Do Psychosocial Variables Predict Weight Loss or Mental Health after Obesity Surgery? A Systematic Review

Abstract

HERPERTZ, S., R. KIELMANN, A.M. WOLF, J. HEBEBRAND, AND W. SENF. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12:1554 -1569. Objective: The objective of this study was to present a systematic review of psychological and psychosocial predictors of weight loss and mental health after bariatric surgery. This systematic review included all controlled and noncontrolled trials of the last 2 decades with either a retrospective or prospective design and a follow-up period of at least 1 year. Research Methods and Procedures:The relevant literature was identified by a search of computerized databases. All articles published in English and German between 1980 and 2002 were reviewed. Results: Using the above inclusion/exclusion criteria, 29 articles were identified focusing on psychosocial predictors of weight loss and mental health after obesity surgery. Discussion: Personality traits have no predictive value for the postoperative course of weight or mental state. Apart from serious psychiatric disorders including personality disorders, psychiatric comorbidity seems to be of more predictive value for mental and physical well-being as two essential aspects of quality of life than for weight loss postsurgery. However, depressive and anxiety symptoms as correlates of psychological stress with regard to obesity seem to be positive predictors of weight loss postsurgery. The severity of the symptoms or the disorder is more relevant for the outcome of obesity surgery than the specificity of the symptoms. It is also not solely the consumption of distinct "forbidden" foods, such as sweets or soft drinks, but rather a general hypercaloric eating behavior, either as an expression of the patient's inadequate compliance or a dysregulation in energy balance, which is associated with a poor weight loss postsurgery.

Weight loss and quality of life after bariatric surgery: a study of 200 patients after vertical gastroplasty or adjustable gastric banding

“…At 1-year follow-up, available in 69% of patients, all QoL scores and depression score were improved, and better than in the control group. A systematic review of 29 articles (Herpetz et al, 2004) concluded that personality traits before bariatric surgery had no predictive value on the post-operative course of weight or mental state. However, depressive and anxiety symptoms, as correlates of psychological stress with regard to obesity, seemed to be predictive of weight loss after surgery.…”

Bariatric surgery for pediatric extreme obesity: now or later?

“…168,169 Further, there is evidence suggesting that pre-existing psychosocial impairment influences adult surgical outcomes. 170 For example, binge eating behavior, depression, or active-untreated problems with alcohol or drug abuse have resulted in higher rates of surgical postoperative Figure 2 Self-reported and parent-proxy HRQOL scores for adolescents with extreme obesity and healthy youth. Adapted from published data on norms for healthy children.…”

A psychiatric perspective view of bariatric surgery patients

“…Moreover, most patients report a smaller amount of food eaten, a decrease in hunger, an earlier satiety, less inadequate eating behaviors and more control over their food intake 22,27 . When patients have binge eating behaviors postoperatively, it is being associated with reduced mental health and poor weight outcome [28][29][30][31][32] .…”