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Development of the Weight Management Skills Questionnaire in a Prebariatric Surgery Sample

  • Hana F. ZickgrafEmail author
  • Emily C. Stefano
  • Andrea Rigby
Original Contributions
  • 30 Downloads

Abstract

Background

Weight loss after bariatric surgery is largely predicted by adherence to diet and lifestyle changes. There is no validated measure of self-reported adherence to a range of behaviors including self-monitoring, portion control, healthy food choice, and awareness of hunger and satiety.

Objectives

The goal of the present study was to develop and provide initial evidence for the validity of the Weight Management Skills Questionnaire, a measure of adherence to these changes, by identifying its factor structure and relating the total score and subscale scores to baseline BMI, weight change during a preoperative education program, dysregulated eating, and binge eating disorder (BED).

Setting

University hospital, USA.

Methods

Four hundred twenty-two bariatric surgery candidates responded the WMSQ and measures of eating behavior. Weight collected at the beginning, midpoint, and end of the presurgical program was used to compute percent total weight loss (%TWL) prior to surgery. Hierarchical factor analysis was used to explore the factor structure of the WMSQ while allowing the items to load onto a single general factor reflecting overall adherence to behavioral weight management.

Results

The WMSQ has three interpretable subfactors, with all items loading onto the general factor. All scales were unrelated to starting BMI; total score and subfactors measuring general and bariatric-specific weight management skills were associated with %TWL. The scale measuring hunger/satiety responsiveness was negatively related to dysregulated eating/BED.

Conclusions

The WMSQ may be a useful tool in future research exploring the key weight management skills associated with successful weight loss before and after bariatric surgery.

Keywords

Sleeve gastrectomy Roux-en-Y gastric bypass Behavioral weight management Binge eating Emotional eating External eating 

Notes

Acknowledgments

The authors would like to acknowledge Dr. Caitlin LaGrotte, Dr. Ann Rogers, and Janelle McLeod, for their work in developing the WMSQ items. We also thank the patients who provided feedback on the WMSQ items and those allowed their data to be used in this research.

Funding Information

Data collection for this research was funded by the Brad Hollinger Eating Disorders Research Endowment Grant 2017-2018. Dr. Zickgraf is funded by the T32MH082761-10 NIH/NIMH, Midwestern Regional Eating Disorders Training Grant.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they no conflict of interest.

