Dataset Information

Dietary assessment and patient-perspective reasons for poor adherence to diet and exercise post bariatric surgery.

ABSTRACT:

Objective

Obesity prevalence is increasing, and as an outcome, bariatric procedures are on the rise. Previous articles about bariatric surgery disclosed tremendous results. This study aims to assess eating patterns and identify the reasons behind poor adherence to diet and exercise in postbariatric patients.

Results

According to the questionnaire used, the majority (85.5%) of our patients scored "good", 12% scored "fair", and only 2% scored "excellent". None scored "needs improvement". Fruits had a mean consumption of 1.51 ± 0.79 and vegetables 1.78 ± 0.76. The main reasons for patient nonadherence to healthy eating were low self-discipline (48%), lack of motivation (28%), and availability of healthy food and being too busy to prepare healthy meals, both at 25%. Additionally, 55.9% of the study subjects engaged in physical activity. Lack of time (47%), low self-discipline (38%), and weather (32%) were the primary reasons for not exercising regularly.

SUBMITTER: Assakran BS

PROVIDER: S-EPMC7659172 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Publications

Dietary assessment and patient-perspective reasons for poor adherence to diet and exercise post bariatric surgery.

Assakran Bandar Saad BS Widyan Adel Mefleh AM Alhumaidan Najla Abdulaziz NA Alharbi Fadiyah Abdullah FA Alhnaya Mohammed Abdullah MA Aljabali Abdullatif Abdullah AA Aleid Mohammed Abdulrahman MA

BMC research notes 20201111 1

<h4>Objective</h4>Obesity prevalence is increasing, and as an outcome, bariatric procedures are on the rise. Previous articles about bariatric surgery disclosed tremendous results. This study aims to assess eating patterns and identify the reasons behind poor adherence to diet and exercise in postbariatric patients.<h4>Results</h4>According to the questionnaire used, the majority (85.5%) of our patients scored "good", 12% scored "fair", and only 2% scored "excellent". None scored "needs improvem ...[more]

PMID: 33176857

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Project description:IntroductionLiterature describing the impact of dietary intake on weight outcomes after bariatric surgery has not been synthesized. This study aimed to synthesize the evidence regarding any association between diet composition and weight outcomes post-bariatric surgery.MethodsCINAHL, Cochrane, Embase, MEDLINE and Scopus were searched for adult studies up to June 2021 that assessed any association between dietary intakes (≥1-macronutrient, food group, or dietary pattern) and weight outcomes at 12-months or longer after bariatric surgery. Risk of bias and quality assessments were conducted using the Scottish Intercollegiate Guidelines Network checklists and the NHMRC's Level of Evidence and Grades for Recommendations. Study findings were presented according to the time of post-surgery dietary intake assessment (≤12months, between 12 and 24 months, ≥24months).Results5923 articles were identified, 260 were retrieved for full text screening, and 36 were eligible for inclusion (9 interventional including five randomized-controlled trials, and 27 observational cohort studies; sample sizes: 20-1610; total sample: 5065; follow-up periods: 1 year-12 years; level of evidence: II to IV, risk of bias: low to high). Findings on the association between long-term weight outcomes and dietary composition up to 24-months were mixed. After 24-months, studies consistently suggested no significant associations between weight loss and macronutrient composition or core food group patterns, or between carbohydrate, protein or food group patterns and weight recurrence. A single cohort study reported a weak association between diet quality score and weight-recurrence after 24-months.ConclusionThere was no strong evidence to support significant associations between diet composition and weight outcomes post-bariatric surgery. The heterogeneity in study design and quality may reduce generalizability to external populations. Individualized dietary recommendations may be useful to support long-term post-surgery weight outcomes. More studies are needed to define and measure diet quality in this patient cohort.RegistrationPROSPERO (CRD42021264120).

