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Psychosocial predictors of weight loss after bariatric surgery.

Kinzl JF, Schrattenecker M, Traweger C, Mattesich M, Fiala M, Biebl W

Department of Psychiatry and Psychotherapy, University Hospital, Medical University Innsbruck, Innsbruck, Austria.

BACKGROUND: 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. METHODS: 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). RESULTS: 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). CONCLUSIONS: 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.

Published 12 January 2007 in Obes Surg, 16(12): 1609-14.
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