Article

Psychosocial Predictors of Weight Loss after Bariatric Surgery

University of Innsbruck, Innsbruck, Tyrol, Austria
Obesity Surgery (Impact Factor: 3.74). 01/2007; 16(12):1609-14. DOI: 10.1381/096089206779319301
Source: PubMed

ABSTRACT The authors investigated the predictive value of various parameters such as age, preoperative weight, eating behavior, psychiatric disorders, adverse childhood experiences and self-efficacy with regard to weight loss after gastric restrictive surgery.
After a minimum follow-up of 30 months (median follow-up 50 months; range 30-84 months), a questionnaire concerning extent of, satisfaction with, and consequences of weight loss was mailed to 220 morbidly obese female patients following laparoscopic Swedish adjustable gastric banding (SAGB).
Questionnaires were completed and returned by 140 patients (63%). Average BMI loss was 14.6 kg/m(2). Most patients (85%) were happy with the extent of weight loss. Satisfaction with weight loss showed a significant correlation with extent of weight loss. BMI loss was greatest in the obese with an atypical eating disorder (20.0 kg/m(2)), and BMI loss was least in the obese with no eating-disordered behavior before surgery (13.4 kg/m(2)). Obese patients with two or more psychiatric disorders showed significantly less weight loss than did obese patients with one or no psychiatric disorder (BMI units 10.8 vs 14.0 vs 16.1; P=.047).
The findings indicate a less successful outcome for obese patients with psychiatric disorders (particularly adjustment disorders, depression and/or personality disorders), compared to patients not mentally ill. An eating disorder preceding surgery, however, was not a negative predictor of success following bariatric surgery. To improve outcome of bariatric surgery in obese patients with psychiatric disorders, more individual psychosocial intervention strategies are necessary.

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    • "Binge eating is one of the most commonly examined disordered eating behaviors amongst individuals pursuing bariatric surgery; however, preoperative binge eating does not necessarily predict poorer outcomes after surgery (Bocchieri-Ricciardi et al., 2006; Burgmer et al., 2005; Kinzl et al., 2006; Legenbauer, Burgmer, Senf, & Herpertz, 2007). Rather, other postoperative eating behaviors and pathology (e.g., loss of control eating and grazing) appear to be better predictors of poorer outcomes. "
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    ABSTRACT: Bariatric surgery is increasingly recognized as a highly effective treatment for individuals who are severely obese. Amount of weight loss and resolution of comorbidities surpass those of nonsurgical approaches; however, suboptimal weight loss and weight regain are not uncommon. These outcomes, though not fully understood, are likely at least partially explained by failure to make long-term behavioral and/or cognitive changes. We are unaware of any established clinical tools to guide providers in assessing postoperative behaviors and identifying those who may require specialized treatment. The goal of this paper is to introduce a brief screening tool, The WATCH, to help clinicians assess and identify patients who may be at risk for poor or untoward outcomes post bariatric surgery. We first review the literature on postoperative outcomes, including weight loss, resolution of comorbidities, suboptimal outcomes, and development of problematic eating behaviors. We then provide an easily-recalled, five-item tool that assesses outcomes, and discuss patient responses that may necessitate further intervention or referral.
    Journal of Clinical Psychology in Medical Settings 05/2013; DOI:10.1007/s10880-012-9358-4 · 1.49 Impact Factor
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    • "The role of psychological factors in the outcome of bariatric surgery seems inconsistent. Some studies have found people with psychiatric disorders have less bodyweight loss [13], but others find no relationship or even more bodyweight loss [8]. An emphasis on psychological impact in the postoperative follow-up and detection of possible psychological needs or need of support throughout the treatment course are important [14]. "
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    ABSTRACT: Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.
    BMC Psychiatry 01/2013; 13(1):1. DOI:10.1186/1471-244X-13-1 · 2.24 Impact Factor
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    • "Further research may examine whether the presence and severity of personality pathology in treatment seeking obese people may affect their response to treatment. Although the presence of personality disorders has been shown to predict less success in weight loss for obese individuals after bariatric surgery (Kinzl et al., 2006), there is still a dearth of research conducted exploring the impact of personality disorders on the outcome of psychological treatment with obese clients. Additional longitudinal research might investigate whether obese individuals who present with an internalizing personality style have the poorest global outcome, similar to previous studies with ED samples (Thompson-Brenner et al., 2008). "
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