Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery

Abstract

Outcomes of bariatric surgery, while frequently impressive, are not universal and vary between patients and across surgical procedures. Between 20-30% of patients experience suboptimal weight loss or significant weight regain within the first few postoperative years. The reasons for this are not fully understood, but likely involve both physiological processes, behavioral factors, and psychological characteristics. Evidence suggests that preoperative psychosocial status and functioning can contribute to suboptimal weight losses and/or postoperative psychosocial distress. Much of this work has focused on the presence of recognized psychiatric diagnoses and with particular emphasis on mood disorders as well as binge eating disorder (BED). Several studies have suggested that the presence of preoperative psychopathology is associated with suboptimal weight losses, postoperative complications, and less positive psychosocial outcomes. Contemporary psychological theory suggests that it may be shared features across diagnoses, rather than a discrete diagnosis, that better characterizes psychopathology. Mood and substance use disorders (SUDs), as well as BED, share common features of impulsivity, although clinicians and researchers often use complementary, yet different terms, such as emotional dysregulation or disinhibition (i.e., loss of control over eating, as applied to food intake), to describe the phenomenon. Impulse control is a central factor in eating behavior and extreme obesity. It also may contribute to the experience of suboptimal outcomes after bariatric surgery, including smallerthan-expected weight loss and psychosocial distress. This paper reviews the literature in these

The Symptom-Checklist-K-9 (SCL-K-9) Discriminates between Overweight/Obese Patients with and without Significant Binge Eating Pathology: Psychometric Properties of an Italian Version

“…The ability of this brief version to discriminate between overweight/obese patients with and without significant binge eating pathology may have important clinical implications. Considering that the presence of both pre-and post-operative binge eating negatively influences the long-term outcomes [17,[61][62][63], this brief tool could help clinicians to promptly identify high-risk individuals. Accordingly, individuals presenting positive screening results could be addressed via a proper psychosocial intervention [64,65], and surgeons may select a more suitable type of intervention based on the patient's eating disorder [66].…”

“…Therefore, a general personality and psychopathology evaluation is considered to be a crucial part of the multidisciplinary assessment for weight-related problems [11,12]. Although the association between psychopathology and the success of weight-loss treatments is controversial [6,13,14], it has often been reported [15][16][17][18][19][20][21][22] that mental health issues (e.g., binge eating disorder) are associated with several aspects of treatment outcomes (e.g., less weight loss, weight regain, and higher drop-out rates). In particular, binge eating disorder in bariatric surgery candidates may predict the development of problematic eating behaviors after surgery [23].…”

The mediating role of depressive and anxiety symptoms in the association between obesity and problematic social media use in young adults

“…36 In this case, impulsivity-a characteristic predictive of maladaptive gambling, higher nicotine use and binge eating, for example-could be predictive of PSMU as well. 37,38 Future research should continue to examine whether the link between obesity and PSMU is unique from that between obesity and other forms of PIU. This may allow both clinicians and community members to better understand the spectrum of internet use and associated risks to health.…”

Are the Results of a Combined Behavioural and Surgical Treatment of Morbid Obesity Satisfactory and Predictable?

“…There are numerous studies of various predictors of weight loss after bariatric surgery, such as personality, anxiety, depression, psychopathology, eating disorders, impulsivity, socioeconomic status, alcohol and drug abuse, cognitive function, cognitive treatment, comorbidity, metabolic diseases, and hormones [6,8,9,[31][32][33][34][35]. Overall, the results are unsatisfactory; no clear predictors have been identified.…”

“…The predictors of treatment success have been studied to improve patient selection for treatment and develop interventions to improve compliance and outcomes. Thus far, the efforts have been disappointing [8].…”