less weight loss, especially in men. Measures of RTC did not predict weight loss, compliance, or surgical complications. Caution is advised when using assessments of RTC to predict outcomes of bariatric surgery.
authors.affiliation: Centre for Obesity Research and Education, Monash University, Victoria, Australia. john.dixon@med.monash.edu.au
authors.forename: John B
authors.initials: JB
authors.lastname: Dixon
authors.forename: Cheryl P
authors.initials: CP
authors.lastname: Laurie
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Anderson
authors.forename: Melissa J
authors.initials: MJ
authors.lastname: Hayden
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Dixon
authors.forename: Paul E
authors.initials: PE
authors.lastname: O'Brien
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods*; D005247:Feeding Behavior / Q000502:physiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance / Q000523:psychology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012528:Satiety Response / Q000502:physiology; D015431:Weight Loss / Q000502:physiology*