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

Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study Lindsy van der Laan, Ellen A M Kuipers, Josien G Timmerman, Mirjam A Kaijser, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4604151/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 04 Jul, 2025 Read the published version in Obesity Surgery → Version 1 posted 13 You are reading this latest preprint version Abstract 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. Key points The main reasons for undergoing MBS were to improve mobility and health. Expectations of weight loss were high. The risk for complications did not discourage patients from choosing MBS. Introduction Metabolic bariatric surgery (MBS) is an effective and durable treatment option for patients with severe obesity in terms of weight loss and improvement of obesity-related comorbidities ( 1 ). Currently, most studies on outcomes after MBS focus almost exclusively on weight loss as the primary outcome of interest and some provide data on obesity-related comorbidity reduction ( 1 – 3 ). However, it is essential to recognize that MBS is an invasive intervention with a broad impact on a patient’s life, including mental health, nutritional habits, and quality of life ( 2 , 4 ). Keeping that in mind, patients have various reasons for undergoing MBS ( 5 – 7 ). To provide realistic information before MBS, it is important to gain knowledge about the patient’s motivation for having surgery as well as their expectations of MBS. Previous literature has demonstrated that the primary motivation for patients seeking MBS is related to physical health, such as weight loss and improvement of comorbidities ( 8 – 12 ). In addition, a variety of other motivations were mentioned, including increasing fertility, pain reduction, and improving physical activity, social life, and emotional well-being ( 7 , 12 , 13 ). Remarkably, Hult et al. showed that the most common preoperative motivation for undergoing MBS, i.e. weight loss, differed from the most common postoperative source of satisfaction, which was improved self-esteem ( 6 ). Nonetheless, weight loss remained one of the three items that participants were most satisfied with after surgery. Existing studies do show that patients have unrealistic goals in terms of weight loss after MBS ( 8 , 12 – 14 ). Expected excess weight loss percentages (%EWL) between 71% and 94% have been reported ( 8 , 12 – 14 ), while 18 studies of gastric bypass surgery showed a weighted mean %EWL of 57% in the long term (≥ 10 years) ( 15 ). Moreover, given that an EWL of at least 50% is defined as an optimal clinical response after surgery, presurgical weight loss expectations are high ( 15 , 16 ). As satisfaction after MBS relates to the preoperative perceptions and expectations of patients, it is important to understand patients’ expectations and motivations to undergo MBS. However, there is a general paucity of information on patients’ perspectives on potential challenges or problems after MBS, which may also contribute to satisfaction levels after MBS. Van Rijswijk et al. concluded that patients accept substantial risks of short-term complications (≤ 30 days after surgery), acute internal herniation (≥ 30 days), and mortality (≤ 30 days) to achieve their weight loss objectives ( 17 ). Patients with a higher body mass index (BMI) accepted higher risks of complications and mortality within 30 days, compared to patients with a lower BMI. Notably, the influence of age on the willingness to accept substantial risks remains unexplored ( 17 ). Furthermore, no attention has been given to other potential problems, difficulties, or challenges in the longer term after surgery. Therefore, we aim to extend earlier work by exploring patients’ main expected concerns, difficulties, and challenges in the long term after MBS, as well as their preoperative expectations of physical, social, and psychological aspects. In addition, potential differences in subgroups based on gender, BMI, age, and the presence of obesity-related comorbidities were assessed. Insight into patients’ preoperative expectations may help in preoperative counseling, manage patients’ expectations, and may have important implications in prioritizing patient-centered outcomes. Methods Study population We performed a cross-sectional multicenter survey in adult patients awaiting primary MBS. Two non-academic teaching hospitals in the Netherlands participated: Medical Center Leeuwarden (MCL) and Hospital Group Twente Almelo/Hengelo (ZGT). All patients who were approved for primary MBS were asked to participate in this study between April and October 2023. Patients not fluent in Dutch or illiterates were excluded, because of the inability to understand and complete the Dutch questionnaire. The medical ethical committee approved the study (RTPO Leeuwarden, nWMO 2023 0030; ZGT 2023-13 nWMO) and informed consent was obtained from all patients. Study procedure All patients complied with the implemented International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) guidelines for undergoing MBS from 2014: BMI ≥ 40 kg/m 2 or BMI ≥ 35 kg/m 2 with at least one comorbidity ( 18 ). Patients attended an information session on MBS before their preoperative consultation with a bariatric surgeon, as per standard care protocol. During the preoperative consultation, patients were invited to participate in the study by the bariatric nurse or surgeon. Upon agreement, they were provided with a questionnaire on paper, including further explanation of the study. Returning the completed questionnaire signified informed consent, as stated in the introduction of the questionnaire. Questionnaire We conducted a questionnaire in Dutch (the patients’ native language), based on literature and clinical expertise (Appendix 1). The following demographic variables were included: gender, age, body weight, length, highest education level, and comorbidities. The top three reasons for seeking surgery and patients’ expectations of MBS about weight loss, and changes of physical, social, and psychological domains were assessed using open-ended questions. Answer options regarding the remission of comorbidities were no remission (no changes in treatment or pain complaints), partial remission (less treatment or less pain complaints), total remission (no longer requiring treatment or no pain complaints anymore), and deterioration (more treatment or more pain complaints). The impact of short-term (≤ 30 days after surgery) and long-term complications (> 2 years after surgery) was assessed in three domains: 1) the importance of being informed about the complication during the preoperative period, 2) the anxiety of developing the complication, and 3) the impact of the complication on the consideration of undergoing MBS. For every complication, patients were asked to rate these three domains on a 5-point Likert scale. Additionally, patients were given the opportunity to express fears about unaddressed issues. Statistical analysis Baseline characteristics were expressed by descriptive statistics. Parametric data were presented as mean ± standard deviation (SD), nonparametric data as median with interquartile range (IQR), and categorical data as frequencies and percentages. Expected weight loss was expressed as %EWL and percentage total weight loss (%TWL). Subgroup analyses were conducted for expected weight loss, expected remission of comorbidities, and the impact of complications for four groups based on: 1) gender (men versus women), 2) BMI (BMI < 50 kg/m 2 versus BMI ≥ 50 kg/m 2 ), 3) age ( 50 years), and 4) presence of obesity-related comorbidities (with versus without comorbidities). The Mann-Whitney U test was performed for non-parametric data. Categorical data were analyzed with a Chi-Square test. A p-value of < 0.05 was considered statistically significant. Statistical analysis was performed using SPSS Statistics (version 28, SPSS Inc., Chicago, IL, USA). Qualitative data from open-ended questions were analyzed inductively, with categories generated by two researchers (L.v.d.L. and E.K.) and discussed with the other authors. The frequency and the percentages of the subsequent categories were reported. Results Patient characteristics A total of 242 patients (81% female) completed the questionnaire, with 137 patients from MCL and 105 from ZGT. The median age was 47 years [35–53], and the median BMI was 42 kg/m 2 [39–47]. Hypertension and obstructive sleep apnea syndrome (OSAS) were the most prevalent obesity-related comorbidities. The highest level of completed education was vocational education (51%). (Table 1 ) Table 1 Participant characteristics Total (N = 242) Age, years ▪ 47 [35–53] Female ◦ 195 (81) Body weight, kg ▪ 124 [113–140] BMI, kg/m 2 ▪ 42 [39–47] Baseline comorbidities - Hypertension - Diabetes mellitus - OSAS - Dyslipidemia - Osteoarthritis - GERD 74 (31) 27 ( 11 ) 63 (26) 28 ( 12 ) 57 ( 24 ) 39 ( 16 ) Highest level of completed education - No degree - Primary school - High school - vocational education - High school – higher vocational education - Vocational education - Higher vocational education - University - Other 3 ( 1 ) 4 ( 2 ) 39 ( 16 ) 9 ( 4 ) 123 (51) 51 ( 21 ) 6 ( 3 ) 7 ( 3 ) ▪ Median [interquartile range] ◦ Absolute number (percentage) BMI = Body Mass Index, kg/m 2 ; OSAS = Obstructive Sleep Apnea Syndrome; GERD = gastroesophageal reflux disease. The characteristics of the subgroups can be found in Table 2 . Women exhibited a notably lower preoperative body weight than men (120 versus 143 kg; p < 0.001). In patients under 30 years old compared to those over 50 years old, preoperative body weight (133 versus 120 kg; p = 0.004) and BMI (45 versus 41 kg/m 2 ; p < 0.001) were significantly higher. Patients with a BMI 50 kg/m 2 (49 versus 39 years; p = 0.017). Additionally, patients with comorbidities were significantly older than those without comorbidities (51 versus 34 years; p < 0.001), also the proportion of males was higher in the group with comorbidities (27% versus 7%; p < 0.001). (Table 2 ) Table 2 – Subgroup analyses for demographics, expected weight loss, and expected remission of comorbidities Gender BMI, kg/m 2 Age Comorbidities Men N = 47 Women N = 195 P value BMI < 50 N = 208 BMI ≥ 50 N = 33 P value 50 years N = 104 P value With comorbidities N = 153 Without comorbidities N = 89 P value Demographics Age, years ▪ 50 [37–55] 47 [34–53] 0.248 49 [36–53] 39 [28–51] 0.017 25 [23–28] 54 [52–60] < 0.001 51 [44–55] 34 [26–46] < 0.001 Female ◦ - 195 (100) - 170 (82) 24 (73) 0.225 35 (85) 79 (76) 0.214 112 (73) 83 (93) < 0.001 Body weight, kg ▪ 143 [132–169] 120 [110–131]* < 0.001 120 [111–132] 165 [151–175] < 0.001 133 [121–154]* 120 [110–137] 0.004 125 [113–139] 124 [113–140]* 0.772 BMI, kg/m 2 ▪ 42 [39–48] 42 [39–46]* 0.439 41 [39–44] 53 [51–56] < 0.001 45 [41–50]* 41 [38–45] < 0.001 42 [38 − 36] 42 [40–47]* 0.055 Expected weight loss ▪ %TWL 30 [28–35] 32 [28–35]* 0.494 31 [28–35]* 35 [32–39]* < 0.001 32 [29–39]* 32 [28–35]* 0.348 32 [28–35]* 33 [29–37]* 0.168 %EWL 78 [67–87] 81 [69–92]* 0.187 83 [72–92]* 68 [59–76]* < 0.001 76 [63–85]* 83 [69–92]* 0.037 82 [69–92]* 79 [68–89]* 0.650 Expected remission of comorbidities ◦/◦◦ Hypertension 21 (45) 53 (27) 0.019 65 (31) 9 (27) 0.645 0 48 (46) - 74 (48) - - Total remission 14 (67) 31 (58) 0.066 41 (63) 4 (44) 0.552 - 29 (60) - 45 (61) - - Partial remission 7 (33) 17 (32) 19 (29) 5 (56) - 16 (33) 24 (32) - No remission - 1 ( 2 ) 1 ( 2 ) - - 1 ( 2 ) 1 ( 1 ) - Deterioration - - - - - - - - Missing - 4 ( 8 ) 4 ( 6 ) - - 2 ( 4 ) 4 ( 5 ) - Diabetes mellitus 8 ( 17 ) 19 ( 10 ) 0.155 22 ( 11 ) 5 ( 15 ) 0.439 0 17 ( 16 ) - 27 ( 18 ) - - Total remission 6 (75) 12 (63) 0.415 14 (64) 4 (80) 0.728 - 11 (65) - 18 (67) - - Partial remission 2 ( 25 ) 6 (32) 7 (32) 1 ( 20 ) - 6 (35) 8 (30) - No remission - - - - - - - - Deterioration - 1 ( 5 ) 1 ( 5 ) - - - 1 ( 4 ) - Missing - - - - - - - - OSAS 28 (60) 35 ( 18 ) < 0.001 49 ( 24 ) 14 (42) 0.022 4 ( 10 ) 37 (36) 0.002 63 (41) - - Total remission 24 (86) 31 (89) < 0.001 42 (86) 13 (93) 0.005 3 (75) 32 (86) 0.008 55 (87) - - Partial remission - - - - - - - - No remission 3 ( 11 ) 2 ( 6 ) 5 ( 10 ) - 1 ( 25 ) 4 ( 11 ) 5 ( 8 ) - Deterioration 1 ( 4 ) - - 1 ( 7 ) - - 1 ( 2 ) - Missing - 2 ( 6 ) 2 ( 4 ) - - 1 ( 3 ) 2 ( 3 ) - Dyslipidemia 10 ( 21 ) 18 ( 9 ) 0.020 24 ( 12 ) 4 ( 12 ) 0.923 0 20 ( 19 ) - 28 ( 18 ) - - Total remission 5 (50) 9 (50) 0.022 13 (54) 1 ( 25 ) 0.611 - 8 (40) - 14 (50) - - Partial remission 5 (50) 5 (28) 8 (33) 2 (50) - 9 (45) 10 (36) - No remission - 3 ( 17 ) 2 ( 8 ) 1 ( 25 ) - 2 ( 10 ) 3 ( 11 ) - Deterioration - - - - - - - - Missing - 1 ( 6 ) 1 ( 4 ) - - 1 ( 5 ) 1 ( 4 ) - Osteoarthritis 8 ( 17 ) 49 ( 25 ) 0.240 55 (26) 2 ( 6 ) 0.010 0 46 (44) - 57 (37) - - Total remission 2 ( 25 ) 7 ( 14 ) 0.645 8 ( 15 ) 1 (50) 0.081 - 8 ( 17 ) - 9 ( 16 ) - - Partial remission 6 (75) 39 (80) 44 (80) 1 (50) - 35 (76) 45 (79) - No remission - 1 ( 2 ) 1 ( 2 ) - - 1 ( 2 ) 1 ( 2 ) - Deterioration - - - - - - - - Missing - 2 ( 4 ) 2 ( 4 ) - - 2 ( 4 ) 2 ( 4 ) - GERD 5 ( 11 ) 34 ( 17 ) 0.255 36 ( 17 ) 3 ( 9 ) 0.234 0 21 ( 20 ) - 39 ( 25 ) - - Total remission 2 (40) 16 (47) 0.699 18 (50) - 0.045 - 6 (29) - 18 (46) - - Partial remission 1 ( 20 ) 11 (32) 11 (31) 1 (33) - 10 (48) 12 (31) - No remission 1 ( 20 ) 4 ( 12 ) 4 ( 11 ) 1 (33) - 2 ( 10 ) 5 ( 13 ) - Deterioration - 1 ( 3 ) - 1 (33) - 1 ( 5 ) 1 ( 3 ) - Missing 1 ( 20 ) 2 ( 6 ) 3 ( 8 ) - - 2 ( 10 ) 3 ( 8 ) - ▪ Median [interquartile range] ◦ Absolute number (percentage) ◦◦ Comorbidity percentages are calculated based on the prevalence in the subgroups. Remission rates are calculated from the number of patients in the subgroup with the specific comorbidity. * Number of missing values: 1 to 9 BMI = Body Mass Index, kg/m 2 ; %TWL = percentage Total Weight Loss; %EWL = percentage Excess Weight Loss; OSAS = Obstructive Sleep Apnea Syndrome; GERD = gastroesophageal reflux disease. Top 3 most important reasons for undergoing MBS Table 3 illustrates the primary reasons for opting for MBS, with mobility and health emerging as the predominant categories across all three top positions. Specifically, 21% of the patients mentioned mobility in the first place, 17% in the second place, followed by 18% in the third place. For the category of health, these percentages were 18%, 19%, and 12%, respectively. Additionally, pain reduction was ranked first by 19% of the participants, remission of comorbidities was ranked second by 17%, and physical fitness was ranked third by 14%. (Table 3 ) Table 3 Top 3 most important reasons for undergoing MBS Rank 1 Rank 2 Rank 3 Children/ family 4 ( 2 ) 8 ( 3 ) 12 ( 5 ) Weight loss 21 ( 8 ) 6 ( 2 ) 18 ( 7 ) Mobility 57 ( 21 ) 46 ( 17 ) 46 ( 18 ) Physical fitness 31 ( 11 ) 45 ( 17 ) 37 ( 14 ) Emotional well-being 1 (0) 2 ( 1 ) 13 ( 5 ) Health 50 ( 18 ) 50 ( 19 ) 31 ( 12 ) Fertility 1 (0) 3 ( 1 ) - Quality of life 5 ( 2 ) 1 (0) 5 ( 2 ) Pain reduction 51 ( 19 ) 34 ( 13 ) 25 ( 10 ) Participation 1 (0) 5 ( 2 ) 7 ( 3 ) Remission of comorbidities 43 ( 16 ) 46 ( 17 ) 30 ( 12 ) Follow-up surgery 4 ( 2 ) 1 (0) - Self-image 3 ( 1 ) 13 ( 5 ) 15 ( 6 ) Other 3 ( 1 ) 4 ( 2 ) 6 ( 2 ) Missing - 2 ( 1 ) 16 ( 6 ) Total 275 (100) 266 (100.0) 261 (100.0) Data expressed as absolute frequencies and percentages (%). Expected weight loss Patients reported an expected median %TWL of 32 [28–35] and a %EWL of 81 [69–90] (N = 241). Patients with BMI ≥ 50 kg/m 2 expected more %TWL than patients with BMI < 50 kg/m 2 (35% versus 31%; p < 0.001) (Table 2 ). Expected remission of comorbidities The prevalence of the comorbidities and the expectations of the remission of comorbidities are presented in Table 2 (columns comorbidities). Most patients expected total remission of hypertension, diabetes mellitus, and OSAS. For dyslipidemia and gastroesophageal reflux disease (GERD), approximately half of the patients expected total remission. Partial remission is mainly expected for osteoarthritis. (Table 2 ) In subgroup 1 (gender), we observed a higher prevalence of men with hypertension (45% versus 27%; p = 0.019), OSAS (60% versus 18%; p < 0.001), and dyslipidemia (21% versus 9%; p = 0.020). More women expected total remission of OSAS (89% versus 86%; p < 0.001). On the other hand, more women had lower expectations of the remission of dyslipidemia. (Table 2 ). In subgroup 2 (BMI < 50 kg/m 2 vs BMI ≥ 50 kg/m 2 ), a higher prevalence of OSAS was noted among patients with a BMI ≥ 50 kg/m 2 (42% versus 24%; p = 0.022). They also expected higher remission rates of OSAS (93% versus 86%; p = 0.005). Conversely, patients with a BMI < 50 kg/m 2 exhibited a greater prevalence of osteoarthritis (26% versus 6%; p = 0.010) and had higher expectations of the remission of GERD. (Table 2 ) Subgroup 3 (age 50 years) revealed a higher prevalence of OSAS in patients older than 50 years (36% versus 10%; p = 0.002), with higher expectations of total remission as well (86% versus 75%; p = 0.008). (Table 2 ) Expectations of physical, social, and psychological changes Expectations of physical, social, and psychological changes after MBS are presented in Table 4 . Given the open-ended nature of each domain, patients occasionally referenced categories that could be associated with another domain. Patients had the opportunity to provide multiple responses to a single question, resulting in a higher count of categories compared to the number of patients. Subsequently, these responses were categorized. Table 4 – Expected physical, social, and psychological changes after MBS Physical (N = 625) Social (N = 346) Psychological (N = 338) Overlap across all three domains Weight loss 23 ( 4 ) Weight loss 1 (0) Weight loss 1 (0) Physical fitness 112 ( 18 ) Physical fitness 3 ( 1 ) Physical fitness 6 ( 2 ) Remission of comorbidities 38 ( 6 ) Remission of comorbidities 1 (0) Remission of comorbidities 1 (0) Mobility 162 (26) Mobility 4 ( 1 ) Mobility 3 ( 1 ) Appearance 107 ( 17 ) Appearance 13 ( 4 ) Appearance 10 ( 3 ) Children/family 3 ( 1 ) Children/family 1 (0) Children/family 2 ( 1 ) Emotional well-being 14 ( 2 ) Emotional well-being 50 ( 15 ) Emotional well-being 81 ( 24 ) Participation 8 ( 1 ) Participation 43 ( 12 ) Participation 11 ( 3 ) Self-image 7 ( 1 ) Self-image 75 ( 22 ) Self-image 151 (45) Overlap across two domains Interaction with others 25 ( 7 ) Interaction with others 2 ( 1 ) Public spaces 24 ( 7 ) Public spaces 2 ( 1 ) Reactions 31 ( 9 ) Reactions 2 ( 1 ) No change 54 ( 16 ) No change 14 ( 4 ) Pain reduction 122 ( 20 ) Pain reduction 3 ( 1 ) Quality of life 3 ( 1 ) Quality of life 1 (0) Health 8 ( 1 ) Health 4 ( 1 ) Unique categories for each domain Sleep 1 (0) Don’t know 13 ( 4 ) Food and emotion 3 ( 1 ) Fertility 1 (0) Other 8 ( 2 ) Balance 2 ( 1 ) Follow-up surgery 1 (0) Sleep 1 (0) Other 15 ( 2 ) Other 9 ( 3 ) Data expressed as absolute frequencies and percentages (%). Mobility, pain reduction, and physical fitness were the most frequently mentioned expected physical changes. In the context of social changes, self-image, no change, and emotional well-being emerged as the most frequently mentioned categories. Self-image and emotional well-being also arose as the first and second categories for expected psychological changes after surgery. Followed by no expected changes in the third place. (Table 4 ) Finally, we enquired about other potential concerns after MBS. In total, 77% expected no other problems (N = 195). Additional 16 potential concerns or topics were mentioned by 59 participants including among others ‘appearance’ (N = 16), ‘complications’ (N = 11), ‘narcosis’ (N = 3), ‘intake/nutrition’ (N = 6), ‘rules for living’ (N = 3), “quality of life” (N = 3), “medication” (N = 2), and “self-image” (N = 2). Impact of complications Table 5 presents the importance of being informed about the complication during the preoperative period, the anxiety of developing the complication, and the impact of the complication on the consideration of undergoing MBS. In general, patients considered it important to be informed about the complications (mean scores between 3.9 and 4.3). However, the complications did not induce anxiety (mean scores between 2.5 and 3.2) or heavily influenced the consideration of undergoing MBS (mean scores between 2.6 and 3.0). Table 5 Information, anxiety, and consideration about complications (N = 242*) Information Anxiety Consideration Short-term complications (≤ 30 days after surgery) Bleeding 4.3 ± 0.8 2.7 ± 1.0 2.7 ± 1.1 Anastomotic leakage 4.3 ± 0.8 2.8 ± 1.0 2.7 ± 1.1 Wound infection 4.3 ± 0.8 2.6 ± 1.0 2.6 ± 1.1 Reoperation 4.2 ± 1.0 2.7 ± 1.0 2.8 ± 1.2 Pneumonia 4.0 ± 1.0 2.4 ± 1.0 2.6 ± 1.1 Thrombosis/ pulmonary embolism 4.2 ± 1.0 2.7 ± 1.0 2.7 ± 1.1 Readmission 4.1 ± 1.0 2.6 ± 1.1 2.6 ± 1.2 Constipation 4.0 ± 1.0 2.5 ± 1.0 2.6 ± 1.1 Difficulties with eating and drinking/ nausea and vomiting 4.3 ± 0.9 2.9 ± 1.1 2.8 ± 1.2 Long-term complications (> 2 years after surgery) Internal herniation 4.2 ± 1.0 3.2 ± 3.3 3.0 ± 1.1 Gastric ulcer 4.1 ± 1.0 2.6 ± 1.1 2.8 ± 1.1 GERD 4.1 ± 1.0 2.9 ± 1.0 2.8 ± 1.1 Dumping 4.2 ± 0.9 3.0 ± 1.1 2.9 ± 1.1 Malnutrition 4.1 ± 1.0 2.6 ± 1.0 2.7 ± 1,1 Underweight 4.0 ± 1.1 2.5 ± 1.0 2.7 ± 1.1 Less weight loss than expected 4.1 ± 1.0 3.1 ± 1.1 2.8 ± 1,1 Recurrent weight gain 4.2 ± 0.9 3.1 ± 1,1 2.9 ± 1.2 Reoperation 4.2 ± 1.0 2.6 ± 1.1 2.8 ± 1.2 Gallstones 3.9 ± 1.1 2.7 ± 1.1 2.7 ± 1.1 Complaints of hypoglycemia 4.0 ± 1.1 2.7 ± 1.0 2.7 ± 1.0 Diarrhea 3.9 ± 1.1 2.7 ± 1.0 2.8 ± 1.1 Deficiency in vitamins and/or minerals 4.2 ± 1.0 2.8 ± 1.1 2.9 ± 1.1 *Numbers of responses varying between 226 and 240 on each domain. Data expressed as mean ± standard deviation. Validation of the 5-point Likert scale: 1 = not important at all, 2 = not important, 3 = neutral, 4 = important, 5 = very important. GERD = gastroesophageal reflux disease. Subgroup analyses on the impact of complications are shown in Appendix 2. In subgroup 1 (gender), women considered it significantly more important to be informed about all the complications than men, except diarrhea, which did not show a significant difference. Additionally, women exhibited greater anxiety of developing specific complications, including anastomotic leakage, reoperation (short-term), difficulties with eating and drinking/ nausea and vomiting, internal herniation, GERD, dumping, less weight loss than expected, recurrent weight gain, reoperation (long-term), gallstones, and deficiency in vitamins and/or minerals. When considering surgery, women found bleeding, reoperation (short-term), pneumonia, readmission, difficulties with eating and drinking/ nausea and vomiting, and reoperation (long-term) to be more important factors to take into account. (Appendix 2, Table 6) In subgroup 2 (BMI < 50 kg/m 2 versus BMI ≥ 50 kg/m 2 ), patients with BMI < 50 kg/m 2 considered it significantly more important to be informed about malnutrition and underweight. This patient group also found more complications to be relevant when considering surgery, including bleeding, anastomotic leakage, wound infection, thrombosis/ pulmonary embolism, and complaints of hypoglycemia. (Appendix 2, Table 7) In subgroup 3 ( 50 years), patients under 30 years old exhibited greater anxiety of developing difficulties with eating and drinking/ nausea and vomiting. On the other hand, patients above 50 years had more anxiety of developing diarrhea. Additionally, the older patient category found malnutrition to be more relevant when considering surgery. (Appendix 2, Table 8) In subgroup 4 (with versus without comorbidities), patients without comorbidities exhibited greater anxiety of developing an internal herniation and difficulties with eating and drinking/ nausea and vomiting. This group also found being informed about internal herniation more important. (Appendix 2, Table 9) Discussion This study aimed to explore patients’ main expected dreads, difficulties, or challenges in the long term after MBS, in conjunction with patients’ preoperative expectations regarding physical, social, and psychological aspects. Despite prioritizing being informed about potential complications, it did not discourage patients from choosing MBS. Mobility, health, and remission of comorbidities emerged as the most important reasons for undergoing surgery. This is in line with previous literature showing that the primary motivation for individuals pursuing MBS is connected to physical health ( 8 – 12 ). While weight loss has also been recognized as an important motivation in previous literature ( 12 , 13 ), it did not emerge as one of the three primary reasons in our study. Interestingly, Hult et al. identified weight loss as the leading motivation, not only in their overall study population but also in a subgroup of patients from the Netherlands ( 12 ). An explanation for this difference might be the higher observed BMI in their population, compared to a lower BMI in ours, suggesting that individuals with a higher BMI may prioritize weight loss as a more important reason for opting for MBS. In our study, we also found a higher expected %TWL in patients with a higher BMI (35% versus 31%). Furthermore, the proportion of patients with BMI > 50 kg/m 2 in our study was small. Although weight loss was not frequently mentioned as the most important reason to undergo MBS, our study population has high expectations in terms of weight loss post-surgery, with a median %TWL of 32% and a %EWL of 81%. This aligns with previous studies, reporting expected %EWL ranging from 71–94% ( 8 , 12 , 13 ). However, gastric bypass surgery has been associated with reported %EWL ranging from 27–69% after ten years ( 15 ). This shows a considerable disparity between anticipated and realized weight loss outcomes, which can result in postoperative disappointment. Nowadays, it is preferable to quantify weight loss in terms of %TWL rather than %EWL ( 19 ). Unfortunately, previous studies relied solely on %EWL for their measurements, making a reliable comparison between their results and our outcomes infeasible. In the