Understanding the patient perspective of weight management while on the liver transplant waitlist

Obesity-associated comorbidities increase risks for patients undergoing liver transplant. In this study, we explore patient perspectives and motivation for healthy weight management among patients on the liver transplant waiting list. This is a cross-sectional, observational, electronic survey-based study. A survey on weight management was administered to patients on the liver transplant waiting list. Demographic and clinical data were collected from patients’ medical records. Data was analyzed using Pearson's chi-squared, Fisher's exact, and Student's t-tests. Respondents had a mean age of 54.4 years, were predominately male (62.0%) with a mean BMI of 29.2 kg/m2 with alcoholic cirrhosis as the leading etiology of liver disease (33.9%). Among patients with a BMI≥30 kg/m2, 59.0% perceived that they were overweight and 23.1% believed they were underweight. Among patients with BMI≥30 kg/m2 who perceived they were overweight, 39.1% were actively trying to lose weight and 60.9% were trying to keep from gaining weight. Regardless of current weight, there was a median increase in BMI for patients who categorized themselves as having lost weight or maintained weight since being waitlisted. Many patients with a BMI≥30 kg/m2 did not perceive themselves as overweight and were not actively trying to lose weight. Weight perception was not consistent with actual weight change while waitlisted for liver transplant. Further research is needed to understand how weight awareness and weight perception impacts motivation for weight loss.