Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study

Objective This study investigates preoperative patient expectations related to metabolic bariatric surgery (MBS), focusing on anticipated challenges and effects on physical, social, and psychological domains. Methods We performed a prospective, cross-sectional multicenter survey in adult patients awaiting primary MBS. The questionnaire gathered data on 1) the top three reasons for seeking surgery, 2) anticipated weight loss, and 3) expected remission of co-morbidities. Patients also rated the importance of information regarding complication risks, anxiety over complications, and their impact on willingness to undergo surgery. Additionally, patients reported their expectations of physical, social, and psychological changes. Results In total, 242 patients filled in the questionnaire. Patients prioritized mobility and health as the main reasons for choosing MBS, with other key factors including pain reduction, remission of comorbidities, and physical fitness. Patients expected a median percentage Total Weight Loss of 32% and a percentage Excess Weight Loss of 81%. Most patients expected total remission of obesity-related comorbidities. Although patients valued information on potential complications, these risks did not induce anxiety or affect the decision to undergo MBS. The most anticipated physical changes included improved mobility, pain reduction, and better health/fitness The most expected social and psychological changes were related to self-image and emotional well-being. Conclusion Improved mobility and health were the main reasons for undergoing MBS. Although participants had high weight loss expectations, their estimations for comorbidity resolutions were accurate. Despite prioritizing being informed about potential complications, it did not discourage patients from choosing MBS.