Quantifying patients' expectations prior to bariatric surgery with the BODY‐Q in an international multicentre cohort

Abstract

Summary Many people living with obesity may have unrealistic expectations prior to undergoing bariatric surgery. These expectations can lead to frustration, regret and even worse psychological outcomes after surgery. Prior to undergoing bariatric surgery, patients completed the BODY‐Q Expectations scale. This 15‐item scale asks patients to imagine what their life will be like when 2 years have passed since bariatric surgery. Scores for expectations range from 0 (low) to 100 (high). Linear regression models were used to assess which of the patient characteristics could predict patients' expectations. From 2019 to 2020, a total of 333 patients were recruited from three different countries. The mean score on the BODY‐Q Expectations scale was 73.1, ±20. Out of the 15 items on the Expectation scale, people living with obesity found it most likely that bariatric surgery would make them feel better and improve their energy, while it was reported least likely that they would look good without clothes on. Younger age (p = <.01) and race (non‐white) (p = .046) were found to be significant predictors for higher scores on the Expectations scale. Participants who identified as non‐white from the Netherlands and United States, and those aged under 40 years reported higher expectations compared with participants who identified as white race and were 40 years of age or older. Prior to bariatric surgery, patients aged under 40 years and those who identified as non‐white for race had higher expectations that their life would change after bariatric surgery. These relevant findings should be considered when giving pre‐operative counselling.

Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study

“…However, the %TWL did not differ between the age groups. These ndings contradict previous studies indicating that younger patients tend to have higher expectations regarding weight loss (20,21). A potential explanation could be that younger patients typically have fewer comorbidities, allowing them to focus more on weight loss.…”

Patient experiences of weight loss and eating after bariatric surgery: A systematic review and qualitative synthesis

“…Expectations for BS is another important consideration for preoperative support because participants in the current review highlighted discrepancies between their expectations of BS and perceived reality postsurgery. Similarly, a recently published study by Dijkhorst et al 32 investigated pre‐surgical patients' expectations of life following BS, using a scale score in which 61 participants (18.5%) scored at the ceiling for the scale (i.e., 100), indicating high expectations for how their life would be after surgery. Improvements in physical health, appearance, confidence and happiness levels were rated the highest among participants.…”

Factors associated with decision regret after bariatric surgery

“…5,6 In addition, the expected results of bariatric surgery might be overestimated by patients, leading to frustration and dissatisfaction. [7][8][9] As a result, individuals may experience decision regret after bariatric surgery.…”

“…Studies have shown that a small proportion of individuals may experience negative outcomes after bariatric surgery including suboptimal weight loss, surgical complications or decreased quality of life (QoL) 5,6 . In addition, the expected results of bariatric surgery might be overestimated by patients, leading to frustration and dissatisfaction 7–9 . As a result, individuals may experience decision regret after bariatric surgery.…”