101 - Freie Mitteilung
Bariatry & hernia II
17. Mai 2019, 14:15 - 15:45, Bellavista 5, 6. OG


The impact of bariatric surgery on the perception of “weight-loss”: A cross-sectional study based on free-word association networks in patients with severe obesity
D. Gero1, B. File2, N. Hinrichs1, M. Müller1, I. Ulbert2, Z. Somogyvári2, M. Bueter1, Presenter: D. Gero1 (1Zurich, 2Budapest/HU)

Bariatric surgery (BS) is the most effective modality in the treatment of obesity and its related diseases. Nevertheless, BS is underused by the eligible patient population, partly due to mindset and communication barriers. Our aim was to improve the understanding of severely obese individuals’ expectations, opinions, emotions and attitudes toward weight-loss.
A cross-sectional anonymized online study, using free word associations was performed among followers of obesity-related Facebook-groups in 2018. Participants were asked to write 5 words that first came to their mind about “weight-loss”, and to select 2 emotions which best described their corresponding feelings. Demographic and obesity-related data was also collected. After exclusion of individuals not qualifying for BS, 1482 respondents were included. Cognitive representations were constructed based on the co-occurrence network of associations, using a validated data-driven, network-based method. Effect size was expressed by OR and Cohen’s d, P<.05 was considered statistically significant.
The respondents were mainly Caucasian (98%) females (94%), aged 42.5±10.1 years, with a current BMI=36.9±9.5 and highest lifetime BMI=50.7±8.7 kg/m2. The association network analysis revealed two distinct cognitive modules (Fig. 1): outcome-oriented (health, attractiveness, happiness, agility) and process-oriented (effort, diet, sport, surgery). Characteristics of modules and patient subgroups are shown in Table 1 and 2. Patients willing to undergo BS were more ‘outcome’-oriented (OR=3, P=0.03), expressed more ‘hope’ (d=0.5, P=0.006) and less ‘frustration’ (d=-0.5, P=0.015). Adherence to a cognitive module was not influenced by history of BS (OR=0.96, P=0.14), although it increased the emotions ‘gratitude’ (d=0.5, P<0.001), ‘pride’ (d=0.3, P<0.001), and decreased ‘hope’ (d=-0.54, P<0.001).
Free word association network to “weight-loss” identified 2 distinct cognitive modules in severely obese individuals. Outcome-oriented respondents were more obese and more likely to consider BS, and had more frequently positive emotions to weight-loss. Accordingly, emphasis on weight-loss induced quality-of-life improvements over the process of achieving weight-loss may represent a future strategy to improve communication with obese patients, and consequently, to increase acceptance of BS.
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