E.F. Sheedy1, J. Diol2, N. Codispoti4, J.N. Lau1,3, L. Wool3 1Loyola University Medical Center, Department Of Surgery, Maywood, IL, USA 2Loyola University Chicago Stritch School Of Medicine, Maywood, IL, USA 3Loyola University Medical Center, Center For Metabolic And Bariatric Surgery, Maywood, IL, USA 4University of Wisconsin, Department Of Obstetrics And Gynecology, Madison, WI, USA
Introduction:
Multiple cognitive, psychological, and metabolic factors play a role in optimizing and maintaining weight loss following bariatric surgery. Therefore, the Center for Metabolic Surgery and Bariatric Care (MSBC) at Loyola University Medical Center (LUMC) employs a multidisciplinary group of surgeons, advanced practice nurses, registered dietitians, and psychologists.
Options for surgical weight loss at the center between the dates of this study include the sleeve gastrectomy (SG) and the Roux en Y gastric bypass (RYGB). Pre- and post-operatively, the MSBC recommends psychology follow-ups for surgical patients, assessing markers such as sleep, mood, alcohol, marijuana and nicotine usage, and surgical satisfaction. We aimed to study the relationship of these factors in surgical weight loss outcomes at the 1-year postoperative mark.
Methods:
A total of 110 patients who underwent SG or RYGB between January 2020 and December 2022 and adhered to the routine six month Psychology follow-up visit were included in the study. A retrospective chart review was conducted to extract data from a previously designed ‘Psychology Postoperative Questionnaire’, identifying potential factors influencing weight loss including substance usage, use of psychotropic medications, and satisfaction with surgery. Patients’ percentage of excess body weight loss (EBWL) at the one year postoperative milestone was then recorded. A statistical analysis was obtained using the Wilcoxon rank sum test and the Kruskal-Wallis rank-sum test comparing percentage of EBWL at one year between cohorts.
Results:
No significant differences were observed in percentage of EBWL in patients who used alcohol, marijuana, or nicotine compared to those who did not use these substances (p > .05). No significant difference was observed in patients who used psychotropic medications compared to those who did not (p>.05). No significant difference was observed in patients who did or did not attend a weight loss support group (p>.05). Patients who reported feeling ‘Very Satisfied’ with their decision to pursue surgery had a statistically significant increased percentage of EBWL compared to those who reported ‘Satisfied’ or ‘Somewhat Satisfied.’
Conclusion:
In patients undergoing surgical weight loss at a large academic center, no significant differences were seen in EBWL in patients who used substances such as nicotine, alcohol, and marijuana postoperatively compared to those who did not. These results may be limited by the small sample size of patients self-reporting substance usage. Additionally, the use of psychotropic medications and the attendance of a weight loss support group do not appear to influence EBWL. A difference was observed in those who reported feeling ‘Very Satisfied’ with their decision to pursue surgery; this may be due to reporting bias in this population having noticed greater amounts of weight loss.