Obesity Surgery

, Volume 28, Issue 4, pp 1146–1146 | Cite as

Reply to: “Patients’ Expectations Are Important for Success in Bariatric Surgery”

  • Sjaak Pouwels
  • Hendrika J. M. Smelt
  • Johannes F. Smulders
Letter to the Editor

Dear editor,

With great interest, we have read the manuscript of Pontiroli et al. [1]. They are suggesting that there are technical and non-technical factors that predict a good or bad response to bariatric surgery. In terms of expectations, patients need to be educated on what to expect and what they need to contribute to the pre- and post-operative period in bariatric surgery. One of the important aspects is the mandatory lifestyle change that patients need to conduct. We do agree with the statement of Pontiroli and colleagues that education is pivotal in this case and that it is time consuming. Besides that, it is important to investigate the causes of incorrect expectations. Self-image, psychosocial factors, and skin surplus in particular are a great part of these expectations. The psychological consequences of these sequelae are severe and tend to blind the patient to the overall success of their initial bariatric management. This underlines the necessity of a multi-disciplinary approach to morbid obesity [2]. However, e-Health platforms can be beneficial and might reduce the time and cost-burden of education. Recently, Raaijmakers et al. [3] did a systematic review on technology-based interventions in the treatment of obesity. They included 27 studies and showed that most interventions were web-based (42%). All the interventions had one or more of the following components: self-monitoring, counselor feedback and communication, group support, use of a structured program, and use of individually tailored program. Unfortunately, no significant differences were found in terms of outcome measures like quality of life and weight loss, but we do believe that such e-Health programs can be helpful in educating patients scheduled for bariatric surgery. Further studies need to substantiate whether these kind of programs are able to adequately educate our patients.


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Does not apply.


  1. 1.
    Pontiroli AE, Ceriani V, Folli F. Patients’ expectations are important for success in bariatric surgery. Obes Surg. 2017;27(9):2469–70.Google Scholar
  2. 2.
    Capon A. Body reshaping surgery after massive weight loss. Journal of visceral surgery. 2010;147(5 Suppl):e53–64.CrossRefPubMedGoogle Scholar
  3. 3.
    Raaijmakers LC, Pouwels S, Berghuis KA, et al. Technology-based interventions in the treatment of overweight and obesity: a systematic review. Appetite. 2015;95:138–51.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery Franciscus Gasthuis & VlietlandSchiedamThe Netherlands
  2. 2.Department of Surgery Catharina HospitalEindhoventhe Netherlands
  3. 3.Obesity CenterCatharina HospitalEindhoventhe Netherlands

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