Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes

ABSTRACT Purpose Pre‐operative eating disorders are well documented within the metabolic and bariatric surgery (MBS) population, yet subthreshold dieting attempts are less understood. The objectives of this study were to define and categorize patients' preoperative dieting attempts, and to dete...

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Main Authors: LeeAnn C. Swager, Keeley J. Pratt, Haley M. Kiser, Ashleigh A. Pona
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Obesity Science & Practice
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Online Access:https://doi.org/10.1002/osp4.70030
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author LeeAnn C. Swager
Keeley J. Pratt
Haley M. Kiser
Ashleigh A. Pona
author_facet LeeAnn C. Swager
Keeley J. Pratt
Haley M. Kiser
Ashleigh A. Pona
author_sort LeeAnn C. Swager
collection DOAJ
description ABSTRACT Purpose Pre‐operative eating disorders are well documented within the metabolic and bariatric surgery (MBS) population, yet subthreshold dieting attempts are less understood. The objectives of this study were to define and categorize patients' preoperative dieting attempts, and to determine how attempts are associated with postoperative outcomes, eating disorders, and demographics. Materials and Methods Three hundred twenty‐one patients (81.0% female; 68.3% White) who had MBS (57.3% Roux‐en‐Y) between 2019 and 2020 were included. Preoperative dieting attempt responses were categorized as provider‐managed, non‐medically managed, and self‐directed attempts; subtypes of dieting methods (e.g., low calorie) were described. Descriptive analyses were conducted for attempt categories and subtypes, and between attempts and readmissions, complications, eating disorders, and demographics. ANOVAs determined associations between attempts and %TWL at 6 and 12 months. Results Patients reported an average of five to six preoperative dieting attempts; self‐directed attempts were the most common (91.9%), and exercise was the most common subcategory (70.7%). Patients with  ≥ 1 provider‐managed attempt were less likely to experience a complication (p < 0.001) and more likely to experience readmission (p = 0.018). Patients with 1 self‐directed attempt were less likely to experience a complication (p = 0.045) and readmission (p < 0.001). Patients who experienced  ≥ 2 low fat diet attempts were more likely to have complications (p < 0.001) and readmissions (p = 0.008); patients with  ≥ 2 VLCD attempts were more likely to have a complication (p < 0.001). Patients who experienced  ≥ 2 non‐medically managed attempts had higher preoperative BMIs (p = 0.03). Discussion Given that patients engaged in frequent dieting attempts that fall outside formal assessments, future work should seek to expand pre‐operative assessments.
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spelling doaj-art-de0fb23f3b0a4254b4aab76a3cac02bc2024-12-27T10:20:33ZengWileyObesity Science & Practice2055-22382024-12-01106n/an/a10.1002/osp4.70030Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative OutcomesLeeAnn C. Swager0Keeley J. Pratt1Haley M. Kiser2Ashleigh A. Pona3Department of Human Sciences College of Education and Human Ecology The Ohio State University Columbus Ohio USADepartment of Human Sciences College of Education and Human Ecology The Ohio State University Columbus Ohio USADepartment of Human Sciences College of Education and Human Ecology The Ohio State University Columbus Ohio USAPsychiatry and Behavioral Health College of Medicine The Ohio State University Columbus Ohio USAABSTRACT Purpose Pre‐operative eating disorders are well documented within the metabolic and bariatric surgery (MBS) population, yet subthreshold dieting attempts are less understood. The objectives of this study were to define and categorize patients' preoperative dieting attempts, and to determine how attempts are associated with postoperative outcomes, eating disorders, and demographics. Materials and Methods Three hundred twenty‐one patients (81.0% female; 68.3% White) who had MBS (57.3% Roux‐en‐Y) between 2019 and 2020 were included. Preoperative dieting attempt responses were categorized as provider‐managed, non‐medically managed, and self‐directed attempts; subtypes of dieting methods (e.g., low calorie) were described. Descriptive analyses were conducted for attempt categories and subtypes, and between attempts and readmissions, complications, eating disorders, and demographics. ANOVAs determined associations between attempts and %TWL at 6 and 12 months. Results Patients reported an average of five to six preoperative dieting attempts; self‐directed attempts were the most common (91.9%), and exercise was the most common subcategory (70.7%). Patients with  ≥ 1 provider‐managed attempt were less likely to experience a complication (p < 0.001) and more likely to experience readmission (p = 0.018). Patients with 1 self‐directed attempt were less likely to experience a complication (p = 0.045) and readmission (p < 0.001). Patients who experienced  ≥ 2 low fat diet attempts were more likely to have complications (p < 0.001) and readmissions (p = 0.008); patients with  ≥ 2 VLCD attempts were more likely to have a complication (p < 0.001). Patients who experienced  ≥ 2 non‐medically managed attempts had higher preoperative BMIs (p = 0.03). Discussion Given that patients engaged in frequent dieting attempts that fall outside formal assessments, future work should seek to expand pre‐operative assessments.https://doi.org/10.1002/osp4.70030dieting behaviorsdisordered eatingmetabolic and bariatric surgeryweight loss
spellingShingle LeeAnn C. Swager
Keeley J. Pratt
Haley M. Kiser
Ashleigh A. Pona
Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
Obesity Science & Practice
dieting behaviors
disordered eating
metabolic and bariatric surgery
weight loss
title Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
title_full Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
title_fullStr Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
title_full_unstemmed Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
title_short Metabolic and Bariatric Surgery Patients' Preoperative Dieting Attempts and Associations With Postoperative Outcomes
title_sort metabolic and bariatric surgery patients preoperative dieting attempts and associations with postoperative outcomes
topic dieting behaviors
disordered eating
metabolic and bariatric surgery
weight loss
url https://doi.org/10.1002/osp4.70030
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