Early post‐operative psychosocial and weight predictors of later outcome in bariatric surgery: a systematic literature review

Abstract

This is the first systematic review to synthesize the evidence concerning early post-operative variables predictive of later weight and psychosocial outcomes in bariatric surgery. Eight electronic databases for empirical studies were searched (1954 to 2016). Most of the 39 included studies reported solely on weight outcomes; eating and psychosocial outcomes were less common. A better early weight loss trajectory was the most consistent predictor of more successful medium-term weight outcome (≤24 months); however, its relationship to longer term weight loss maintenance is less certain. Early eating adaptation may be associated with later weight loss, but further research is needed. Evidence is lacking for associations between early adherence or early psychosocial variables and later outcome. In particular, the relationship between early post-operative depression and later weight remains unclear. Little research has considered early prediction of later eating or psychosocial outcomes. Consideration of mediating or moderating relationships is lacking. The body of evidence is limited, and synthesis is hampered by heterogeneity in the type and time at which predictors and outcomes are measured and quality of statistical reporting. Further research on prospective prediction of bariatric surgery outcome is needed to guide early post-operative intervention for those at greatest risk of poor outcomes.

Emotional food cravings predicts poor short‐term weight loss following laparoscopic sleeve gastrectomy

“…A recent systematic literature review on early post‐operative psychosocial and weight predictors of later outcome in bariatric surgery concluded that there is consistent evidence that better early weight loss, particularly during the first 6 months, is indicative of more successful weight outcome, at least up to 24 months post‐surgery (Hindle et al ., ). Given that the present study found that post‐operative food cravings in response to emotional cues in LSG patients negatively impacts the early weight loss trajectory, future research should investigate whether the early identification and treatment of emotional food cravings and eating improve the weight loss trajectory of LSG patients.…”

“…Thus, it is suggested that the consequent changes in peptides because of the surgery type may also precede and predict changes in food cravings (Cushing et al ., ). Additionally, post‐operative but not pre‐operative eating behaviour is of predictive value for the extent of weight loss after bariatric surgery, and pre‐operative predictors have shown few consistent relationships with bariatric surgery outcome (Burgmer et al ., ; Herpertz, Kielmann, Wolf, Hebebrand, & Senf, ; Hindle, de la Piedad Garcia, & Brennan, ; Livhits et al ., ). Consequently, post‐operative variables have become an important area for research.…”

Effects of Cognitive Behavioral Therapy on Eating Behaviors, Affective Symptoms, and Weight Loss After Bariatric Surgery: a Randomized Clinical Trial

“…The discrepancy between the significant immediate and 4-year effects of CBT and the lack of 1-year effect might have several explanations. First, although the CBT before surgery did not focus on weight loss, it is plausible that the considerable CBT-related improvement in eating behaviors and reduction of affective symptoms might have contributed to the small weight loss before surgery [ 11 , 16 , 17 , 21 ]. Second, the large effect of bariatric surgery at 1 year on both groups might have overshadowed a smaller effect of CBT.…”

“…In addition, a retrospective chart review study showed that a brief cognitive behavioral group psychotherapy was associated with reduced binge eating behaviors among bariatric surgery candidates [ 20 ]. Although it has been hypothesized that postoperative eating adaptation and depression may affect later weight loss, the evidence is insufficient [ 21 ].…”

Porcentaje de peso perdido y su recuperación en pacientes bariátricos: un análisis desde la perspectiva temporal

“…Así, estudios han señalado que entre un 25%-30% de los pacientes que se someten a cirugía bariátrica no alcanzan los rangos de pérdida de peso esperado o recuperan la pérdida de peso en el corto plazo 9,10 . Ello ha conducido al estudio de los predictores de la pérdida de peso y su mantención post-cirugía bariátrica 11,12 . Entre los predictores de la pérdida del peso y su mantención, se encuentran el IMC previo y el IMC posterior a un año de la cirugía 13,14 .…”