questionnaire, we did not define a specific timeframe for expected weight loss after surgery. Consequently, participants might have referred to expected weight loss in the short term after surgery rather than in the long term. Our study reveals a notable difference in weight loss expectations between age groups, with patients over 50 years anticipating more excess weight loss compared to those under 30 years (83% versus 76%). However, the %TWL did not differ between the age groups. These findings contradict previous studies indicating that younger patients tend to have higher expectations regarding weight loss ( 20 , 21 ). A potential explanation could be that younger patients typically have fewer comorbidities, allowing them to focus more on weight loss. Although participants had unrealistic weight loss expectations, their estimations for comorbidity resolutions were accurate. The anticipated total remission rates for comorbidities were as follows: 61% for hypertension, 87% for OSAS, and 67% for diabetes mellitus. These rates align closely with those reported in a meta-analysis by Buchwald et al., where hypertension resolution occurred in 62% of the patients and OSAS resolution in 86% ( 22 ). However, the expected total remission rate of diabetes mellitus in our population was lower than the actual remission rate reported by Buchwald et al. (67% vs. 77%) ( 22 ). Similarly to our expected remission rate, Svanenik et al. reported an actual diabetes remission rate of 67% in their patients ( 23 ). Overall, these findings suggests that our preoperative information session on MBS is effective regarding obesity-related comorbidities. Patients older than 50 years anticipated higher resolution rates for OSAS compared to their younger counterparts. Notably, these higher expected remission rates align with those reported in the literature, suggesting that older patients' expectations are realistic ( 22 ). Unfortunately, we were unable to compare the expected remission rates for other comorbidities, as patients younger than 30 years did not have any additional comorbidities. In the literature, the reported remission rate of obesity-related comorbidities is higher in younger adults compared to older individuals ( 24 ). Our findings suggest a prioritization of physical factors over social and psychological factors when seeking MBS. Although the expected changes in physical, social, and psychological domains after MBS were addressed separately through open-ended questions, there was overlap in the responses across these domains. Differentiating between the domains appears challenging for patients, which is understandable given the interconnected nature of these domains. For instance, feeling better when in the company of others can be categorized as both psychological and social. Mobility, pain reduction, and physical fitness emerged as primary motivations for individuals considering MBS in our study, alongside considerations such as improved health and remission of comorbidities. Consistent with prior research, low percentages of self-image and emotional well-being were seen as the top three motivations for undergoing MBS ( 25 ). Conversely, findings from a study conducted by Hult et al. revealed that self-esteem, mental health, and social life were ranked as very important by 72%, 76%, and 56% of the participants, respectively ( 6 , 12 ). However, their study considered a broad spectrum of motivations to undergo MBS as very important. Our results show that patients consider it important to be informed about both short-term and long-term complications. However, the complications do not induce anxiety or heavily influence the consideration of undergoing MBS. This aligns with the conclusions drawn by van Rijswijk et al., who found that patients are willing to accept considerable risks, including short-term complications (≤ 30 days after surgery), acute internal herniation (≥ 30 days), and mortality (≤ 30 days), to achieve their weight loss goals ( 17 ). However, only the short-term complications were incorporated in the study of van Rijswijk et al. ( 17 ), while we also included long-term complications. Furthermore, we conducted subgroup analyses to assess patients' perceptions of complications. The primary findings from these analyses indicate that female patients exhibit greater anxiety of developing complications and have a stronger desire for comprehensive information. These subgroup differences should be considered when discussing treatment options with patients, such as taking more time for explanations or referring them to reliable sources. Strengths and Limitations. The strengths of this study are the large sample size and the administration of the questionnaire in two independent hospitals. Additionally, it expands upon previous literature by adding patients’ main expected dreads, difficulties, or challenges in the long term after MBS. Our study has some limitations that need to be mentioned: first, the questionnaire is not validated. However, it was developed based on literature and clinical expertise. Second, we did not inquire about the preferred bariatric procedure, while this could influence results regarding weight loss expectations or specific complications. Third, the generalizability of the study may be limited as this study was solely conducted in the Netherlands. Administering the questionnaire globally could enhance generalizability. Finally, due to our study design, we were not able to compare preoperative expectations with postoperative outcomes. Nevertheless, to answer our research question, the cross-sectional study design was deemed appropriate. Future studies could explore the concordance between patients’ preoperative expectations and postoperative outcomes. Conclusion In conclusion, improvement of 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 information about potential complications, it did not discourage patients from choosing MBS. The insights from this study are crucial for clinicians as they highlight the importance of addressing patient expectations and providing thorough information on potential outcomes and complications to ensure informed decision-making. Preoperative discussions about expectations are crucial in this regard to prevent potential disappointment. Declarations Compliance with Ethical Standards Acknowledgments : none. Funding information : none. Conflict of Interest : The authors declare they have no conflict of interest. Ethical Approval: Formal consent is not required for this type of study (RTPO Leeuwarden, nWMO 2023 0030; ZGT 2023-13 nWMO). Informed consent : Informed consent was obtained from all individual participants included in the study. References Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database of Systematic Reviews. 2014;2014(8). Sjöström L, Narbro K, Sjöström D, Karason K, Larsson B, Wedel H, et al. From the Institutes of Medicine [Internet]. Vol. 23. 2007. Available from: www.nejm.org Courcoulas AP, King WC, Belle SH, Berk P, Flum DR, Garcia L, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018 May 1;153(5):427–34. de Zwaan M, Enderle J, Wagner S, Mühlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011 Sep;133(1–2):61–8. Jolles SA, Alagoz E, Liu N, Voils CI, Shea G, Funk LM. Motivations of Males with Severe Obesity, Who Pursue Medical Weight Management or Bariatric Surgery. Journal of Laparoendoscopic and Advanced Surgical Techniques. 2019 Jun 1;29(6):730–40. Hult M, Bonn SE, Brandt L, Wirén M, Lagerros YT. Women’s Satisfaction with and Reasons to Seek Bariatric Surgery—a Prospective Study in Sweden with 1-Year Follow-up. Obes Surg. 2019 Jul 15;29(7):2059–70. Ahlich E, Verzijl CL, Cunning A, Wright E, Rancourt D. Patient Motivations and Goals for Bariatric Surgery: A Mixed Methods Study. Surgery for Obesity and Related Diseases. 2021 Sep 1;17(9):1591–602. Karmali S, Kadikoy H, Brandt ML, Sherman V. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2011 May;21(5):595–603. Peacock JC, Perry L, Morien K. Bariatric patients’ reported motivations for surgery and their relationship to weight status and health. Surgery for Obesity and Related Diseases. 2018 Jan 1;14(1):39–45. Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surgery for Obesity and Related Diseases. 2019 Apr 1;15(4):636–42. Cohn I, Raman J, Sui Z. Patient motivations and expectations prior to bariatric surgery: A qualitative systematic review. Vol. 20, Obesity Reviews. Blackwell Publishing Ltd; 2019. p. 1608–18. Hult M, te Riele W, Fischer L, Röstad S, Orava K, Heikkinen T, et al. Women’s Reasons to Seek Bariatric Surgery and Their Expectations on the Surgery Outcome — a Multicenter Study from Five European Countries. Obes Surg. 2022 Nov 1;32(11):3722–31. Fischer L, Nickel F, Sander J, Ernst A, Bruckner T, Herbig B, et al. Patient expectations of bariatric surgery are gender specific - A prospective, multicenter cohort study. Surgery for Obesity and Related Diseases. 2014;10(3):516–23. Wee CC, Hamel MB, Apovian CM, Blackburn GL, Dragana Bolcic-Jankovic ;, Mary M;, et al. Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery. Vol. 148, JAMA SURG. O’Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019;29(1):3–14. Grover BT, Morell MC, Kothari SN, Borgert AJ, Kallies KJ, Baker MT. Defining Weight Loss After Bariatric Surgery: a Call for Standardization. Obes Surg. 2019 Nov 1;29(11):3493–9. van Rijswijk AS, Evren I, Geubbels N, Hutten BA, Acherman YIZ, van der Peet DL, et al. Outcome expectation and risk tolerance in patients seeking bariatric surgery. Surgery for Obesity and Related Diseases. 2021 Jan 1;17(1):139–46. Fried M, Yumuk V, Oppert JM, Scopinaro N, Torres A, Weiner R, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55. Van De Laar AW, Emous M, Hazebroek EJ, Evert- &, Boerma J, Faneyte IF, et al. Reporting Weight Loss 2021: Position Statement of the Dutch Society for Metabolic and Bariatric Surgery (DSMBS). Obes Surg. 2021;4607–11. Dijkhorst PJ, de Vries CEE, Mou D, Poulsen L, Sørensen JA, Hoogbergen MM, et al. Quantifying patients’ expectations prior to bariatric surgery with the BODY‐Q in an international multicentre cohort . Clin Obes. 2023 Feb;13(1). Kaly P, Orellana S, Torrella T, Takagishi C, Saff-Koche L, Murr MM. Unrealistic weight loss expectations in candidates for bariatric surgery. Surgery for Obesity and Related Diseases. 2008 Jan;4(1):6–10. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric Surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724. Svanevik M, Lorentzen J, Borgeraas H, Sandbu R, Seip B, Medhus AW, et al. Patient-reported outcomes, weight loss, and remission of type 2 diabetes 3 years after gastric bypass and sleeve gastrectomy (Oseberg); a single-centre, randomised controlled trial. Lancet Diabetes Endocrinol. 2023 Aug;11(8):555–66. Pfefferkorn U, Hort S, Beluli M, La Vista M, Züger T. Weight Loss After Bariatric Surgery in Different Age Groups. Obes Surg. 2023 Apr 9;33(4):1154–9. Munoz DJ, Lal M, Chen EY, Mansour M, Fischer S, Roehrig M, et al. Why Patients Seek Bariatric Surgery: A Qualitative and Quantitative Analysis of Patient Motivation. Obes Surg. 2007 Nov 12;17(11):1487–91. Additional Declarations No competing interests reported. Supplementary Files Supplementarymaterial.docx Cite Share Download PDF Status: Published Journal Publication published 04 Jul, 2025 Read the published version in Obesity Surgery → Version 1 posted Editorial decision: Revision requested 18 Mar, 2025 Reviews received at journal 18 Mar, 2025 Reviews received at journal 16 Mar, 2025 Reviewers agreed at journal 16 Mar, 2025 Reviews received at journal 15 Mar, 2025 Reviews received at journal 13 Mar, 2025 Reviewers agreed at journal 12 Mar, 2025 Reviewers agreed at journal 12 Mar, 2025 Reviewers agreed at journal 12 Mar, 2025 Reviewers invited by journal 19 Jul, 2024 Editor assigned by journal 11 Jul, 2024 Submission checks completed at journal 09 Jul, 2024 First submitted to journal 19 Jun, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4604151","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":331283251,"identity":"f5878e54-46e9-4a3d-991a-d30c58402895","order_by":0,"name":"Lindsy van der Laan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYBACPgjFDMINQMIGKl6AWwsbQgsjSEsaVNyAeC2HidHCY/i5gMFazryBsfHDzx3nE9e2H7/AXIBfi7H0DIZ0Y5kDjM2SvWduJ247k1PAPAOvFrYEaR6Gw4kzgA6T4G0DarnBk8DMg19L8m+glnqgluaff9vOEaOF+RjIlgQJBsY2ad62A0At7Afwa2FmPmbNY5BuOIOZsc1ati3ZGOgXhsP4tPCzNzbf5qmwlpdgbz58822bney248cfPuapwK0FHCPgWGCGC/EYHMCjAStgf0CqjlEwCkbBKBjeAABh10PJAPG40QAAAABJRU5ErkJggg==","orcid":"","institution":"Center for Obesity Northern-Netherlands (CON), Department of Metabolic Bariatric Surgery, Medical Center Leeuwarden","correspondingAuthor":true,"prefix":"","firstName":"Lindsy","middleName":"van der","lastName":"Laan","suffix":""},{"id":331283253,"identity":"8b964a86-a31c-4599-ac9e-be35f03f1132","order_by":1,"name":"Ellen A M Kuipers","email":"","orcid":"","institution":"Department of Surgery, Hospital Group Twente