Guiding Patients Toward the Appropriate Surgical Treatment for Obesity: Should Presurgery Psychological Correlates Influence Choice Between Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy?

This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG.MethodsFour hundred twenty-two patients (RYGB  = 305; VSG = 117) completed screening questionnaires presurgery and underwent surgery between August 2012 and April 2015. Associations between demographics and questionnaires with percentage weight change were evaluated using multivariable linear regression models.ResultsMedian age was 48  years and median BMI 45.3 kg/m2 presurgery. Median percentage changes in weight from baseline to years 1 and 2 follow-up were − 31.5% (range − 52.2 to − 9.2%) and − 31.2% (range − 50.0 to − 1.2%) for RYGB and 25.3% (range − 49.8 to − 4.7%) and − 23.3% (range −  58.9 to − 1.6%) for VSG, respectively. Linear regression models revealed that younger patients lost more weight than older patients at years 1 (RYGBp <  0.0001; VSGp = 0.0001) and 2 (RYGBp = 0.005; VSGp = 0.002). No psychological correlates were significantly associated with weight loss outcomes. Post hoc analyses comparing patients who had surgery to those in the same cohort who did not have surgery revealed significantly higher rates of depression (p <  0.001), anxiety (p <  0.001), binge eating (p = 0.003), night eating (p <  0.001), food addiction (p = 0.042), and lower self-efficacy (p <  0.001) among patients who did not have surgery.DiscussionPatients who are psychologically h...
Source: Obesity Surgery - Category: Surgery Source Type: research