Negative psychological sequelae have been reported after bariatric surgery. It is unclear which factors affect psychological function in the first postoperative years.
Evaluation of significant predictors of improved psychological function following bariatric surgery by analyzing data from the BODY-Q questionnaire.
Multicenter prospective cohort in 3 centers located in The Netherlands and Denmark.
The BODY-Q questionnaire was used to assess 6 domains of health-related quality of life. The domain of interest, psychological function, consists of 10 questions from which a converted score of 0 (low) to 100 (high) can be calculated. Linear mixed models were used to analyze which patient characteristics were most predictive of the psychological function score. Secondary outcomes of interest were cross-sectional scores of psychological function and the impact of weight loss, and the effect of major short-term complications on psychological function.
Data were analyzed from 836 patients who underwent bariatric surgery from 2015 to 2020. Patients with lower expectations concerning weight loss (<40% desired total weight loss), higher educational level, no history of psychiatric illness, and employment before bariatric surgery demonstrated the highest psychological function scores after bariatric surgery. At 1 and 2 years after bariatric surgery, more weight loss was associated with significantly higher psychological function scores. Experiencing a major short-term complication did not significantly impact psychological function.
Several relevant predictors of improved postoperative psychological function have been identified. This knowledge can be used to enhance patient education preoperatively and identify patients at risk for poor psychological functioning postoperatively.
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- Patient motivations and expectations prior to bariatric surgery: a qualitative systematic review.Obes Rev. 2019; 20: 1608-1618
- Quality of life: its definition and measurement.Res Dev Disabil. 1995; 16: 51-74
- Recommendations on the most suitable quality-of-life measurement instruments for bariatric and body contouring surgery: a systematic review.Obes Rev. 2018; 19: 1395-1411
- The BODY-Q: a patient-reported outcome instrument for weight loss and body contouring treatments.Plast Reconstr Surg Glob Open. 2016; 4: e679
- Patient-Reported Outcome Measures: BODY-Q.Clin Plast Surg. 2019; 46: 15-24
- Quality of life outcomes of bariatric surgery: a systematic review.Obes Surg. 2016; 26: 395-409
- The impact of bariatric surgery on quality of life: a systematic review and meta-analysis.Obes Rev. 2015; 16: 639-651
- Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis.JAMA. 2016; 315: 150-163
- Mental health quality of life after bariatric surgery: a systematic review and meta-analysis of randomized clinical trials.Clin Obes. 2019; 9e12290
- Depression and suicide after bariatric surgery.Curr Psychiatry Rep. 2019; 21: 84
- The psychosocial effects of perioperative complications after bariatric surgery.Psychosomatics. 2018; 59: 452-463
- Predictors of psychological symptoms in morbidly obese patients after gastric bypass surgery.Surg Obes Relat Dis. 2012; 8: 770-776
- Psychosocial predictors of quality of life and weight loss two years after bariatric surgery: results from the Toronto Bari-PSYCH study.Gen Hosp Psychiatry. 2017; 47: 7-13
- Predictors of early quality-of-life improvement after laparoscopic gastric bypass surgery.Am J Surg. 2007; 193: 471-475
- Differences in health-related quality of life after gastric bypass surgery: a cross-sectional study.Obes Surg. 2021; 31: 3194-3202
- Improvements of health-related quality of life 5 years after gastric bypass. what is important besides weight loss? A study from Scandinavian Obesity Surgery Register.Surg Obes Relat Dis. 2020; 16: 1249-1257
- Changes in quality of life 5 years after sleeve gastrectomy: a prospective cohort study.BMJ Open. 2019; 9e031170
- Differences in physical and mental health-related quality of life outcomes 3 years after bariatric surgery: a group-based trajectory analysis.Surg Obes Relat Dis. 2020; 16: 1837-1849
- Psychosocial functioning and quality of life in patients with loose redundant skin 4 to 5 years after bariatric surgery.Surg Obes Relat Dis. 2018; 14: 1740-1747
- Is the RAND-36 an adequate patient-reported outcome measure to assess health-related quality of life in patients undergoing bariatric surgery?.Obes Surg. 2022; 32: 48-54
- Outcomes of the first global multidisciplinary consensus meeting including persons living with obesity to standardize patient-reported outcome measurement in obesity treatment research.Obes Rev. 2022; 23e13452
- A longitudinal analysis of variation in psychological well-being and body image in patients before and after bariatric surgery.Ann Surg. 2020; 271: 885-890
- Clinical practice guidelines of the European Association for Endoscopic Surgery (EAES) on bariatric surgery: update 2020 endorsed by IFSO-EC, EASO and ESPCOP.Surg Endosc. 2020; 34: 2332-2358
- BODY-Q patient-reported outcomes measure (PROM) to assess sleeve gastrectomy vs. Roux-en-Y gastric bypass: eating behavior, eating-related distress, and eating-related symptoms.Surg Endosc. 2021; 35: 4609-4617
- Electronic Data Capture (EDC).Castor, New York, NY2021
- Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.J Biomed Inform. 2009; 42: 377-381
- IBM SPSS Statistics for Windows.IBM, Armonk, NY2020 (Version 27.0)
- Variable selection strategies and its importance in clinical prediction modelling.Fam Med Community Health. 2020; 8e000262
- General population normative scores for interpreting the BODY-Q.Clin Obes. 2022; 12e12528
- Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study.Int J Obes (Lond). 2007; 31: 1248-1261
- Six-year changes in health-related quality of life in gastric bypass patients versus obese comparison groups.Surg Obes Relat Dis. 2012; 8: 625-633
- The impact of bariatric surgery on psychological health.J Obes. 2013; 2013837989
- Quality of life among patients undergoing bariatric surgery: associations with mental health- A 1 year follow-up study of bariatric surgery patients.Health Qual Life Outcomes. 2011; 9: 79
- Psychological predictors of mental health and health-related quality of life after bariatric surgery: a review of the recent research.Obes Res Clin Pract. 2014; 8: e314-e324
- Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study.Surg Obes Relat Dis. 2015; 11: 70-76
- The influence of socioeconomic factors on quality-of-life after laparoscopic gastric bypass surgery.Obes Surg. 2019; 29: 3569-3576
- Predictors of health-related quality of life after bariatric surgery.Obes Surg. 2015; 25: 2302-2305
- Psychosocial predictors of success following bariatric surgery.Obes Surg. 2005; 15: 552-560
- The relationship between weight loss and psychosocial functioning among bariatric surgery patients.Am J Surg. 2010; 199: 183-188
- Surgery, complications, and quality of life: a longitudinal cohort study exploring the role of psychosocial factors.Ann Surg. 2019; 270: 95-101
- Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery.J Int Med. 2013; 273: 219-234
- Weight loss expectations and weight loss after surgery: the mediating role of body image and weight concerns.Surg Obes Relat Dis. 2020; 16: 932-939
Published online: January 31, 2023
Accepted: January 21, 2023
Received: August 25, 2022
Publication stageIn Press Journal Pre-Proof
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.