Almelo/Hengelo","correspondingAuthor":false,"prefix":"","firstName":"Ellen","middleName":"A M","lastName":"Kuipers","suffix":""},{"id":331283254,"identity":"755f93a1-0972-4962-8362-5e7633644b05","order_by":2,"name":"Josien G Timmerman","email":"","orcid":"","institution":"ZGT Academy, Hospital Group Twente Almelo/Hengelo","correspondingAuthor":false,"prefix":"","firstName":"Josien","middleName":"G","lastName":"Timmerman","suffix":""},{"id":331283255,"identity":"e5ccb4c2-1c48-4a85-9fa9-4a157f7e03d2","order_by":3,"name":"Mirjam A Kaijser","email":"","orcid":"","institution":"Center for Obesity Northern-Netherlands (CON), Department of Metabolic Bariatric Surgery, Medical Center Leeuwarden","correspondingAuthor":false,"prefix":"","firstName":"Mirjam","middleName":"A","lastName":"Kaijser","suffix":""},{"id":331283257,"identity":"ec4255ee-1f8c-4d57-ba9c-bfc719a88627","order_by":4,"name":"Marc J van Det","email":"","orcid":"","institution":"Department of Surgery, Hospital Group Twente Almelo/Hengelo","correspondingAuthor":false,"prefix":"","firstName":"Marc","middleName":"J van","lastName":"Det","suffix":""},{"id":331283258,"identity":"69956eca-84d8-418f-8444-51d9b181e449","order_by":5,"name":"Marloes Emous","email":"","orcid":"","institution":"Center for Obesity Northern-Netherlands (CON), Department of Metabolic Bariatric Surgery, Medical Center Leeuwarden","correspondingAuthor":false,"prefix":"","firstName":"Marloes","middleName":"","lastName":"Emous","suffix":""}],"badges":[],"createdAt":"2024-06-19 07:57:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4604151/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4604151/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11695-025-07997-0","type":"published","date":"2025-07-04T15:57:59+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":86179098,"identity":"b7dcc5c3-ba3e-4a43-95e4-6d4eb287e2c7","added_by":"auto","created_at":"2025-07-07 16:15:42","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1368584,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4604151/v1/26d77fda-e60f-4b84-8ef5-07fd99b4ccc5.pdf"},{"id":61563639,"identity":"925e41fc-41e4-4f9d-b90d-0bb80d347426","added_by":"auto","created_at":"2024-08-01 09:21:17","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":216804,"visible":true,"origin":"","legend":"","description":"","filename":"Supplementarymaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-4604151/v1/cd6d302615779dd0a4465ecc.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study","fulltext":[{"header":"Key points","content":"\u003cul\u003e\n \u003cli\u003eThe main reasons for undergoing MBS were to improve mobility and health.\u003c/li\u003e\n \u003cli\u003eExpectations of weight loss were high.\u003c/li\u003e\n \u003cli\u003eThe risk for complications did not discourage patients from choosing MBS.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eMetabolic bariatric surgery (MBS) is an effective and durable treatment option for patients with severe obesity in terms of weight loss and improvement of obesity-related comorbidities (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). Currently, most studies on outcomes after MBS focus almost exclusively on weight loss as the primary outcome of interest and some provide data on obesity-related comorbidity reduction (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e–\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). However, it is essential to recognize that MBS is an invasive intervention with a broad impact on a patient’s life, including mental health, nutritional habits, and quality of life (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). Keeping that in mind, patients have various reasons for undergoing MBS (\u003cspan additionalcitationids=\"CR6\" citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e–\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). To provide realistic information before MBS, it is important to gain knowledge about the patient’s motivation for having surgery as well as their expectations of MBS.\u003c/p\u003e \u003cp\u003ePrevious literature has demonstrated that the primary motivation for patients seeking MBS is related to physical health, such as weight loss and improvement of comorbidities (\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e–\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In addition, a variety of other motivations were mentioned, including increasing fertility, pain reduction, and improving physical activity, social life, and emotional well-being (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Remarkably, Hult et al. showed that the most common preoperative motivation for undergoing MBS, i.e. weight loss, differed from the most common postoperative source of satisfaction, which was improved self-esteem (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Nonetheless, weight loss remained one of the three items that participants were most satisfied with after surgery.\u003c/p\u003e \u003cp\u003eExisting studies do show that patients have unrealistic goals in terms of weight loss after MBS (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e–\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Expected excess weight loss percentages (%EWL) between 71% and 94% have been reported (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e–\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), while 18 studies of gastric bypass surgery showed a weighted mean %EWL of 57% in the long term (≥ 10 years) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Moreover, given that an EWL of at least 50% is defined as an optimal clinical response after surgery, presurgical weight loss expectations are high (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs satisfaction after MBS relates to the preoperative perceptions and expectations of patients, it is important to understand patients’ expectations and motivations to undergo MBS. However, there is a general paucity of information on patients’ perspectives on potential challenges or problems after MBS, which may also contribute to satisfaction levels after MBS. Van Rijswijk et al. concluded that patients accept substantial risks of short-term complications (≤ 30 days after surgery), acute internal herniation (≥ 30 days), and mortality (≤ 30 days) to achieve their weight loss objectives (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Patients with a higher body mass index (BMI) accepted higher risks of complications and mortality within 30 days, compared to patients with a lower BMI. Notably, the influence of age on the willingness to accept substantial risks remains unexplored (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). Furthermore, no attention has been given to other potential problems, difficulties, or challenges in the longer term after surgery.\u003c/p\u003e \u003cp\u003eTherefore, we aim to extend earlier work by exploring patients’ main expected concerns, difficulties, and challenges in the long term after MBS, as well as their preoperative expectations of physical, social, and psychological aspects. In addition, potential differences in subgroups based on gender, BMI, age, and the presence of obesity-related comorbidities were assessed. Insight into patients’ preoperative expectations may help in preoperative counseling, manage patients’ expectations, and may have important implications in prioritizing patient-centered outcomes.\u003c/p\u003e "},{"header":"Methods","content":"\u003ch2\u003eStudy population\u003c/h2\u003e\u003cp\u003eWe performed a cross-sectional multicenter survey in adult patients awaiting primary MBS. Two non-academic teaching hospitals in the Netherlands participated: Medical Center Leeuwarden (MCL) and Hospital Group Twente Almelo/Hengelo (ZGT). All patients who were approved for primary MBS were asked to participate in this study between April and October 2023. Patients not fluent in Dutch or illiterates were excluded, because of the inability to understand and complete the Dutch questionnaire.\u003c/p\u003e\u003cp\u003e The medical ethical committee approved the study (RTPO Leeuwarden, nWMO 2023 0030; ZGT 2023-13 nWMO) and informed consent was obtained from all patients.\u003c/p\u003e\u003ch2\u003eStudy procedure\u003c/h2\u003e\u003cp\u003eAll patients complied with the implemented International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) guidelines for undergoing MBS from 2014: BMI ≥ 40 kg/m\u003csup\u003e2\u003c/sup\u003e or BMI ≥ 35 kg/m\u003csup\u003e2\u003c/sup\u003e with at least one comorbidity (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Patients attended an information session on MBS before their preoperative consultation with a bariatric surgeon, as per standard care protocol. During the preoperative consultation, patients were invited to participate in the study by the bariatric nurse or surgeon. Upon agreement, they were provided with a questionnaire on paper, including further explanation of the study. Returning the completed questionnaire signified informed consent, as stated in the introduction of the questionnaire.\u003c/p\u003e\u003ch2\u003eQuestionnaire\u003c/h2\u003e\u003cp\u003eWe conducted a questionnaire in Dutch (the patients’ native language), based on literature and clinical expertise (Appendix 1). The following demographic variables were included: gender, age, body weight, length, highest education level, and comorbidities. The top three reasons for seeking surgery and patients’ expectations of MBS about weight loss, and changes of physical, social, and psychological domains were assessed using open-ended questions. Answer options regarding the remission of comorbidities were no remission (no changes in treatment or pain complaints), partial remission (less treatment or less pain complaints), total remission (no longer requiring treatment or no pain complaints anymore), and deterioration (more treatment or more pain complaints).\u003c/p\u003e\u003cp\u003eThe impact of short-term (≤ 30 days after surgery) and long-term complications (\u0026gt; 2 years after surgery) was assessed in three domains: 1) the importance of being informed about the complication during the preoperative period, 2) the anxiety of developing the complication, and 3) the impact of the complication on the consideration of undergoing MBS. For every complication, patients were asked to rate these three domains on a 5-point Likert scale. Additionally, patients were given the opportunity to express fears about unaddressed issues.\u003c/p\u003e\u003ch2\u003eStatistical analysis\u003c/h2\u003e\u003cp\u003eBaseline characteristics were expressed by descriptive statistics. Parametric data were presented as mean ± standard deviation (SD), nonparametric data as median with interquartile range (IQR), and categorical data as frequencies and percentages. Expected weight loss was expressed as %EWL and percentage total weight loss (%TWL). Subgroup analyses were conducted for expected weight loss, expected remission of comorbidities, and the impact of complications for four groups based on: 1) gender (men versus women), 2) BMI (BMI \u0026lt; 50 kg/m\u003csup\u003e2\u003c/sup\u003e versus BMI ≥ 50 kg/m\u003csup\u003e2\u003c/sup\u003e), 3) age (\u0026lt; 30 years versus \u0026gt; 50 years), and 4) presence of obesity-related comorbidities (with versus without comorbidities). The Mann-Whitney U test was performed for non-parametric data. Categorical data were analyzed with a Chi-Square test. A p-value of \u0026lt; 0.05 was considered statistically significant. Statistical analysis was performed using SPSS Statistics (version 28, SPSS Inc., Chicago, IL, USA).\u003c/p\u003e\u003cp\u003eQualitative data from open-ended questions were analyzed inductively, with categories generated by two researchers (L.v.d.L. and E.K.) and discussed with the other authors. The frequency and the percentages of the subsequent categories were reported.\u003c/p\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003ePatient characteristics\u003c/h2\u003e \u003cp\u003eA total of 242 patients (81% female) completed the questionnaire, with 137 patients from MCL and 105 from ZGT. The median age was 47 years [35\u0026ndash;53], and the median BMI was 42 kg/m\u003csup\u003e2\u003c/sup\u003e [39\u0026ndash;47]. Hypertension and obstructive sleep apnea syndrome (OSAS) were the most prevalent obesity-related comorbidities. The highest level of completed education was vocational education (51%). