A history of adjustment disorder predicts greater weight loss after sleeve gastrectomy


Background

Bariatric surgery is one of the most effective long-term options for treating class
III obesity or class II obesity with medical co-morbidities; however, a significant
number of patients do not achieve the expected weight loss. New studies are needed
to find the predictive value of different variables on surgery outcomes.

Objectives

Our aim was to study a number of physical, medical, and psychopathological variables
as potential risk factors for poor outcomes in patients with class II–IV obesity scheduled
for sleeve gastrectomy.

Setting

Sagrat Cor University Hospital in Barcelona, Spain.

Methods

This prospective longitudinal study enrolled a sample consisting of 441 patients from
whom a descriptive analysis was obtained. For 235 of them, we performed a comparative
analysis between the patients with differing responses to sleeve gastrectomy after
1 year of follow-up. The remaining patients had differing follow-up data or were lost
to follow-up. To collect the data, a semi-structured interview was conducted, and
various tests were administered to assess the patients’ psychopathology (Hamilton
Rating Scale for Depression, Hamilton Anxiety Rating Scale) and functionality (Global
Assessment of Functioning Scale).

Results

The results show the prognostic relationship between certain presurgery variables
and the good or poor outcomes of the bariatric surgery, based on the patients’ weight
loss. Advanced age, high body mass index, diabetes, and respiratory problems were
significant predictors of a poor response to surgery. Contrarywise, a history of adjustment
disorder predicted a better response.

Conclusions

The results allow us to conclude that, beyond well-established physical and medical
conditions, a psychopathological study of patients prior to bariatric surgery including
adjustment disorders could be predictive of therapeutic response and could help to
personalize the follow-up.



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