Effects of a psychosocial intervention on eating behavior compliance in bariatric surgery patients

Abstract

Obesity is a leading cause of preventable death in America and its prevalence is increasing at an alarming rate. Given the medical and psychosocial consequences of obesity, surgical intervention for weight loss ("bariatric" surgery) is now considered a viable option. Although the initial success rate of bariatric surgery is high, sustained weight loss requires adherence to strict post-surgical guidelines. There is increasing evidence that a percentage of patients have difficulties adhering to the post-surgical guidelines, with reemergence of poor eating habits (overeating, binge eating) being a major contributing factor. Recurrence of such eating habits can be detrimental to successful weight loss after surgery. Given the difficulties many patients face after surgery, it is possible that the typical post-surgical eating behavior guidelines presented to bariatric surgery patients are ineffective in motivating some individuals to comply. Protection Motivation Theory (PMT), a model that specifies the components of health messages that increase compliance with a health behavior, has been proven to be a reliable model for creating health promotion messages. The present study utilized a PMT-based intervention directed at patients undergoing bariatric surgery. Eighty-two obese individuals seeking surgical treatment of obesity were recruited to participate in this study. Participants were divided into two groups: PMT vs. Control. In addition to routine messages from the bariatric surgeon, participants in the PMT group received an intervention focused on the importance of adhering to post-surgical eating behavior guidelines and how best to adhere to these guidelines. This intervention was in the form of lectures, guided readings, and participant discussion. Participants in the control group received standard of care information from the bariatric surgeon. Those participants who had bariatric surgery during the time frame of the study were followed after surgery to assess post-surgical eating habits and weight loss. Results indicated that overall, the PMT intervention did not have a significant impact. However, follow-up analyses indicated that perceived self-efficacy and perceived threat of not following the guidelines may predict patients' intentions to comply with post-surgical guidelines. In addition, perceived self-efficacy was found to be a significant predictor of post-surgical weight loss. Findings are discussed in terms of the methodological compromises that resulted from the applied research setting as well as promising avenues for future investigation.