Project description:BackgroundMetabolic Bariatric Surgery (MBS) has gained significant popularity over the past decade. Legally and ethically, physicians should obtain the patient's voluntary and informed consent before proceeding with the surgery. However, the decision to undergo MBS is often influenced by external factors, prompting questions about their impact on the patient's ability to choose voluntarily. In addressing this issue, the study focuses on two key questions: first, which factors influence MBS candidates during the decision-making process, and second, whether these influences undermine the candidates' ability to make decisions voluntarily, according to theories of autonomy.MethodsThe study employed a qualitative methodology, conducting 21 in-depth semi-structured interviews with adults who had undergone bariatric surgery. The conclusions were drawn from an inductive analysis of the interview data conducted using a grounded theory approach, and by applying theories of autonomy to the empirical findings.ResultsOur study indicates that interviewees were exposed to different external influences, which had diverse effects on the interviewees' decision to undergo MBS. Category 1 influences included intentional attempts to induce people, through arguments and reason, to accept the attitudes advocated by the persuader in support of the surgery. Applying theoretical accounts of autonomy to these influences suggests that they did not compromise the interviewees' autonomy. Category 2 influences included threats made by a physician or a family member. These influences were found to undermine autonomy. Category 3 influences included emotional manipulation, informational manipulation, and the construction of medical and social norms. Manipulations and norms were experienced differently by different interviewees, and their impact on autonomy varies depending on the theoretical framework applied.ConclusionsAcknowledging that the influences exerted on MBS candidates may undermine their ability to make autonomous decisions regarding surgery, we suggest reformulating the duties that apply to medical practitioners with respect to informed consent to MBS. Medical practitioners who discuss the option of MBS with candidates should be aware of the various factors that influence this choice, and actively promote the candidates' ability to make autonomous decisions.

Project description:BackgroundPrurigo pigmentosa (PP), also referred to as Nagashima disease, is an acquired dermatological condition that is characterized by pruritic erythematous eruptions including papules and plaques surrounded by a reticular pattern of hyperpigmentation. It was first described in 1971 when Japanese dermatologist Masaji Nagashima noticed similar dermatological manifestations among 8 patients of Asian descent. The disease has been strongly associated with ketosis and ketogenic diet; however, the underlying etiology is unknown. Effective treatment involves an oral antibiotic and a balanced diet. The disease classically affects young women of Asian descent, but cases affecting males and people of non-Asian ancestry have also been observed. We present an unusual case of PP in a Saudi male that started 18 days following bariatric surgery.Case descriptionThe patient is a 25-year-old morbidly obese Saudi male who complained of an intensely pruritic rash 3 weeks after undergoing bariatric surgery. His past medical history is positive for irritable bowel syndrome (IBS). A punch skin biopsy yielded the diagnosis, and a combination treatment consisting of minocycline and a topical corticosteroid was prescribed. The patient presented again 2 weeks after the initial visit with complete resolution of the rash. He reported adherence to the medication regimen. Pruritus had resolved. Upon examination, post-inflammatory hyperpigmentation in a reticular pattern was observed over the trunk, upper abdomen, and chest. Hydroquinone 4% cream was prescribed to treat the post-inflammatory hyperpigmentation.ConclusionsNowadays, PP cases are being reported from all around the world, including cases of PP that appeared following bariatric surgery for weight loss without ketogenic dietary modification. Theoretically, the typical PP patient is a young adult female from Eastern Asia who has been adherent to a ketogenic diet. In contrast, we report a case of a Saudi male who did no dietary modifications, but underwent bariatric surgery. Treatment with minocycline resulted in successful complete resolution.

Project description:The low rates of regular exercise and overall physical activity (PA) in the general population represent a significant public health challenge. Previous research suggests that, for many people, exercise leads to a negative affective response and, in turn, reduced likelihood of future exercise. The purpose of this paper is to examine this exercise-affect-adherence relationship from an evolutionary perspective. Specifically, we argue that low rates of physical exercise in the general population are a function of the evolved human tendency to avoid unnecessary physical exertion. This innate tendency evolved because it allowed our evolutionary ancestors to conserve energy for physical activities that had immediate adaptive utility such as pursuing prey, escaping predators, and engaging in social and reproductive behaviors. The commonly observed negative affective response to exercise is an evolved proximate psychological mechanism through which humans avoid unnecessary energy expenditure. The fact that the human tendencies toward negative affective response to and avoidance of unnecessary physical activities are innate does not mean that they are unchangeable. Indeed, it is only because of human-engineered changes in our environmental conditions (i.e., it is no longer necessary for us to work for our food) that our predisposition to avoid unnecessary physical exertion has become a liability. Thus, it is well within our capabilities to reengineer our environments to once again make PA necessary or, at least, to serve an immediate functional purpose. We propose a two-pronged approach to PA promotion based on this evolutionary functional perspective: first, to promote exercise and other physical activities that are perceived to have an immediate purpose, and second, to instill greater perceived purpose for a wider range of physical activities. We posit that these strategies are more likely to result in more positive (or less negative) affective responses to exercise, better adherence to exercise programs, and higher rates of overall PA.

Dataset Information

Dietary assessment and patient-perspective reasons for poor adherence to diet and exercise post bariatric surgery.

Objective

Results

Publications

Dietary assessment and patient-perspective reasons for poor adherence to diet and exercise post bariatric surgery.

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