Six-year bariatric surgery outcomes: the predictive and incremental validity of presurgical psychological testing

Martin-Fernandez, Katy; Marek, Ryan J.; Heinberg, Leslie J.; Ben‐Porath, Yossef S.

doi:10.1016/j.soard.2021.01.012

Cited by 20 publications

(7 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, factors associated with postsurgical NEBs and EDs deserve clarification beyond their presurgical presentation. 71 Evidence is widely lacking on long-term trajectories and diagnostic transitions of NEBs and EDs. 30 Postsurgical EDs often remain undetected and untreated.…”

Section: Discussionmentioning

confidence: 99%

“…Because of possible differences in the course and prospective value of NEBs and EDs by surgical procedure, separate analyses should be conducted for SG at a larger sample size. In addition, factors associated with postsurgical NEBs and EDs deserve clarification beyond their presurgical presentation . Evidence is widely lacking on long-term trajectories and diagnostic transitions of NEBs and EDs …”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery

et al. 2022

View full text Add to dashboard Cite

ImportanceIndividuals with severe obesity presenting for obesity surgery (OS) frequently show nonnormative eating behaviors (NEBs) and eating disorders (EDs), but the long-term course and prospective associations with weight loss and health-related quality of life (HRQOL) remain unclear.ObjectiveTo examine the prevalence and prospective relevance of presurgical and postsurgical NEBs and EDs according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosed through clinical interview, for weight loss and HRQOL up to 6 years following OS.Design, Setting, and ParticipantsIn the prospective, multicenter Psychosocial Registry for Obesity Surgery cohort study, patients seeking OS were recruited at 6 OS centers in Germany and assessed at baseline before surgery and at 6 months and 1 to 6 years after surgery. From a consecutive sample of 1040 volunteers with planned OS from March 1, 2012, to December 31, 2020, a total of 748 (71.92%) were included in this study. Across follow-up, 93 of the 748 patients (12.43%) dropped out. Data were analyzed from April to November 2021.InterventionsLaparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy.Main Outcomes and MeasuresBoth NEBs and EDs were identified using the Eating Disorder Examination interview. Main outcomes were the percentage of total body weight loss (%TBWL) and HRQOL (Impact of Weight on Quality of Life-Lite; range, 0-100, with 0 indicating worst and 100 indicating best).ResultsIn 748 patients undergoing OS (mean [SD] age, 46.26 [11.44] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 48.38 [8.09]; 513 [68.58%] female), the mean (SD) %TBWL was 26.70% (9.61%), and the mean (SD) HRQOL improvement was 35.41 (20.63) percentage points across follow-up. Both NEBs and EDs were common before surgery, with postsurgical improvements of varying degrees. Whereas NEBs and EDs did not reveal significant prospective associations with %TBWL, loss-of-control eating at follow-up was concurrently associated with lower %TBWL (estimate, −0.09; 95% CI, −0.14 to −0.04). Loss-of-control eating (estimate, −0.10; 95% CI, −0.17 to −0.03 percentage points) and binge-eating disorder of low frequency and/or limited duration (estimate, −6.51; 95% CI, −12.69 to −0.34 percentage points) at follow-up showed significant prospective associations with lower HRQOL.Conclusions and RelevanceThis cohort study found prospective relevance of loss-of-control eating and binge-eating disorder of low frequency and/or limited duration for reduced long-term HRQOL following OS. These findings underline the importance of monitoring both NEBs, especially loss-of-control eating, and EDs in the long term postsurgically to identify patients in need of targeted prevention or psychotherapy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The MMPI has also demonstrated incremental validity. For example, Martin-Fernandez et al (2021) found that MMPI-2-RF scale scores accounted for an additional 3%-24% of the variability in postoperative eating behaviors and quality of life in bariatric surgery patients, above and beyond other preoperative variables including the EDE-Q, Binge Eating Scale, and interview portion of the psychological evaluation. Presurgical psychological evaluations are higher stake evaluations and, given the literature on the tendency for this population to present favorably (Ambwani et al, 2013;Marek, 2014), the validity scales can be helpful to assess for underreporting.…”

Section: Discussionmentioning

confidence: 99%

Examination of the Reliability and Validity of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) in a Preoperative Bariatric Surgery Sample

Pona

Marek

Panigrahi

et al. 2022

J Clin Psychol Med Settings

Self Cite

View full text Add to dashboard Cite

Presurgical psychological assessment of bariatric surgery candidates aims to identify psychosocial risk factors and provide treatment recommendations to facilitate optimal outcomes. Such assessment typically includes psychometric testing and a clinical interview. The Minnesota Multiphasic Personality Inventory (MMPI) has been commonly used as a broadband measure to assess a number of psychosocial domains in bariatric clinics. The newest version of the MMPI, the MMPI-3, was recently released. This study sought to (1) establish whether the MMPI-3 is comparable to the MMPI-2-RF in a sample of patients seeking bariatric surgery, (2) report reliability data for all MMPI-3 scale scores in this sample, and (3) explore associations between commonly used self-report symptom measures and substantive scales of the MMPI-3 to ascertain convergent and discriminant validity patterns. Six hundred and thirty-five presurgical patients completed the MMPI-3 in addition to the Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), and Eating Disorder Examination-Questionnaire (EDE-Q). The majority (79.1%) of the sample was female, 65.5% was white, and 26.6% was Black. Scores on most of the MMPI-3 Emotional/Internalizing Dysfunction scales were meaningfully associated with the PHQ-9, GAD-7, and most EDE-Q subscales (except for Restraint). Meaningful discriminant patterns were observed as well. We conclude that the substantive scales of the MMPI-3 are reliable, comparable to their MMPI-2-RF counterparts, and evidence good convergent validity with extra-test measures assessing depression, anxiety, alcohol use, and eating disorder psychopathology in a preoperative bariatric sample. Supplementary Information The online version contains supplementary material available at 10.1007/s10880-022-09908-2.

show abstract

“…Disordered eating behaviours progressively reappear post bariatric surgery and their underlying mechanisms are unclear (Ivezaj et al., 2021). Preoperative disordered eating has been linked to long‐term post‐operative disordered eating behaviours (Martin‐Fernandez et al., 2021), although pre‐operative binge eating had no effect on post‐surgical weight‐loss up to 60 months after surgery (Kops et al., 2021). Among bariatric surgery candidates, higher interoceptive dysregulation was associated to binge eating symptoms and emotional eating (Cella, Cipriano, et al., 2019; Willem et al., 2021).…”

Section: Introductionmentioning

confidence: 99%

Bodily sensations and bariatric surgery: Links between interoceptive sensibility, intuitive and disordered eating behaviour in obesity and obesity surgery

Joshi,

Graziani,

Del‐Monte

2024

Euro Eating Disorders Rev

View full text Add to dashboard Cite

ObjectiveThis study evaluated interoceptive sensibility, intuitive and disordered eating among bariatric candidates, operated individuals and individuals with obesity seeking non‐surgical treatment.MethodWe recruited 57 individuals with obesity seeking nonsurgical weight‐loss (IOB), 84 bariatric candidates (Pre) and 22 individuals post‐bariatric surgery (Post) who responded to questionnaires: Multidimensional Assessment of Interoceptive Awareness, Intuitive Eating Scale‐2 (IES‐2), Dutch Eating Behaviour Questionnaire, Binge Eating Scale, State‐Trait Anxiety Inventory, Beck's Depression Inventory.ResultsOverall, the Post group manifested higher scores on ‘Body‐Listening’ (F = 4.95, p = 0.01), ‘Emotional Awareness’ (F = 8.83, p < 0.001) and ‘Trusting’ (F = 6.71, p = 0.002) interoceptive dimensions, on the IES‐2 total score (F = 5.48, p = 0.007) and ‘Reliance on hunger and satiety cues’ (F = 31.3, p < 0.001) when age was controlled. The IOB group presented higher scores on emotional (F = 3.23, p = 0.047) and binge eating (F = 5.99, p = 0.004). Among operated individuals, intuitive eating mediated the relationship between interoceptive sensibility dimensions and binge eating: ‘Attention regulation’ (54%) ‘Self‐regulation’ (75.1%), ‘Body listening’ (94.09%) and ‘Trusting’ (84.9%).ConclusionsOur results suggest the therapeutic potential of interoceptive sensibility and intuitive eating in obesity management in/beyond the bariatric context.

show abstract

Six-year bariatric surgery outcomes: the predictive and incremental validity of presurgical psychological testing

Cited by 20 publications

References 44 publications

Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery

Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery

Examination of the Reliability and Validity of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3) in a Preoperative Bariatric Surgery Sample

Bodily sensations and bariatric surgery: Links between interoceptive sensibility, intuitive and disordered eating behaviour in obesity and obesity surgery

Contact Info

Product

Resources

About