Journal of Obesity & Eating Disorders

Description

Over the last decade, South Korea has witnessed a gradual rise in obesity rates, particularly class III obesity (BMI ≥ 35 kg/m²), which has nearly tripled from 0.30% in 2009 to 0.89% in 2019. This increase poses significant health risks, as obesity is linked to various comorbidities such as type 2 diabetes and cardiovascular diseases. Consequently, there is a growing emphasis on recognizing obesity as a disease and promoting early interventions.

First-line treatments for obesity typically include lifestyle changes like nutritional therapy, physical activity and behavioral modifications. If these measures do not yield sufficient weight loss, pharmacotherapy may be considered. Bariatric surgery is recommended for patients with a BMI ≥ 35 kg/m² or those with a BMI ≥ 30 kg/m² accompanied by obesity-related health issues who fail to achieve a target weight loss of at least 5% through non-surgical means.

Understanding diverging views in anorexia nervosa

Recent international studies have highlighted disparities in perceptions of obesity and its treatment between patients and Health Care Professionals (HCPs). In Korea, most patients first learned about bariatric surgery through HCP recommendations. However, there is a significant divergence in treatment suggestions, with only 1% of patients considering bariatric surgery compared to 11% of HCPs. Despite this, both groups agree on the effectiveness of bariatric surgery as a long-term treatment option.

Qualitative studies have examined the experiences of patients who underwent bariatric surgery, focusing on the importance of nutritional and psychological support, as well as connections to support groups. However, less attention has been paid to how patients learn about bariatric surgery and what drives their decision to pursue it.

This study aims to investigate the perspectives of patients who underwent bariatric and metabolic surgery at a tertiary hospital in Korea, particularly their decision-making process and satisfaction with the information received.

The study involved a telephone interview with patients who had undergone bariatric surgery at Asan Medical Center between August 2020 and February 2022. Only those who were at least six months’ post-surgery and had their operations within the previous two years were included. Out of 33 eligible patients, 21 agreed to participate.

Participants were informed about the study's purpose and their consent was confirmed. Interviews focused on two main areas: The factors behind their decision to undergo surgery and their satisfaction with the information provided during the perioperative period. Details that could be retrieved from medical records were excluded from the discussions.

The study received approval from the institutional review board of asan medical center and informed consent was waived. Among the 21 interviewees, 19 were female, with an average age of 40.1 years and a pre-surgery mean BMI of 41.2 kg/m². By the time of the interview, the average BMI had decreased to 30.8 kg/m², representing an average total weight loss of 25% and an excess weight loss of 73%. Many patients had comorbid conditions, with hypertension and diabetes being the most prevalent.

A substantial portion of patients (71%) learned about bariatric surgery from HCPs, primarily family physicians and endocrinologists. Over half (52%) decided to proceed with surgery based on HCP recommendations, often due to ongoing care at Asan Medical Center.

Regarding the information provided before surgery, patients rated their satisfaction at an average of 8.75 out of 10. While many were pleased with the overall information quality and delivery, some felt the details on side effects were insufficient and turned to online resources for more comprehensive insights. After surgery, satisfaction increased to an average score of 9, although concerns about the adequacy of explanations regarding potential complications persisted.

Eighty-five percent of participants expressed satisfaction with their weight post-surgery, but several indicated worries about regaining weight and the challenges of maintaining weight loss. Patients voiced concerns about discomfort and anxiety regarding future health issues related to weight management.

The findings underscore that most patients pursued bariatric surgery following recommendations from HCPs, highlighting the importance of healthcare provider engagement in the decisionmaking process. Patients often felt motivated by health-related concerns and the desire to manage comorbidities.

Barriers to considering surgery included limited knowledge about the procedure and fears surrounding safety and outcomes. Thus, improving awareness and perceptions of bariatric surgery among both patients and the general public is vital. Strategies could involve leveraging digital platforms and social media to disseminate accurate information.

Furthermore, educational initiatives for HCPs across various specialties could facilitate more informed discussions about bariatric surgery options, enhancing patient care and potentially increasing surgical rates.

In conclusion, while patient satisfaction with information provided during the perioperative period is generally high, there remains room for improvement in the depth and clarity of information. Future studies should survey additional factors influencing patient satisfaction and long-term outcomes postsurgery.