Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity
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ORIGINAL ARTICLE
Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity Giulia Testa1,2,5 · Roser Granero2,3 · Cinzia Siragusa4 · Anna Belligoli4,6 · Marta Sanna4,6 · Maria Luisa Rusconi5 · Paolo Angeli4 · Roberto Vettor4,6 · Mirto Foletto6,7 · Luca Busetto4,6 · Fernando Fernández‑Aranda1,2,8 · Sami Schiff4 Received: 4 June 2019 / Accepted: 17 October 2019 © Springer Nature Switzerland AG 2019
Abstract Purpose After bariatric surgery (BS) a significant minority of patients do not reach successful weight loss or tend to regain weight. In recent years, interest for the psychological factors that predict post-surgical weight loss has increased with the objective of developing interventions aimed to ameliorate post-surgical outcomes. In the present study, predictive models of successful or poor weight loss 12 months after BS were investigated considering pre-surgery level of psychopathological symptoms, dysfunctional eating behaviors and trait impulsivity at baseline (pre-surgery). Methods Sixty-nine patients with morbid obesity canditates for laparoscopic sleeve gastrectomy were assessed regarding metabolic and psychological dimensions. Successful post-surgery weight loss was defined as losing at least 50% of excess body weight (%EWL). Results Logistic models adjusted for patient sex, age and presence of metabolic diseases showed that the baseline presence of intense psychopathological symptoms and low attentional impulsivity predict poor %EWL ( 35 kg/m2 with obesity-related comorbidities (e.g., type 2 diabetes mellitus, arterial hypertension, dyslipidemia, obstructive sleep apnea, severe osteoarthritis), which are necessary conditions to be considered for bariatric surgery. Participants were informed about the experimental procedure and gave their written consent. The study was
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity
performed in accordance with the Helsinki Declaration [42] and approved by the local Ethical Committee of the Padua University Hospital.
Pre‑surgical assessment Participants underwent complete pre-surgery clinical evaluation conducted by a highly trained interdisciplinary team including endocrinologists, surgeons and psychologists at the Centre of the Study and the Integrated Treatment of Obesity (Ce.S.I.T.O), of the Padua University Hospital. Demographic information (i.e., sex, age) was collected along with the assessment of pre-surgery metabolic diseases: hypertension, Type-2 diabetes, dyslipidemia, obstructive sleep apnea (OSA) and hypothyroidism. Anthropometric measures (i.e., height, weight, BMI) were collected prior to surgery and 12 months after LSG. Preoperative psychological evaluation was performed by a short-structured interview oriented to assess history of eating and/or psychopathological disorders, and to evaluate the presence of clinical psychological conditions which may interfere with post-surgical weight loss. Patients did not systematically receive a pre-surgical psychological interven
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