Table 4 Links between terminology used by recruiters and reasons mentioned by patients for preferences

From: Enabling recruitment success in bariatric surgical trials: pilot phase of the By-Band-Sleeve study

Terminology used by recruiters to describe

Reasons mentioned by patients for preferences

 

For

Against

Bypass a

• Guaranteed and gets you/carries you there

- Permanent

- Too permanent

• Once it’s done, it’s done

- Once it’s done, it’s done

- Too rapid weight loss

• Restriction ‘and’ malabsorption

- Rapid weight loss

- Too severe/complicated operation/strong anesthetic, stomach cut

• Not much else you can do after bypass

- Straight-forward

- Needle phobia (bypass needs lifelong vitamin injections)

• 60–70% excess weight loss

- Prevents cheating

- Only for heaviest

  

- Dumping syndrome

  

- Excess skin

Band b

• Requires a lot more patient input/is hard work and you have to get there yourself

- Only temporary/can be removed/can be adjusted

- Not permanent

• You can cheat on the band

- Less rapid weight loss

- Slow/not enough weight loss

• Only restriction

- Easier operation

- Can cheat

• You still have options post band

- Weaker anesthetic

- Foreign object inside

• 40–50% excess weight loss

- Less excess skin

- Fiddly follow-up

  

- Needle phobia (band adjustments with a chest needle)

  1. aInformation in the patient information leaflet (PIL) regarding bypass surgery: entails an operation that takes 1 to 2 h in which a small pouch is made in the top of the stomach and a loop of bowel connected to this pouch to bypass the rest of the stomach. A 1- to 3 -day hospital stay is required. Follow-up schedule of clinic visits are required at 4 weeks, 3, 6 and 12 months after surgery and annually thereafter. Patients are required to take long-term vitamin and mineral tablets and also require regular 3 monthly vitamin B12 injections. Possible advantages/disadvantages include that it requires significant dietary modification by the patient; rapid weight loss in first 6 months, which slows then stabilizes at 18 months; at this stage weight may be regained and can be significant in about one in five patients; and if significant weight loss is achieved, health problems such as diabetes may resolve.
  2. bInformation in the PIL regarding band surgery: entails an operation that takes less than 1 h in which a band is inserted around the top of the stomach to reduce its size. An overnight stay in hospital is usually required. Follow-up schedule of clinic visits for band adjustments are required. There may be up to 10 visits in the first 2 years. Patients are required to take long-term vitamin and mineral tablets. Possible advantages/disadvantages include that it requires significant dietary modification by the patient; weight loss is gradual over a long period (2–3 years); and if significant weight loss is achieved, health problems such as diabetes may resolve.
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