S. Sheikh1, T. Bell1, R. Grim1, P. Hartmann1, V. Ahuja1 1York Hospital,Surgery,York, PA, USA
Introduction: Obesity is commonly associated with a myriad of psychosocial conditions. However, the effects of these conditions in patients undergoing bariatric surgery is relatively understudied. The purpose of this study was to 1) identify psychosocial conditions in bariatric surgery patients, 2) assess changes in weight and psychosocial variables before and after bariatric surgery, and 3) identify psychosocial predictors of successful bariatric procedures at 5 years post-surgery.
Methods: Data of 93 patients undergoing Roux-en-Y gastric bypass surgery with age>18 years, BMI>40kg/m2, and/or had obesity related medical conditions were reviewed. Psychosocial variables were obtained from the Bariatric Surgery Screening Tool, Beck Depression Inventory II, Self-Report Family Inventory, and the Obesity Adjustment Survey (OAS). Factors analyzed included depression, obesity related quality of life (O-QoL), and family functioning. Descriptive statistics, paired-sample t-test and multiple regression were used. Successful bariatric surgery was defined as significant weight loss and few or no surgical complications.
Results: Results indicated that a high proportion (66.7%) of this sample had a behavioral health condition. Of note, 41.5% indicated some form of verbal/emotional abuse, and 20.7% indicate sexual abuse. On average, weight was about 76.09 pounds lower at six months, 94.75 lower at one year, and 84.53 at five years. Weight and measures of depression and obesity-related quality of life significantly improved at 5 years post-surgery. The regression model accounted for 13.9% of the variance; however, only one predictor variable (obesity-related quality of life) was found to be significant (p = 0.014). All other variables did not significantly contribute to predicting weight loss at five years after surgery. No psychosocial variable was predictive of complications.
Conclusion: Obese patients had a higher prevalence of behavioral health conditions such as depression when compared to the general population. However, this data did not reach statistical significance. Patients with a poor preoperative O-QoL were more likely to lose the maximum amount of weight after surgery. However, O-QoL, did not predict the risk of complications after bariatric surgery.
While all psychosocial factors should be considered, this study indicates that preoperative assessment of the O-QoL is important in identifying and optimizing the bariatric surgery candidates and therefore maximizing the success of the procedure.