Tone Nygaard Flølo1, Grethe S Tell2, Ronette L Kolotkin3, Anny Aasprang4, Tone M Norekvål5, Villy Våge6, John R Andersen4. 1. Department of Surgery, Voss Hospital, Haukeland University Hospital, Voss, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. Electronic address: tone.flolo@helse-bergen.no. 2. Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway. 3. Western Norway University of Applied Sciences, Faculty of Health and Social Sciences, Førde, Norway; Center of Health Research, Førde Hospital Trust, Førde, Norway; Department of Community and Family Medicine, Duke University School of Medicine, Durham, North Carolina. 4. Western Norway University of Applied Sciences, Faculty of Health and Social Sciences, Førde, Norway; Center of Health Research, Førde Hospital Trust, Førde, Norway. 5. Western Norway University of Applied Sciences, Faculty of Health and Social Sciences, Førde, Norway; Center of Health Research, Førde Hospital Trust, Førde, Norway; Department of Heart Diseases, Haukeland University Hospital, Bergen, Norway. 6. Department of Surgery, Haraldsplass Diaconal Hospital, Bergen, Norway; Scandinavian Obesity Surgery Registry (SOReg-N), The Western Norway Health Region Authority, Bergen, Norway.
Abstract
BACKGROUND: A person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery. OBJECTIVE: We investigated the association between ESE, weight loss, and obesity-specific quality of life (QOL) after sleeve gastrectomy (SG). SETTING: A single-center longitudinal study. METHODS: Data from adult patients were collected before SG, and at mean 16 months (±standard deviation 4 mo) and 55 (±4) months postoperatively. ESE was measured by the Weight Efficacy Lifestyle Questionnaire Short-Form. Multiple regression analyses were performed with excess body mass index loss (%EBMIL) and obesity-specific QOL as dependent variables. Age, sex, and other preoperative values were covariates in all models. RESULTS: Of 114 preoperative patients, 91 (80%) and 84 (74%) were available for follow-up 16 and 55 months after SG, respectively. Mean %EBMIL from baseline to 16 and 55 months was 76% (95% confidence interval: 71.9, 79.6) and 67% (95% confidence interval: 61.9, 72.2), respectively. Preoperative ESE scores improved significantly at both 16 and 55 months (P = .002) but did not predict postoperative %EBMIL or QOL at 55 months (β = -.08, P = .485). Greater change in ESE from 0 to 16 months predicted higher %EBMIL (β = .34, P = .013) at 55 months, and improvements in ESE from 0 to 55 months were significantly associated with higher %EBMIL (β = .46, P = .001) and obesity-specific QOL (β = .50, P < .001) 55 months after SG. CONCLUSION: Significant improvements in ESE were seen at 16 months, and remained high at 55 months after SG in this cohort. Patients who improved their ESE the most also experienced the highest weight loss and obesity-specific QOL 5 years postoperatively. Future research should address whether enhancement of ESE corresponds to sustained improvements in eating behavior after bariatric surgery.
BACKGROUND: A person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery. OBJECTIVE: We investigated the association between ESE, weight loss, and obesity-specific quality of life (QOL) after sleeve gastrectomy (SG). SETTING: A single-center longitudinal study. METHODS: Data from adult patients were collected before SG, and at mean 16 months (±standard deviation 4 mo) and 55 (±4) months postoperatively. ESE was measured by the Weight Efficacy Lifestyle Questionnaire Short-Form. Multiple regression analyses were performed with excess body mass index loss (%EBMIL) and obesity-specific QOL as dependent variables. Age, sex, and other preoperative values were covariates in all models. RESULTS: Of 114 preoperative patients, 91 (80%) and 84 (74%) were available for follow-up 16 and 55 months after SG, respectively. Mean %EBMIL from baseline to 16 and 55 months was 76% (95% confidence interval: 71.9, 79.6) and 67% (95% confidence interval: 61.9, 72.2), respectively. Preoperative ESE scores improved significantly at both 16 and 55 months (P = .002) but did not predict postoperative %EBMIL or QOL at 55 months (β = -.08, P = .485). Greater change in ESE from 0 to 16 months predicted higher %EBMIL (β = .34, P = .013) at 55 months, and improvements in ESE from 0 to 55 months were significantly associated with higher %EBMIL (β = .46, P = .001) and obesity-specific QOL (β = .50, P < .001) 55 months after SG. CONCLUSION: Significant improvements in ESE were seen at 16 months, and remained high at 55 months after SG in this cohort. Patients who improved their ESE the most also experienced the highest weight loss and obesity-specific QOL 5 years postoperatively. Future research should address whether enhancement of ESE corresponds to sustained improvements in eating behavior after bariatric surgery.
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