Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity

Eat Weight Disord. 2020 Dec;25(6):1621-1629. doi: 10.1007/s40519-019-00800-x. Epub 2019 Nov 14.

Abstract

Purpose: After bariatric surgery (BS) a significant minority of patients do not reach successful weight loss or tend to regain weight. In recent years, interest for the psychological factors that predict post-surgical weight loss has increased with the objective of developing interventions aimed to ameliorate post-surgical outcomes. In the present study, predictive models of successful or poor weight loss 12 months after BS were investigated considering pre-surgery level of psychopathological symptoms, dysfunctional eating behaviors and trait impulsivity at baseline (pre-surgery).

Methods: Sixty-nine patients with morbid obesity canditates for laparoscopic sleeve gastrectomy were assessed regarding metabolic and psychological dimensions. Successful post-surgery weight loss was defined as losing at least 50% of excess body weight (%EWL).

Results: Logistic models adjusted for patient sex, age and presence of metabolic diseases showed that the baseline presence of intense psychopathological symptoms and low attentional impulsivity predict poor %EWL (< 50%), as assessed 12-month post-surgery.

Conclusions: The present findings suggest that intensity of general psychopathology and impulsivity, among other psychological factors, might affect post-surgery %EWL. Conducting adequate psychological assessment at baseline of patients candidates for BS seems to be crucial to orient specific therapeutic interventions.

Level of evidence: Level III, case-control analytic study.

Keywords: Bariatric surgery; Impulsivity; Laparoscopic sleeve gastrectomy; Psychological predictors of weight loss; Psychopathology.

MeSH terms

  • Bariatric Surgery*
  • Body Mass Index
  • Gastrectomy
  • Humans
  • Impulsive Behavior
  • Laparoscopy*
  • Mental Disorders*
  • Obesity, Morbid* / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss