Background: Long-term behavioral and psychological aspects associated with weight outcomes after reoperative bariatric surgery have rarely been investigated.
Objectives: This study sought (1) to identify differences in weight loss trajectories during the first 24 months in reoperative bariatric surgery (R group) and primary bariatric surgery (P group) and (2) to investigate pre- and postsurgery psychobehavioral predictors of weight loss and weight regain for both groups.
Setting: Hospital center and university, Portugal.
Methods: This longitudinal study compared an R group (n = 157) and a P group (n = 216). Patients were assessed at presurgery and at 6, 12, 18, and 24 months postsurgery. Assessment included the Eating Disorder Examination-Questionnaire and Repetitive Eating Questionnaire diagnostic interviews and a set of self-report measures assessing eating disorder symptomatology, grazing, depression, anxiety, and impulsive behavior.
Results: The P and R groups presented a similar trajectory for the percentage of total weight loss (%TWL) (β = 1.46, standard error = 1.96; Wald χ2 = .55, P = .457) and weight regain (β = 1.66, standard error = 2.72; Wald χ2 = .24, P = .622). No significant presurgery predictors of weight loss and weight regain were found for the P and R groups. Regarding postsurgery predictors, higher Eating Disorder Examination-Questionnaire scores (Wald χ2(1) = 6.88, P = .009) and grazing behavior (Wald χ2(1) = 8.30, P = .004) were associated with less %TWL for both groups. Belonging to the P group emerged as a significant predictor of more weight loss (Wald χ2(1) = 7.25, P = .007). Postsurgery anxiety predicted less %TWL in R group (Wald χ2(1) = 3.89, P = .043). Considering weight regain, higher postoperative disordered eating (global Eating Disorder Examination-Questionnaire; Wald χ2(1) = 4.66, P = .031) was associated with increased weight regain for the P and R groups.
Conclusions: Problematic eating behaviors and psychological distress are significant predictors of poor weight outcomes for both groups.
Keywords: Longitudinal study; Predictors of outcome; Reoperative bariatric surgery; Trajectories of weight loss.
Copyright © 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Psychological and Behavioral Aspects of Primary and Reoperative Surgery: A 6-Month Longitudinal StudyA Pinto-Bastos et al. Obes Surg 28 (12), 3984-3991. PMID 30105661.At 6 months after surgery, the R-Group presented more problematic eating and general psychological distress, which may put these patients at greater risk of poorer long-t …
Psychological, Behavioral, and Weight-Related Aspects of Patients Undergoing Reoperative Bariatric Surgery After Gastric Band: Comparison With Primary Surgery PatientsE Conceição et al. Surg Obes Relat Dis 14 (5), 603-610. PMID 29567056.Despite the preoperative similarities between patients undergoing reoperative or primary surgeries, the differences in binge eating and weight-related variables may assoc …
Stability of Problematic Eating Behaviors and Weight Loss Trajectories After Bariatric Surgery: A Longitudinal Observational StudyEM Conceição et al. Surg Obes Relat Dis 13 (6), 1063-1070. PMID 28209532.Our data do not support the stability of all PEBs across time, highlighting that the absence of preoperative PEBs does not preclude an unfavorable weight loss outcome aft …
Cognitive Behavioral Therapy and Predictors of Weight Loss in Bariatric Surgery PatientsL Paul et al. Curr Opin Psychiatry 30 (6), 474-479. PMID 28795980. - ReviewCBT seems to be effective in reducing risk factors for weight regain after bariatric surgery, such as disordered eating behavior and depression. Controlled studies with l …
Systematic Review on Reoperative Bariatric Surgery: American Society for Metabolic and Bariatric Surgery Revision Task ForceSA Brethauer et al. Surg Obes Relat Dis 10 (5), 952-72. PMID 24776071. - ReviewThe indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, c …
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Disordered Eating After Bariatric Surgery: Clinical Aspects, Impact on Outcomes, and Intervention StrategiesEM Conceição et al. Curr Opin Psychiatry 32 (6), 504-509. PMID 31343419.We recommend the following to improve clinical care and move research forward: a common language for DEB constructs is needed to improve cross-talk among researchers and …