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal (N\u0026thinsp;=\u0026thinsp;242)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, years ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47 [35\u0026ndash;53]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale ◦\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e195 (81)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody weight, kg ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e124 [113\u0026ndash;140]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 [39\u0026ndash;47]\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBaseline comorbidities\u003c/p\u003e \u003cp\u003e- Hypertension\u003c/p\u003e \u003cp\u003e- Diabetes mellitus\u003c/p\u003e \u003cp\u003e- OSAS\u003c/p\u003e \u003cp\u003e- Dyslipidemia\u003c/p\u003e \u003cp\u003e- Osteoarthritis\u003c/p\u003e \u003cp\u003e- GERD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74 (31)\u003c/p\u003e \u003cp\u003e27 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e63 (26)\u003c/p\u003e \u003cp\u003e28 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e57 (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e39 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHighest level of completed education\u003c/p\u003e \u003cp\u003e- No degree\u003c/p\u003e \u003cp\u003e- Primary school\u003c/p\u003e \u003cp\u003e- High school - vocational education\u003c/p\u003e \u003cp\u003e- High school \u0026ndash; higher vocational education\u003c/p\u003e \u003cp\u003e- Vocational education\u003c/p\u003e \u003cp\u003e- Higher vocational education\u003c/p\u003e \u003cp\u003e- University\u003c/p\u003e \u003cp\u003e- Other\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e39 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e9 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e123 (51)\u003c/p\u003e \u003cp\u003e51 (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e6 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e7 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e▪ Median [interquartile range]\u003c/p\u003e \u003cp\u003e◦ Absolute number (percentage)\u003c/p\u003e \u003cp\u003eBMI\u0026thinsp;=\u0026thinsp;Body Mass Index, kg/m\u003csup\u003e2\u003c/sup\u003e; OSAS\u0026thinsp;=\u0026thinsp;Obstructive Sleep Apnea Syndrome; GERD\u0026thinsp;=\u0026thinsp;gastroesophageal reflux disease.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe characteristics of the subgroups can be found in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Women exhibited a notably lower preoperative body weight than men (120 versus 143 kg; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). In patients under 30 years old compared to those over 50 years old, preoperative body weight (133 versus 120 kg; p\u0026thinsp;=\u0026thinsp;0.004) and BMI (45 versus 41 kg/m\u003csup\u003e2\u003c/sup\u003e; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) were significantly higher. Patients with a BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e were notably older than those with a BMI\u0026thinsp;\u0026gt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e (49 versus 39 years; p\u0026thinsp;=\u0026thinsp;0.017). Additionally, patients with comorbidities were significantly older than those without comorbidities (51 versus 34 years; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), also the proportion of males was higher in the group with comorbidities (27% versus 7%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Subgroup analyses for demographics, expected weight loss, and expected remission of comorbidities\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"13\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c13\" namest=\"c11\"\u003e \u003cp\u003eComorbidities\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eMen\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eWomen\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eBMI\u0026thinsp;\u0026lt;\u0026thinsp;50\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;208\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eBMI\u003c/em\u003e\u0026thinsp;\u003cspan type=\"ItalicUnderline\" class=\"ItalicUnderline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;\u003cem\u003e50\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003e\u0026lt;\u0026thinsp;30 years\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cem\u003e\u0026gt;\u0026thinsp;50 years\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u003cem\u003eWith comorbidities\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003eWithout comorbidities\u003c/em\u003e\u003c/p\u003e \u003cp\u003eN\u0026thinsp;=\u0026thinsp;89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"13\" nameend=\"c13\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eDemographics\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, years ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e50 [37\u0026ndash;55]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47 [34\u0026ndash;53]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.248\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 [36\u0026ndash;53]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39 [28\u0026ndash;51]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e25 [23\u0026ndash;28]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e54 [52\u0026ndash;60]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e51 [44\u0026ndash;55]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e34 [26\u0026ndash;46]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale ◦\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e195 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e170 (82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24 (73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e35 (85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e79 (76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e112 (73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e83 (93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody weight, kg ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e143 [132\u0026ndash;169]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e120 [110\u0026ndash;131]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e120 [111\u0026ndash;132]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e165 [151\u0026ndash;175]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e133 [121\u0026ndash;154]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e120 [110\u0026ndash;137]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.004\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e125 [113\u0026ndash;139]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e124 [113\u0026ndash;140]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.772\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e ▪\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42 [39\u0026ndash;48]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42 [39\u0026ndash;46]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41 [39\u0026ndash;44]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e53 [51\u0026ndash;56]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e45 [41\u0026ndash;50]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e41 [38\u0026ndash;45]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e42 [38\u0026thinsp;\u0026minus;\u0026thinsp;36]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e42 [40\u0026ndash;47]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.055\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"13\" nameend=\"c13\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eExpected weight loss ▪\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%TWL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e30 [28\u0026ndash;35]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 [28\u0026ndash;35]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.494\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31 [28\u0026ndash;35]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e35 [32\u0026ndash;39]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e32 [29\u0026ndash;39]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e32 [28\u0026ndash;35]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.348\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e32 [28\u0026ndash;35]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e33 [29\u0026ndash;37]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e%EWL\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e78 [67\u0026ndash;87]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81 [69\u0026ndash;92]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83 [72\u0026ndash;92]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68 [59\u0026ndash;76]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e76 [63\u0026ndash;85]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e83 [69\u0026ndash;92]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.037\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e82 [69\u0026ndash;92]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e79 [68\u0026ndash;89]*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e0.650\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"13\" nameend=\"c13\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eExpected remission of comorbidities\u003c/em\u003e ◦/◦◦\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHypertension\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53 (27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65 (31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.645\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e48 (46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e74 (48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41 (63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.552\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e29 (60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e45 (61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19 (29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e16 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e24 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDiabetes mellitus\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e17 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e27 (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.415\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14 (64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.728\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e11 (65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e18 (67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6 (35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8 (30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOSAS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28 (60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14 (42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e37 (36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0.002\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e63 (41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31 (89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42 (86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e32 (86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e0.008\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e55 (87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDyslipidemia\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e0.020\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.923\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20 (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e28 (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e0.022\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.611\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8 (40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e14 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"2\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9 (45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e10 (36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOsteoarthritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55 (26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.010\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e46 (44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e57 (37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7 (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.645\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.081\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44 (80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e35 (76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e45 (79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGERD\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.234\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e21 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e39 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2 (40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003e0.045\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6 (29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e18 (46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePartial remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11 (32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e10 (48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e12 (31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo remission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeterioration\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c13\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"13\" nameend=\"c13\" namest=\"c1\"\u003e \u003cp\u003e▪ Median [interquartile range]\u003c/p\u003e \u003cp\u003e◦ Absolute number (percentage)\u003c/p\u003e \u003cp\u003e◦◦ Comorbidity percentages are calculated based on the prevalence in the subgroups. Remission rates are calculated from the number of patients in the subgroup with the specific comorbidity.