References

  1. 1.
    Livhits M, Mercado C, Yermilov I, et al. Behavioral factors associated with successful weight loss after gastric bypass. Am Surg. 2002;76(10):1139–42.Google Scholar
  2. 2.
    Sarwer DB, Wadden TA, Moore RH, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.CrossRefGoogle Scholar
  3. 3.
    Groller KD. Systematic review of patient education practices in weight loss surgery. Surg Obes Relat Dis. 2017;13(6):1072–85.CrossRefGoogle Scholar
  4. 4.
    Tewksbury C, Williams NN, Dumon KR, et al. Preoperative medical weight management in bariatric surgery: a review and reconsideration. Obes Surg. 2017;27:208–14.CrossRefGoogle Scholar
  5. 5.
    Gerber P, Anderin C, Thorell A. Weight loss prior to bariatric surgery: an updated review of the literature. Scand J Surg. 2015;104(1):33–9.CrossRefGoogle Scholar
  6. 6.
    Livhits M, Mercado C, Yermilov I, et al. Does weight loss immediately before bariatric surgery improve outcomes: a systematic review. Surg Obes Relat Dis. 2009;5(6):713–21.CrossRefGoogle Scholar
  7. 7.
    MacLean PS, Wing RR, Davidson T, et al. NIH working group report: innovative research to improve maintenance of weight loss. Obesity. 2005;23(1):7–15.CrossRefGoogle Scholar
  8. 8.
    Franz, MJ, VanWormer JJ, Crain AL, Boucher JL, Histon, T, Caplan, W et al. Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. J Am Diet Assoc 2007; 107(10):1755-1767.CrossRefGoogle Scholar
  9. 9.
    Anderson JW, Konz EC, Frederich RC, et al. Long-term weight-loss maintenance: a meta-analysis of US studies. J Am Diet Assoc. 2001;74(5):579–84.Google Scholar
  10. 10.
    Dombrowski SU, Knittle K, Avenell A, et al. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ. 2004;348:g2646.CrossRefGoogle Scholar
  11. 11.
    Egberts K., Brown WA, Brennan L, O’Brien PE. Does exercise improve weight loss after bariatric surgery? A systematic review. Obes Surg 2012; 22(2):335-341.CrossRefGoogle Scholar
  12. 12.
    Look AHEAD Research Group. Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity. 2014;22(1):5–13.CrossRefGoogle Scholar
  13. 13.
    Thomas JG, Bond DS, Phelan S, et al. Weight-loss maintenance for 10 years in the National Weight Control Registry. Am J Prev Med. 2014;46(1):17–23.CrossRefGoogle Scholar
  14. 14.
    Karmali S, Brar B, Shi X, et al. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–33.CrossRefGoogle Scholar
  15. 15.
    Zalesin KC, Franklin BA, Miller WM, et al. Preventing weight regain after bariatric surgery: an overview of lifestyle and psychosocial modulators. Am J Lifestyle Med. 2010;4(2):113–20.CrossRefGoogle Scholar
  16. 16.
    Essayli JH, LaGrotte CA, Fink-Miller EL, et al. Patients’ reported usage of weight management skills following bariatric surgery. Obes Surg. 2018;28(2):584–8.CrossRefGoogle Scholar
  17. 17.
    Odom J, Zalesin KC, Washington TL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56.CrossRefGoogle Scholar
  18. 18.
    Pinto AM, Fava JL, Raynor HA, et al. Development and validation of the weight control strategies scale. Obesity. 2013;21(12):2429–36.CrossRefGoogle Scholar
  19. 19.
    Scheffer J. Dealing with missing data. Res Lett Inf Math Sci. 2001;3:53–160.Google Scholar
  20. 20.
    Wadden TA, Foster GD. Weight and lifestyle inventory (WALI). Obesity. 2006;14(S3):99S–118S.CrossRefGoogle Scholar
  21. 21.
    Fabricatore AN, Wadden TA, Sarwer DB, et al. Self-reported eating behaviors of extremely obese persons seeking bariatric surgery: a factor analytic approach. Obesity. 2006;14(S3):83S–9S.CrossRefGoogle Scholar
  22. 22.
    Saunders R. Compulsive eating and gastric bypass surgery: what does hunger have to do with it? Obes Surg. 2001;11(6):757–61.CrossRefGoogle Scholar
  23. 23.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington, American Psychiatric Pub; 2013.Google Scholar
  24. 24.
    Revelle WR. Psych: procedures for personality and psychological research; 2017.Google Scholar
  25. 25.
    Buuren SV, Groothuis-Oudshoorn K. Mice: multivariate imputation by chained equations in R. J Stat Softw. 2010;1–68.Google Scholar
  26. 26.
    Schmid J, Leiman JM. The development of hierarchical factor solutions. Psychometrika. 1957;22(1):53–61.CrossRefGoogle Scholar
  27. 27.
    Revelle W, Zinbarg RE. Coefficients alpha, beta, omega, and the glb: comments on Sijtsma. Psychometrika. 2009;74(1):145.CrossRefGoogle Scholar
  28. 28.
    Zinbarg RE, Revelle W, Yovel I, Li W. Cronbach’s α, Revelle’s β, and McDonald’s ω H: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika 2005; 70(1):123-133.CrossRefGoogle Scholar
  29. 29.
    Boutelle KN, Knatz S, Carlson J, et al. An open trial targeting food cue reactivity and satiety sensitivity in overweight and obese binge eaters. Cogn Behav Pract. 2017;24(3):363–73.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Pritzker School of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Wake Forest UniversityWinston-SalemUSA
  3. 3.Penn State College of Medicine/Hershey Medical CenterHersheyUSA

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