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The field of bariatric surgery has changed rapidly in the past two decades, and guiding patients toward the appropriate procedure for their clinically severe obesity is complex. Here, the authors review bariatric surgical procedure options, including sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with or without duodenal switch, evidence on procedure safety and efficacy, and other factors that can influence patient choice of one procedure over another. Shared decision-making in the context of patients' acceptance of treatment risk, medical problems, weight loss expectations, eating behaviors, and mental health are discussed along with reasons for undergoing bariatric surgery. Priorities of weight loss, such as type 2 diabetes resolution, play a role in surgical choice and assessment tools like the Individual Metabolic Surgery score exist to aid in selection of a procedure according to a patient's diabetes severity. Through a series of prepared medical visit vignettes, the authors provide insights for how providers might guide conversations about surgical choice with their patients, carefully balancing patient preference with their own perceptions of which bariatric surgery will result in optimal improvements in physical and mental health. [ABSTRACT FROM AUTHOR]

Research studies have demonstrated that patients have unrealistic expectations for weight loss after having bariatric surgery. If patients’ expectations are unmet, this may contribute to nonadherence to recommended lifestyle changes, weight regain, and the return of medical comorbidities in the future. In this article, the authors review available literature on patients’ presurgery expectations for changes in weight, quality of life, body image, and relationships after bariatric surgery and provide recommendations on how healthcare providers can guide patients toward achieving an accurate understanding of treatment outcome. Patient vignettes on the topics of expectations for weight loss, body image, and relationships further illustrate how healthcare providers might talk to patients about expectations for outcomes after bariatric surgery. [ABSTRACT FROM AUTHOR]

The purpose of this article is to discuss potential applications of a method of communication called motivational interviewing. This educational article is based on the book, Motivational Interviewing: Helping People Change, 3rd Edition. It is designed to introduce readers to the fundamental processes and core skills of motivational interviewing and how they may be applied in conversation with patients with obesity. [ABSTRACT FROM AUTHOR]