\u003c/p\u003e \u003cp\u003e* Number of missing values: 1 to 9\u003c/p\u003e \u003cp\u003eBMI\u0026thinsp;=\u0026thinsp;Body Mass Index, kg/m\u003csup\u003e2\u003c/sup\u003e; %TWL\u0026thinsp;=\u0026thinsp;percentage Total Weight Loss; %EWL\u0026thinsp;=\u0026thinsp;percentage Excess Weight Loss; OSAS\u0026thinsp;=\u0026thinsp;Obstructive Sleep Apnea Syndrome; GERD\u0026thinsp;=\u0026thinsp;gastroesophageal reflux disease.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eTop 3 most important reasons for undergoing MBS\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e illustrates the primary reasons for opting for MBS, with mobility and health emerging as the predominant categories across all three top positions. Specifically, 21% of the patients mentioned mobility in the first place, 17% in the second place, followed by 18% in the third place. For the category of health, these percentages were 18%, 19%, and 12%, respectively. Additionally, pain reduction was ranked first by 19% of the participants, remission of comorbidities was ranked second by 17%, and physical fitness was ranked third by 14%. (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTop 3 most important reasons for undergoing MBS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRank 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRank 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRank 3\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildren/ family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21 (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMobility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e57\u003c/b\u003e (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e46\u003c/b\u003e (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e46\u003c/b\u003e (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical fitness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31 (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e37\u003c/b\u003e (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional well-being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e50\u003c/b\u003e (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e50\u003c/b\u003e (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e31\u003c/b\u003e (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuality of life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePain reduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e51\u003c/b\u003e (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRemission of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43 (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e46\u003c/b\u003e (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFollow-up surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-image\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e275 (100)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e266 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e261 (100.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eData expressed as absolute frequencies and percentages (%).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003eExpected weight loss\u003c/h2\u003e \u003cp\u003ePatients reported an expected median %TWL of 32 [28\u0026ndash;35] and a %EWL of 81 [69\u0026ndash;90] (N\u0026thinsp;=\u0026thinsp;241). Patients with BMI\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e expected more %TWL than patients with BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e (35% versus 31%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003eExpected remission of comorbidities\u003c/h2\u003e \u003cp\u003eThe prevalence of the comorbidities and the expectations of the remission of comorbidities are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e (columns comorbidities). Most patients expected total remission of hypertension, diabetes mellitus, and OSAS. For dyslipidemia and gastroesophageal reflux disease (GERD), approximately half of the patients expected total remission. Partial remission is mainly expected for osteoarthritis. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eIn subgroup 1 (gender), we observed a higher prevalence of men with hypertension (45% versus 27%; p\u0026thinsp;=\u0026thinsp;0.019), OSAS (60% versus 18%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and dyslipidemia (21% versus 9%; p\u0026thinsp;=\u0026thinsp;0.020). More women expected total remission of OSAS (89% versus 86%; p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). On the other hand, more women had lower expectations of the remission of dyslipidemia. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn subgroup 2 (BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e vs BMI\u0026thinsp;\u0026ge;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e), a higher prevalence of OSAS was noted among patients with a BMI\u0026thinsp;\u0026ge;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e (42% versus 24%; p\u0026thinsp;=\u0026thinsp;0.022). They also expected higher remission rates of OSAS (93% versus 86%; p\u0026thinsp;=\u0026thinsp;0.005). Conversely, patients with a BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e exhibited a greater prevalence of osteoarthritis (26% versus 6%; p\u0026thinsp;=\u0026thinsp;0.010) and had higher expectations of the remission of GERD. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eSubgroup 3 (age\u0026thinsp;\u0026lt;\u0026thinsp;30 years versus \u0026gt;\u0026thinsp;50 years) revealed a higher prevalence of OSAS in patients older than 50 years (36% versus 10%; p\u0026thinsp;=\u0026thinsp;0.002), with higher expectations of total remission as well (86% versus 75%; p\u0026thinsp;=\u0026thinsp;0.008). (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eExpectations of physical, social, and psychological changes\u003c/h2\u003e \u003cp\u003eExpectations of physical, social, and psychological changes after MBS are presented in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. Given the open-ended nature of each domain, patients occasionally referenced categories that could be associated with another domain. Patients had the opportunity to provide multiple responses to a single question, resulting in a higher count of categories compared to the number of patients. Subsequently, these responses were categorized.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u0026ndash; Expected physical, social, and psychological changes after MBS\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePhysical (N\u0026thinsp;=\u0026thinsp;625)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eSocial (N\u0026thinsp;=\u0026thinsp;346)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003ePsychological (N\u0026thinsp;=\u0026thinsp;338)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOverlap across all three domains\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWeight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eWeight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eWeight loss\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePhysical fitness\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e112\u003c/b\u003e (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePhysical fitness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePhysical fitness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRemission of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRemission of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRemission of comorbidities\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMobility\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e162 (26)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMobility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMobility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppearance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e107 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAppearance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eAppearance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildren/family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eChildren/family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChildren/family\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional well-being\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eEmotional well-being\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e50\u003c/b\u003e (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eEmotional well-being\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e81\u003c/b\u003e (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParticipation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eParticipation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43 (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eParticipation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSelf-image\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eSelf-image\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e75\u003c/b\u003e (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eSelf-image\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e151 (45)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eOverlap across two domains\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"3\" nameend=\"c2\" namest=\"c1\" rowspan=\"4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eInteraction with others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eInteraction with others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePublic spaces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24 (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePublic spaces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eReactions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31 (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eReactions\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eNo change\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e54\u003c/b\u003e (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eNo change\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e14\u003c/b\u003e (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePain reduction\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e122\u003c/b\u003e (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"2\" nameend=\"c4\" namest=\"c3\" rowspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePain reduction\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eQuality of life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eQuality of life\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHealth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eUnique categories for each domain\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDon\u0026rsquo;t know\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFood and emotion\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBalance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2 (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFollow-up surgery\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c4\" namest=\"c3\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1 (0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9 (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003eData expressed as absolute frequencies and percentages (%).\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMobility, pain reduction, and physical fitness were the most frequently mentioned expected physical changes. In the context of social changes, self-image, no change, and emotional well-being emerged as the most frequently mentioned categories. Self-image and emotional well-being also arose as the first and second categories for expected psychological changes after surgery. Followed by no expected changes in the third place. (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eFinally, we enquired about other potential concerns after MBS. In total, 77% expected no other problems (N\u0026thinsp;=\u0026thinsp;195). Additional 16 potential concerns or topics were mentioned by 59 participants including among others \u0026lsquo;appearance\u0026rsquo; (N\u0026thinsp;=\u0026thinsp;16), \u0026lsquo;complications\u0026rsquo; (N\u0026thinsp;=\u0026thinsp;11), \u0026lsquo;narcosis\u0026rsquo; (N\u0026thinsp;=\u0026thinsp;3), \u0026lsquo;intake/nutrition\u0026rsquo; (N\u0026thinsp;=\u0026thinsp;6), \u0026lsquo;rules for living\u0026rsquo; (N\u0026thinsp;=\u0026thinsp;3), \u0026ldquo;quality of life\u0026rdquo; (N\u0026thinsp;=\u0026thinsp;3), \u0026ldquo;medication\u0026rdquo; (N\u0026thinsp;=\u0026thinsp;2), and \u0026ldquo;self-image\u0026rdquo; (N\u0026thinsp;=\u0026thinsp;2).