title: Perceptions of weight, diabetes and willingness to participate in randomised controlled trials of bariatric surgery for patients with type 2 diabetes mellitus and body mass index 30-39.9 kg/m(2).
abstract: OBJECTIVE
  Evidence from high-quality randomised controlled trials (RCTs) is needed to establish the long-term benefit of bariatric surgery in people with type 2 diabetes mellitus (T2DM) and body mass index (BMI) 30-39.9 kg/m(2). However, willingness amongst this group to be randomised and undergo surgery is uncertain. This study assessed UK patients' perceptions of their weight and diabetes, and associations with willingness to participate in RCTs involving bariatric surgery, amongst this population.
  
  
  METHODS
  Postal survey of 1820 patients from four regions in England. Eligible patients were as follows: BMI 30-39.9 kg/m(2), 18-74 years, diagnosis of T2DM ≥2 years. A reminder survey was sent after 4 weeks. Independent predictors influencing patients' willingness to consider RCT participation were identified using multiple logistic regression analysis.
  
  
  RESULTS
  Thirty-four per cent (614/1820) of patients responded. Weight was considered to be harder to control than diabetes [468/584 (80 %) vs. 107/600 (17 %)]. More people reported a negative impact on life for weight rather than diabetes [379/579 (63 %) vs. 180/574 (31 %)]. Feeling unsatisfied/very unsatisfied with weight loss ability was common 261/578 (45 %). Sixty-four per cent (379/594, CI = 60-68) were willing to consider participating in an RCT. In multivariate analysis, negative impact of weight on life (OR = 2.55, 95 % CI = 1.68-3.89, P < 0.001) and feeling unsatisfied with weight loss ability (OR = 2.47, 95 % CI = 1.55-3.95, P < 0.001) positively influenced patients' willingness to participate in an RCT.
  
  
  CONCLUSIONS
  Strong patient interest supports the feasibility of such trials for this group. Perceptions of obesity negatively impacting on life and difficulties in achieving weight loss were common and influenced attitudes to potential participation in bariatric surgery RCTs.
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK, R.Summers@soton.ac.uk.
authors.forename: Rachael H
authors.initials: RH
authors.lastname: Summers
authors.forename: Michael
authors.initials: M
authors.lastname: Moore
authors.forename: James
authors.initials: J
authors.lastname: Byrne
authors.forename: Christopher
authors.initials: C
authors.lastname: Byrne
authors.forename: Mark
authors.initials: M
authors.lastname: Mullee
authors.forename: Richard
authors.initials: R
authors.lastname: Welbourn
authors.forename: Helen
authors.initials: H
authors.lastname: Elsey
authors.forename: Paul
authors.initials: P
authors.lastname: Roderick
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000601:surgery; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology* / Q000601:surgery; D035842:Research Subjects / Q000523:psychology*; D012649:Self Concept; D055815:Young Adult