title: Risk perception of obesity and bariatric surgery in patients seeking treatment for obesity.
abstract: Bariatric surgery (BSx) produces clinically relevant weight loss that translates into improved quality of life, decreased mortality, and reduction in medical comorbidities, including cardiovascular (CV) risk. Little is known about patients' decision-making process to undergo BSx, but risk perception is known to influence medical decision-making. This study examined CV and BSx risk perception in obese subjects undergoing BSx (n = 268) versus those managed medically (MM) (n = 273). This retrospective population-based survey of subjects evaluated for BSx had 148 (55%) and 88 (32%) responders in the BSx and MM groups, respectively. Survey questions assessed risk perceptions and habits prior to weight loss intervention. CV risk was calculated using the Framingham Risk Score (FRS). At baseline, BSx subjects had a greater body mass index and greater prevalence of diabetes and depression. Follow-up mean weight loss was greater in the BSx group. BSx subjects perceived obesity as a greater risk to their overall health than the surgical risk. FRS declined in the BSx group (10 to 5%; p < 0.001) while there was no change in the MM group (8 to 8%; p = 0.54). Those without a measurable decrease in CV risk had a greater tendency to perceive the risk of BSx as greater than that of obesity. Obese subjects undergoing BSx are more likely than MM subjects to perceive obesity as a greater risk to their health than BSx. MM subjects generally underestimate their CV risk and overestimate the risk of BSx. Active discussion of CV risk using the FRS and the perception of risk associated with bariatric surgery can enhance patients' ability to make an informed decision regarding their management.
authors.affiliation: Division of General Internal Medicine, University of Pittsburgh Medical Center, USA prasadc@upmc.edu.
authors.forename: Chaithra
authors.initials: C
authors.lastname: Prasad
authors.affiliation: Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, USA Geisel School of Medicine, Dartmouth College, Lebanon, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Batsis
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, USA.
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Clark
authors.affiliation: Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, USA.
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
authors.affiliation: Division of Endocrinology, Nutrition, Metabolism & Diabetes, Mayo Clinic, Rochester, USA.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Collazo-Clavell
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000601:surgery*; D010361:Patients / Q000523:psychology*; D010465:Perception / Q000502:physiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Obesity; bariatric surgery; risk perception