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eImpact of complications\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e presents the importance of being informed about the complication during the preoperative period, the anxiety of developing the complication, and the impact of the complication on the consideration of undergoing MBS. In general, patients considered it important to be informed about the complications (mean scores between 3.9 and 4.3). However, the complications did not induce anxiety (mean scores between 2.5 and 3.2) or heavily influenced the consideration of undergoing MBS (mean scores between 2.6 and 3.0).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInformation, anxiety, and consideration about complications (N\u0026thinsp;=\u0026thinsp;242*)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eInformation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eConsideration\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003eShort-term complications (\u0026le;\u0026thinsp;30 days after surgery)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBleeding\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnastomotic leakage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWound infection\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReoperation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePneumonia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.4\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThrombosis/ pulmonary embolism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReadmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstipation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDifficulties with eating and drinking/ nausea and vomiting\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLong-term complications (\u0026gt;\u0026thinsp;2 years after surgery)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInternal herniation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGastric ulcer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGERD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDumping\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1,1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnderweight\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLess weight loss than expected\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1,1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecurrent weight gain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;0.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1,1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReoperation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.6\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGallstones\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eComplaints of hypoglycemia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.0\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiarrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.7\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeficiency in vitamins and/or minerals\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.2\u0026thinsp;\u0026plusmn;\u0026thinsp;1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e*Numbers of responses varying between 226 and 240 on each domain.\u003c/p\u003e \u003cp\u003eData expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. \u003c/p\u003e \u003cp\u003eValidation of the 5-point Likert scale: 1\u0026thinsp;=\u0026thinsp;not important at all, 2\u0026thinsp;=\u0026thinsp;not important, 3\u0026thinsp;=\u0026thinsp;neutral, 4\u0026thinsp;=\u0026thinsp;important, 5\u0026thinsp;=\u0026thinsp;very important.\u003c/p\u003e \u003cp\u003eGERD\u0026thinsp;=\u0026thinsp;gastroesophageal reflux disease.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSubgroup analyses on the impact of complications are shown in Appendix 2.\u003c/p\u003e \u003cp\u003eIn subgroup 1 (gender), women considered it significantly more important to be informed about all the complications than men, except diarrhea, which did not show a significant difference. Additionally, women exhibited greater anxiety of developing specific complications, including anastomotic leakage, reoperation (short-term), difficulties with eating and drinking/ nausea and vomiting, internal herniation, GERD, dumping, less weight loss than expected, recurrent weight gain, reoperation (long-term), gallstones, and deficiency in vitamins and/or minerals. When considering surgery, women found bleeding, reoperation (short-term), pneumonia, readmission, difficulties with eating and drinking/ nausea and vomiting, and reoperation (long-term) to be more important factors to take into account. (Appendix 2, Table\u0026nbsp;6)\u003c/p\u003e \u003cp\u003eIn subgroup 2 (BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e versus BMI\u0026thinsp;\u0026ge;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e), patients with BMI\u0026thinsp;\u0026lt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e considered it significantly more important to be informed about malnutrition and underweight. This patient group also found more complications to be relevant when considering surgery, including bleeding, anastomotic leakage, wound infection, thrombosis/ pulmonary embolism, and complaints of hypoglycemia. (Appendix 2, Table\u0026nbsp;7)\u003c/p\u003e \u003cp\u003eIn subgroup 3 (\u0026lt;\u0026thinsp;30 years versus \u0026gt;\u0026thinsp;50 years), patients under 30 years old exhibited greater anxiety of developing difficulties with eating and drinking/ nausea and vomiting. On the other hand, patients above 50 years had more anxiety of developing diarrhea. Additionally, the older patient category found malnutrition to be more relevant when considering surgery. (Appendix 2, Table\u0026nbsp;8)\u003c/p\u003e \u003cp\u003eIn subgroup 4 (with versus without comorbidities), patients without comorbidities exhibited greater anxiety of developing an internal herniation and difficulties with eating and drinking/ nausea and vomiting. This group also found being informed about internal herniation more important. (Appendix 2, Table\u0026nbsp;9)\u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to explore patients\u0026rsquo; main expected dreads, difficulties, or challenges in the long term after MBS, in conjunction with patients\u0026rsquo; preoperative expectations regarding physical, social, and psychological aspects. Despite prioritizing being informed about potential complications, it did not discourage patients from choosing MBS.\u003c/p\u003e \u003cp\u003eMobility, health, and remission of comorbidities emerged as the most important reasons for undergoing surgery. This is in line with previous literature showing that the primary motivation for individuals pursuing MBS is connected to physical health (\u003cspan additionalcitationids=\"CR9 CR10 CR11\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). While weight loss has also been recognized as an important motivation in previous literature (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), it did not emerge as one of the three primary reasons in our study. Interestingly, Hult et al. identified weight loss as the leading motivation, not only in their overall study population but also in a subgroup of patients from the Netherlands (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). An explanation for this difference might be the higher observed BMI in their population, compared to a lower BMI in ours, suggesting that individuals with a higher BMI may prioritize weight loss as a more important reason for opting for MBS. In our study, we also found a higher expected %TWL in patients with a higher BMI (35% versus 31%). Furthermore, the proportion of patients with BMI\u0026thinsp;\u0026gt;\u0026thinsp;50 kg/m\u003csup\u003e2\u003c/sup\u003e in our study was small.\u003c/p\u003e \u003cp\u003eAlthough weight loss was not frequently mentioned as the most important reason to undergo MBS, our study population has high expectations in terms of weight loss post-surgery, with a median %TWL of 32% and a %EWL of 81%. This aligns with previous studies, reporting expected %EWL ranging from 71\u0026ndash;94% (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, gastric bypass surgery has been associated with reported %EWL ranging from 27\u0026ndash;69% after ten years (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This shows a considerable disparity between anticipated and realized weight loss outcomes, which can result in postoperative disappointment. Nowadays, it is preferable to quantify weight loss in terms of %TWL rather than %EWL (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Unfortunately, previous studies relied solely on %EWL for their measurements, making a reliable comparison between their results and our outcomes infeasible. In the questionnaire, we did not define a specific timeframe for expected weight loss after surgery. Consequently, participants might have referred to expected weight loss in the short term after surgery rather than in the long term.\u003c/p\u003e \u003cp\u003eOur study reveals a notable difference in weight loss expectations between age groups, with patients over 50 years anticipating more excess weight loss compared to those under 30 years (83% versus 76%). However, the %TWL did not differ between the age groups. These findings contradict previous studies indicating that younger patients tend to have higher expectations regarding weight loss (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). A potential explanation could be that younger patients typically have fewer comorbidities, allowing them to focus more on weight loss.\u003c/p\u003e \u003cp\u003eAlthough participants had unrealistic weight loss expectations, their estimations for comorbidity resolutions were accurate. The anticipated total remission rates for comorbidities were as follows: 61% for hypertension, 87% for OSAS, and 67% for diabetes mellitus. These rates align closely with those reported in a meta-analysis by Buchwald et al., where hypertension resolution occurred in 62% of the patients and OSAS resolution in 86% (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). However, the expected total remission rate of diabetes mellitus in our population was lower than the actual remission rate reported by Buchwald et al. (67% vs. 77%) (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Similarly to our expected remission rate, Svanenik et al. reported an actual diabetes remission rate of 67% in their patients (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Overall, these findings suggests that our preoperative information session on MBS is effective regarding obesity-related comorbidities. Patients older than 50 years anticipated higher resolution rates for OSAS compared to their younger counterparts. Notably, these higher expected remission rates align with those reported in the literature, suggesting that older patients' expectations are realistic (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Unfortunately, we were unable to compare the expected remission rates for other comorbidities, as patients younger than 30 years did not have any additional comorbidities. In the literature, the reported remission rate of obesity-related comorbidities is higher in younger adults compared to older individuals (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOur findings suggest a prioritization of physical factors over social and psychological factors when seeking MBS. Although the expected changes in physical, social, and psychological domains after MBS were addressed separately through open-ended questions, there was overlap in the responses across these domains. Differentiating between the domains appears challenging for patients, which is understandable given the interconnected nature of these domains. For instance, feeling better when in the company of others can be categorized as both psychological and social. Mobility, pain reduction, and physical fitness emerged as primary motivations for individuals considering MBS in our study, alongside considerations such as improved health and remission of comorbidities. Consistent with prior research, low percentages of self-image and emotional well-being were seen as the top three motivations for undergoing MBS (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Conversely, findings from a study conducted by Hult et al. revealed that self-esteem, mental health, and social life were ranked as very important by 72%, 76%, and 56% of the participants, respectively (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). However, their study considered a broad spectrum of motivations to undergo MBS as very important.