Lisa Schäfer1, Claudia Hübner1, Thomas Carus2, Beate Herbig3, Florian Seyfried4, Stefan Kaiser5, Tatjana Schütz6, Arne Dietrich1, Anja Hilbert1. 1. Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany. 2. Department of General Surgery, Asklepios Clinic, Suurheid 20, Hamburg, 22559, Germany. 3. Schön Klinik Hamburg Eilbek Bariatric Clinic, Dehnhaide 120, Hamburg, 22081, Germany. 4. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Oberdürrbacher Strasse 6, Würzburg, 97080, Germany. 5. Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Luisenstrasse 7, Konstanz, 78464, Germany. 6. Core Unit Nutrition and Clinical Phenotyping, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany.
Abstract
OBJECTIVE: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in prebariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of this study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor postbariatric weight loss outcome. METHOD: Within a prospective multicenter registry, N = 370 prebariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. RESULTS: Five prebariatric subtypes were identified with specific profiles regarding self-control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. CONCLUSION: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific prebariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for postbariatric weight loss and health-related outcomes.
OBJECTIVE: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in prebariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of this study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor postbariatric weight loss outcome. METHOD: Within a prospective multicenter registry, N = 370 prebariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. RESULTS: Five prebariatric subtypes were identified with specific profiles regarding self-control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. CONCLUSION: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific prebariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for postbariatric weight loss and health-related outcomes.
Authors: David B Sarwer; Kelly C Allison; Thomas A Wadden; Rebecca Ashare; Jacqueline C Spitzer; Courtney McCuen-Wurst; Caitlin LaGrotte; Noel N Williams; Michael Edwards; Colleen Tewksbury; Jingwei Wu Journal: Surg Obes Relat Dis Date: 2019-02-23 Impact factor: 4.734