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Buyer's remorse: what predicts post-decision dissonance after bariatric surgery? Surg Obes Relat Dis 2019 Jul;15(7):1182-1188



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BACKGROUND: Bariatric surgery continues to be the most effective long-term treatment for obesity and its associated co-morbidities. Despite the benefits, not all patients may repeat the decision to undergo bariatric surgery based on their postoperative experience (postdecision dissonance).

OBJECTIVES: In this study, we explore the predictors of postdecision dissonance following bariatric surgery.

SETTING: Accredited bariatric center at an academic medical center.

METHODS: Patients at an accredited Bariatric Center who underwent bariatric surgery between 2011 and 2017 were surveyed to determine factors predictive of postdecision dissonance, as well as expectations, well-being, and overall satisfaction.

RESULTS: A total of 591 patients were sent surveys, of whom 184 (31.1%) responded. Of the 184 responders, 20 (10.9%) patients would not choose to undergo bariatric surgery if they had it do to over again (postdecision dissonance). There was no difference in the time since surgery, age, sex, or type of bariatric surgery among groups. Dissonant patients were less likely to be married and privately insured. Dissonant patients were more likely to feel they had inadequate preoperative education on postoperative expectations (P < .001). These patients also had significantly greater postoperative weight regain, failed weight loss expectations, depression, and dissatisfied body image.

CONCLUSION: Postdecision dissonance is driven in part by a patient's perceived inadequacy of preoperative preparation for postoperative outcomes coupled with postoperative weight regain, depression, dissatisfied body image, and failed weight loss expectations. This highlights the importance of preoperative counseling on managing expectations and outcomes after surgery, as well as the need for continued postoperative engagement with a bariatric program to address weight regain and provide mental health support.

Author List

Wallace L, Horecki EK, Helm MC, Higgins RM, Gould JC, Lak K, Kindel TL


Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin
Rana Higgins MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Tammy Lyn Kindel MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin
Kathleen L. Lak MD Assistant Professor in the Surgery department at Medical College of Wisconsin
Lyndsey Wallace PsyD Assistant Professor in the Psychiatry department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bariatric Surgery
Decision Making
Middle Aged
Obesity, Morbid
Patient Satisfaction
Surveys and Questionnaires
Treatment Outcome
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a