\u003c/p\u003e \u003cp\u003eOur results show that patients consider it important to be informed about both short-term and long-term complications. However, the complications do not induce anxiety or heavily influence the consideration of undergoing MBS. This aligns with the conclusions drawn by van Rijswijk et al., who found that patients are willing to accept considerable risks, including short-term complications (\u0026le;\u0026thinsp;30 days after surgery), acute internal herniation (\u0026ge;\u0026thinsp;30 days), and mortality (\u0026le;\u0026thinsp;30 days), to achieve their weight loss goals (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). However, only the short-term complications were incorporated in the study of van Rijswijk et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e), while we also included long-term complications. Furthermore, we conducted subgroup analyses to assess patients' perceptions of complications. The primary findings from these analyses indicate that female patients exhibit greater anxiety of developing complications and have a stronger desire for comprehensive information. These subgroup differences should be considered when discussing treatment options with patients, such as taking more time for explanations or referring them to reliable sources.\u003c/p\u003e \u003cp\u003eStrengths and Limitations.\u003c/p\u003e \u003cp\u003eThe strengths of this study are the large sample size and the administration of the questionnaire in two independent hospitals. Additionally, it expands upon previous literature by adding patients\u0026rsquo; main expected dreads, difficulties, or challenges in the long term after MBS. Our study has some limitations that need to be mentioned: first, the questionnaire is not validated. However, it was developed based on literature and clinical expertise. Second, we did not inquire about the preferred bariatric procedure, while this could influence results regarding weight loss expectations or specific complications. Third, the generalizability of the study may be limited as this study was solely conducted in the Netherlands. Administering the questionnaire globally could enhance generalizability. Finally, due to our study design, we were not able to compare preoperative expectations with postoperative outcomes. Nevertheless, to answer our research question, the cross-sectional study design was deemed appropriate. Future studies could explore the concordance between patients\u0026rsquo; preoperative expectations and postoperative outcomes.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, improvement of 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 information about potential complications, it did not discourage patients from choosing MBS. The insights from this study are crucial for clinicians as they highlight the importance of addressing patient expectations and providing thorough information on potential outcomes and complications to ensure informed decision-making. Preoperative discussions about expectations are crucial in this regard to prevent potential disappointment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eCompliance with Ethical Standards\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAcknowledgments\u003c/strong\u003e:\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003enone.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding information\u003c/strong\u003e: none.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e: The authors declare they have no conflict of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical\u0026nbsp;\u003c/strong\u003eApproval: Formal consent is not required for this type of study\u0026nbsp;(RTPO Leeuwarden, nWMO 2023 0030; ZGT 2023-13 nWMO).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e: Informed consent was obtained from all individual participants included in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eColquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database of Systematic Reviews. 2014;2014(8). \u003c/li\u003e\n\u003cli\u003eSj\u0026ouml;str\u0026ouml;m L, Narbro K, Sj\u0026ouml;str\u0026ouml;m D, Karason K, Larsson B, Wedel H, et al. From the Institutes of Medicine [Internet]. Vol. 23. 2007. Available from: www.nejm.org\u003c/li\u003e\n\u003cli\u003eCourcoulas AP, King WC, Belle SH, Berk P, Flum DR, Garcia L, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018 May 1;153(5):427\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003ede Zwaan M, Enderle J, Wagner S, M\u0026uuml;hlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011 Sep;133(1\u0026ndash;2):61\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eJolles SA, Alagoz E, Liu N, Voils CI, Shea G, Funk LM. Motivations of Males with Severe Obesity, Who Pursue Medical Weight Management or Bariatric Surgery. Journal of Laparoendoscopic and Advanced Surgical Techniques. 2019 Jun 1;29(6):730\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eHult M, Bonn SE, Brandt L, Wir\u0026eacute;n M, Lagerros YT. Women\u0026rsquo;s Satisfaction with and Reasons to Seek Bariatric Surgery\u0026mdash;a Prospective Study in Sweden with 1-Year Follow-up. Obes Surg. 2019 Jul 15;29(7):2059\u0026ndash;70. \u003c/li\u003e\n\u003cli\u003eAhlich E, Verzijl CL, Cunning A, Wright E, Rancourt D. Patient Motivations and Goals for Bariatric Surgery: A Mixed Methods Study. Surgery for Obesity and Related Diseases. 2021 Sep 1;17(9):1591\u0026ndash;602. \u003c/li\u003e\n\u003cli\u003eKarmali S, Kadikoy H, Brandt ML, Sherman V. What is my goal? Expected weight loss and comorbidity outcomes among bariatric surgery patients. Obes Surg. 2011 May;21(5):595\u0026ndash;603. \u003c/li\u003e\n\u003cli\u003ePeacock JC, Perry L, Morien K. Bariatric patients\u0026rsquo; reported motivations for surgery and their relationship to weight status and health. Surgery for Obesity and Related Diseases. 2018 Jan 1;14(1):39\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003ePearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surgery for Obesity and Related Diseases. 2019 Apr 1;15(4):636\u0026ndash;42. \u003c/li\u003e\n\u003cli\u003eCohn I, Raman J, Sui Z. Patient motivations and expectations prior to bariatric surgery: A qualitative systematic review. Vol. 20, Obesity Reviews. Blackwell Publishing Ltd; 2019. p. 1608\u0026ndash;18. \u003c/li\u003e\n\u003cli\u003eHult M, te Riele W, Fischer L, R\u0026ouml;stad S, Orava K, Heikkinen T, et al. Women\u0026rsquo;s Reasons to Seek Bariatric Surgery and Their Expectations on the Surgery Outcome \u0026mdash; a Multicenter Study from Five European Countries. Obes Surg. 2022 Nov 1;32(11):3722\u0026ndash;31. \u003c/li\u003e\n\u003cli\u003eFischer L, Nickel F, Sander J, Ernst A, Bruckner T, Herbig B, et al. Patient expectations of bariatric surgery are gender specific - A prospective, multicenter cohort study. Surgery for Obesity and Related Diseases. 2014;10(3):516\u0026ndash;23. \u003c/li\u003e\n\u003cli\u003eWee CC, Hamel MB, Apovian CM, Blackburn GL, Dragana Bolcic-Jankovic ;, Mary M;, et al. Expectations for Weight Loss and Willingness to Accept Risk Among Patients Seeking Weight Loss Surgery. Vol. 148, JAMA SURG. \u003c/li\u003e\n\u003cli\u003eO\u0026rsquo;Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, et al. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obes Surg. 2019;29(1):3\u0026ndash;14. \u003c/li\u003e\n\u003cli\u003eGrover BT, Morell MC, Kothari SN, Borgert AJ, Kallies KJ, Baker MT. Defining Weight Loss After Bariatric Surgery: a Call for Standardization. Obes Surg. 2019 Nov 1;29(11):3493\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003evan Rijswijk AS, Evren I, Geubbels N, Hutten BA, Acherman YIZ, van der Peet DL, et al. Outcome expectation and risk tolerance in patients seeking bariatric surgery. Surgery for Obesity and Related Diseases. 2021 Jan 1;17(1):139\u0026ndash;46. \u003c/li\u003e\n\u003cli\u003eFried M, Yumuk V, Oppert JM, Scopinaro N, Torres A, Weiner R, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42\u0026ndash;55. \u003c/li\u003e\n\u003cli\u003eVan De Laar AW, Emous M, Hazebroek EJ, Evert- \u0026amp;, Boerma J, Faneyte IF, et al. Reporting Weight Loss 2021: Position Statement of the Dutch Society for Metabolic and Bariatric Surgery (DSMBS). Obes Surg. 2021;4607\u0026ndash;11. \u003c/li\u003e\n\u003cli\u003eDijkhorst PJ, de Vries CEE, Mou D, Poulsen L, S\u0026oslash;rensen JA, Hoogbergen MM, et al. Quantifying patients\u0026rsquo; expectations prior to bariatric surgery with the BODY‐Q in an international multicentre cohort . Clin Obes. 2023 Feb;13(1). \u003c/li\u003e\n\u003cli\u003eKaly P, Orellana S, Torrella T, Takagishi C, Saff-Koche L, Murr MM. Unrealistic weight loss expectations in candidates for bariatric surgery. Surgery for Obesity and Related Diseases. 2008 Jan;4(1):6\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eBuchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric Surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724. \u003c/li\u003e\n\u003cli\u003eSvanevik M, Lorentzen J, Borgeraas H, Sandbu R, Seip B, Medhus AW, et al. Patient-reported outcomes, weight loss, and remission of type 2 diabetes 3 years after gastric bypass and sleeve gastrectomy (Oseberg); a single-centre, randomised controlled trial. Lancet Diabetes Endocrinol. 2023 Aug;11(8):555\u0026ndash;66. \u003c/li\u003e\n\u003cli\u003ePfefferkorn U, Hort S, Beluli M, La Vista M, Z\u0026uuml;ger T. Weight Loss After Bariatric Surgery in Different Age Groups. Obes Surg. 2023 Apr 9;33(4):1154\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eMunoz DJ, Lal M, Chen EY, Mansour M, Fischer S, Roehrig M, et al. Why Patients Seek Bariatric Surgery: A Qualitative and Quantitative Analysis of Patient Motivation. Obes Surg. 2007 Nov 12;17(11):1487\u0026ndash;91. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"obesity-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"obsu","sideBox":"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-4604151/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4604151/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eThis study investigates preoperative patient expectations related to metabolic bariatric surgery (MBS), focusing on anticipated challenges and effects on physical, social, and psychological domains.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe 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.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn 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.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eImproved 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.\u003c/p\u003e","manuscriptTitle":"Patient Expectations of Bariatric outcomes, Baseline, and Long-term Evaluation: PEBBLE study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-01 09:21:12","doi":"10.21203/rs.3.rs-4604151/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-18T21:49:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-18T11:33:30+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-16T16:28:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"334811165200700550028389842424359443009","date":"2025-03-16T15:45:06+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-15T22:09:02+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-13T20:01:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"46635598667371020493931854194894209378","date":"2025-03-12T15:55:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"84365835248984230580348809722251136933","date":"2025-03-12T15:35:55+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"229409180845881822880851459040554783211","date":"2025-03-12T15:34:27+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-07-19T13:57:24+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-07-11T13:17:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-07-09T10:47:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"Obesity Surgery","date":"2024-06-19T07:56:01+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"obesity-surgery","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"obsu","sideBox":"Learn more about [Obesity Surgery](https://link.springer.com/journal/11695)","snPcode":"11695","submissionUrl":"https://submission.springernature.com/new-submission/11695/3","title":"Obesity Surgery","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"e2e61eb7-e7f5-44e7-adf5-1ae4d349ddd8","owner":[],"postedDate":"August 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:04:55+00:00","versionOfRecord":{"articleIdentity":"rs-4604151","link":"https://doi.org/10.1007/s11695-025-07997-0","journal":{"identity":"obesity-surgery","isVorOnly":false,"title":"Obesity Surgery"},"publishedOn":"2025-07-04 15:57:59","publishedOnDateReadable":"July 4th, 2025"},"versionCreatedAt":"2024-08-01 09:21:12","video":"","vorDoi":"10.1007/s11695-025-07997-0","vorDoiUrl":"https://doi.org/10.1007/s11695-025-07997-0","workflowStages":[]},"version":"v1","identity":"rs-4604151","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4604151","identity":"rs-4604151","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}