Ryan J Marek1, Yossef S Ben-Porath2, Manfred H M van Dulmen2, Kathleen Ashton3, Leslie J Heinberg3. 1. Department of Psychological Sciences, Kent State University, Kent, OH. Electronic address: rmarek1@kent.edu. 2. Department of Psychological Sciences, Kent State University, Kent, OH. 3. Cleveland Clinic Lerner College of Medicine, Cleveland, OH.
Abstract
BACKGROUND: Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. OBJECTIVES: Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes. SETTING: Cleveland Clinic Bariatric and Metabolic Institute METHODS: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m2 [SD = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling. RESULTS: Older patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes. CONCLUSION: Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes.
BACKGROUND: Psychosocial factors contribute to poorer weight loss outcomes following bariatric surgery; however, findings on associations between preoperative psychiatric diagnoses, psychological testing, and weight loss are inconsistent. OBJECTIVES: Examine associations between presurgical psychiatric diagnoses derived from a semi-structured clinical interview and test scores from the Minnesota Multiphasic Personality-Inventory-2 - Restructured Form (MMPI-2-RF) and 5-year Body Mass Index (BMI) outcomes. SETTING: Cleveland Clinic Bariatric and Metabolic Institute METHODS: 446 consecutively consented patients who underwent a Roux-en-Y gastric bypass (RYGB) at least 5 years prior were included in the study. A majority were women (74.2%) and Caucasian (66.2%). Patients' mean presurgical BMI was 49.14 kg/m2 [SD = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a presurgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their presurgical evaluations. BMIs were collected at 4 postoperative time points across a 5-year trajectory. This prospective design utilized latent growth curve modeling. RESULTS: Older patients evidenced a slower rate of BMI reduction over time. A presurgical diagnosis of Binge Eating Disorder predicted higher BMIs at the 5-year outcome. Scores on MMPI-2-RF measures of emotional and behavioral dysfunction domains incrementally predicted poorer weight loss outcomes. CONCLUSION: Preoperative indicators of psychopathology, notably indicators that are dimensional in nature, are important in predicting postoperative outcomes. Closer follow-up with patients who evidence presurgical psychological factors, both before and after surgery, may help improve outcomes.
Authors: Janelle D Vaughns; Elaine F Williams; Eleanor R Mackey; Jane C Muret; John van den Anker; Evan P Nadler; Zenaide M Quezado Journal: Obes Surg Date: 2019-05 Impact factor: 4.129
Authors: Allison A Holgerson; Matthew M Clark; Gretchen E Ames; Maria L Collazo-Clavell; Todd A Kellogg; Karen M Graszer; Sarah A Kalsy; Karen Grothe Journal: Obes Surg Date: 2018-11 Impact factor: 4.129
Authors: Kyler Mulhauser; Evan L Reynolds; Brian C Callaghan; Cassandra Fierro; Bruno Giordani; Kristen Votruba Journal: Obes Surg Date: 2021-03-04 Impact factor: 4.129