46 J. C. Peacock et al.
/ Surgery for Obesity and Related Diseases 14 (2018) 39–46
Editorial
Paired editorial: bariatric patients' reported motivations for surgery and
their relationship to weight status and health
Let us not forget that although weight loss surgery
continues to grow in popularity, it remains a contested
procedure. For instance, some critical voices contend that
solutions to severe obesity should not be sought in surgery
of individual patients’ healthy organs to remedy what is
essentially a societal health problem [1,2]. Therefore,
patients will need to motivate and justify their decision to
undergo weight loss surgery for themselves as well as for
others, and almost certainly more so than for commonly
accepted surgical procedures, such as a bone fracture repair
or tonsillectomy. The study that is paired with this editorial
looks at the motivations for bariatric surgery as voiced by
patients who underwent the procedure.
Patients in the physician’s consultation room are likely
to focus more on the physical health factors motivating
their wish for surgery, while anonymous and open text
formats tend to give more voice to affective motivators
[3,4]. The paired study indeed confirms that affective
reasons for weight loss surgery (“tired of being a social
outcast,” “not having the surgery was like committing
passive suicide”) are at least as common as more prag-
matic reasons. Moreover, the study is one of the first to
show that motivations for weight loss surgery can be
linked to postsurgery results in that patients who voiced
greater affective motivations were those with on average
better weight loss outcomes.
It remains to be seen to what extent the ways in which
patients voiced their motivations for bariatric surgery in the
paired study were also shaped by their weight loss
outcomes. Thus, motivations may have shaped weight loss
outcomes while at the same time outcomes may have
shaped motivations as voiced in hindsight. Also, differences
in the type of surgery between the different motivation
groups may form an alternative explanation for weight loss
outcomes. Nevertheless, the paired study clearly contributes
to answering the important question how motivation for an
invasive procedure, such as bariatric surgery relates to the
prospects of weight loss, as much for those who contest the
procedure as for those who meet with prospective patients
in their consultation room every day.
Sandra Zwier, Ph.D.
Amsterdam School of Communication Research ASCoR
University of Amsterdam
Amsterdam, the Netherlands
References
[1] Hofmann B. Stuck in the middle: the many moral challenges with
bariatric surgery. Am J Bioeth 210;10(12):3–11.
[2] Garrett JR, McNolty LA. Bariatric surgery and the social character of
the obesity epidemic (2010). AM J Bioeth 2010;10(12):20–2.
[3] Zwier S. “What motivates her”: motivations for considering labial
reduction surgery as recounted on women's online communities and
surgeons' websites. Sex Med 2014;2(1):16–23.
[4] Munoz DJ, Lal M, Chen EY, et al. Why patients seek bariatric surgery:
a qualitative and quantitative analysis of patient motivation. Obes Surg
2007;17(11):1487–91.