title: Is bariatric surgery an option for women with gynecologic cancer? Examining weight loss counseling practices and training among gynecologic oncology providers.
abstract: OBJECTIVE
  The objective of this study was to evaluate gynecologic oncology provider (GOP) practices regarding weight loss (WL) counseling, and to assess their willingness to initiate weight loss interventions, specifically bariatric surgery (WLS).
  
  
  METHODS
  Members of the Society of Gynecologic Oncology were invited to complete an online survey of 49 items assessing knowledge, attitudes, and behaviors related to WL counseling.
  
  
  RESULTS
  A total of 454 participants initiated the survey, yielding a response rate of 30%. The majority of respondents (85%) were practicing GOP or fellows. A majority of responders reported that >50% of their patient population is clinically obese (BMI ≥ 30). Only 10% reported having any formal training in WL counseling, most often in medical school or residency. Providers who feel adequate about WL counseling were more likely to offer multiple WL options to their patients (p<.05). Over 90% of responders believe that WLS is an effective WL option and is more effective than self-directed diet and medical management of obesity. Providers who were more comfortable with WL counseling were significantly more likely to recommend WLS (p<.01). Approximately 75% of respondents expressed interest in clinical trials evaluating WLS in obese cancer survivors.
  
  
  CONCLUSIONS
  The present study suggests that GOP appreciate the importance of WL counseling, but often fail to provide it. Our results demonstrate the paucity of formal obesity training in oncology. Providers seem willing to recommend WLS as an option to their patients but also in clinical trials examining gynecologic cancer outcomes in women treated with BS.
authors.affiliation: Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Neff
authors.affiliation: University of Texas Health Sciences at San Antonio, San Antonio, TX, United States.
authors.forename: Georgia A
authors.initials: GA
authors.lastname: McCann
authors.affiliation: Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, OH, United States.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Carpenter
authors.affiliation: Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States.
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.affiliation: Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH, United States.
authors.forename: Sabrena
authors.initials: S
authors.lastname: Noria
authors.affiliation: Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH, United States.
authors.forename: Dean
authors.initials: D
authors.lastname: Mikami
authors.affiliation: Division of General and Gastrointestinal Surgery, The Ohio State University, Columbus, OH, United States.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Needleman
authors.affiliation: Division of Gynecologic Oncology, The Ohio State University, Columbus, OH, United States. Electronic address: David.O'Malley@osumc.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: O'Malley
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D037001:Directive Counseling; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications*; D006176:Gynecology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000601:surgery* / Q000628:therapy; D010818:Practice Patterns, Physicians'; D015431:Weight Loss
keywords: Endometrial cancer; Obesity; Weight loss surgery; Weight loss training