Melissa Opozda1, Gary Wittert2, Anna Chur-Hansen3. 1. School of Psychology, University of Adelaide, Adelaide, Australia; Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia. Electronic address: melissa.opozda@adelaide.edu.au. 2. Freemasons Foundation Centre for Men's Health, School of Medicine, University of Adelaide, Adelaide, Australia; Centre for Nutrition and Gastrointestinal Diseases, South Australian Health and Medicine Research Institute, Adelaide, Australia. 3. School of Psychology, University of Adelaide, Adelaide, Australia.
Abstract
BACKGROUND: The most common bariatric procedures, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (LAGB), and sleeve gastrectomy (SG), generally induce significant weight loss and health improvements. However, little is known about how patients decide which procedure to undergo. OBJECTIVE: Investigate patients' reasons for and against undergoing RYGB, LAGB, and SG. SETTING: Online questionnaire. METHODS: Data were analyzed from 236 Australian adults with current RYGB (15.7%), LAGB (22.0%), or SG (62.3%) who completed a questionnaire including an open-ended question about why they underwent their procedure. Data were coded for content and analyzed. RESULTS: Patients most often underwent RYGB because of its evidence base and success rate and the patient's characteristics, whereas the most common reason for SG was a medical practitioner's recommendation, preference, or choice, followed by the patients' evaluation of information gathered from their own research and observations of others' success. The most common reasons for undergoing LAGB related to characteristics of the procedure, including its reversibility and a perception of LAGB as less invasive. The most common reason against undergoing both RYGB and SG was a desire to avoid postsurgical complications and risks such as leaks or malabsorption, whereas the most common reason against LAGB was information and evidence from other people's unsuccessful experiences and failure rates. CONCLUSIONS: Patients' reasons for and against procedures differed by procedure. In addition to the surgeon's influence, patients demonstrated clear procedure preferences based on their own research, knowledge, and experiences. Preferences should be understood to assist patients to select the most appropriate procedure for their circumstances.
BACKGROUND: The most common bariatric procedures, Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (LAGB), and sleeve gastrectomy (SG), generally induce significant weight loss and health improvements. However, little is known about how patients decide which procedure to undergo. OBJECTIVE: Investigate patients' reasons for and against undergoing RYGB, LAGB, and SG. SETTING: Online questionnaire. METHODS: Data were analyzed from 236 Australian adults with current RYGB (15.7%), LAGB (22.0%), or SG (62.3%) who completed a questionnaire including an open-ended question about why they underwent their procedure. Data were coded for content and analyzed. RESULTS:Patients most often underwent RYGB because of its evidence base and success rate and the patient's characteristics, whereas the most common reason for SG was a medical practitioner's recommendation, preference, or choice, followed by the patients' evaluation of information gathered from their own research and observations of others' success. The most common reasons for undergoing LAGB related to characteristics of the procedure, including its reversibility and a perception of LAGB as less invasive. The most common reason against undergoing both RYGB and SG was a desire to avoid postsurgical complications and risks such as leaks or malabsorption, whereas the most common reason against LAGB was information and evidence from other people's unsuccessful experiences and failure rates. CONCLUSIONS:Patients' reasons for and against procedures differed by procedure. In addition to the surgeon's influence, patients demonstrated clear procedure preferences based on their own research, knowledge, and experiences. Preferences should be understood to assist patients to select the most appropriate procedure for their circumstances.
Authors: Michael D Rozier; Amir A Ghaferi; Angela Rose; Norma-Jean Simon; Nancy Birkmeyer; Lisa A Prosser Journal: JAMA Surg Date: 2019-01-16 Impact factor: 14.766