Lisa Schäfer1, Claudia Hübner2, Thomas Carus3, Beate Herbig4, Florian Seyfried5, Stefan Kaiser6, Arne Dietrich7, Anja Hilbert2. 1. Integrated Research and Treatment Center Adiposity Diseases, Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. lisa.schaefer@medizin.uni-leipzig.de. 2. Integrated Research and Treatment Center Adiposity Diseases, Departments of Medical Psychology and Medical Sociology and Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. 3. Department of General Surgery, Asklepios Clinic, Hamburg, Germany. 4. Schön Klinik Hamburg Eilbek Bariatric Clinic, Hamburg, Germany. 5. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany. 6. Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Constance, Germany. 7. Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
Abstract
BACKGROUND: Although bariatric surgery is the most effective treatment for severe obesity, a subgroup of patients shows insufficient postbariatric outcomes. Differences may at least in part result from heterogeneous patient profiles regarding reactive and regulative temperament, emotion dysregulation, and disinhibited eating. This study aims to subtype patients based on these aspects before and 2 years after bariatric surgery and tests the predictive value of identified subtypes for health-related outcomes 3 years after surgery. METHODS: Within a prospective multicenter patient registry, N = 229 bariatric patients were examined before bariatric surgery, 2 and 3 years postoperatively via clinical interviews and self-report questionnaires. Pre- and postbariatric subtypes were differentiated by temperament, emotion dysregulation, and disinhibited eating using latent profile analyses (LPA). The predictive value of pre- and postbariatric subtypes for surgery outcomes measured 3 years postoperatively was tested via linear regression analyses. RESULTS: LPA resulted in five prebariatric and three postbariatric subtypes which were significantly associated with different levels of general and eating disorder psychopathology. Post- versus prebariatric subtypes explained more variance regarding eating disorder psychopathology, depression, and quality of life assessed 3 years postoperatively, whereas neither pre- nor postbariatric subtypes predicted postbariatric weight loss. Patients with prebariatric deficits in self- and emotional control had an increased risk for showing these deficits postoperatively. CONCLUSIONS: A re-evaluation of patients' psychological status after bariatric surgery is recommended to detect patients with potential risk for adverse psychological surgery outcomes in the long term.
BACKGROUND: Although bariatric surgery is the most effective treatment for severe obesity, a subgroup of patients shows insufficient postbariatric outcomes. Differences may at least in part result from heterogeneous patient profiles regarding reactive and regulative temperament, emotion dysregulation, and disinhibited eating. This study aims to subtype patients based on these aspects before and 2 years after bariatric surgery and tests the predictive value of identified subtypes for health-related outcomes 3 years after surgery. METHODS: Within a prospective multicenter patient registry, N = 229 bariatric patients were examined before bariatric surgery, 2 and 3 years postoperatively via clinical interviews and self-report questionnaires. Pre- and postbariatric subtypes were differentiated by temperament, emotion dysregulation, and disinhibited eating using latent profile analyses (LPA). The predictive value of pre- and postbariatric subtypes for surgery outcomes measured 3 years postoperatively was tested via linear regression analyses. RESULTS:LPA resulted in five prebariatric and three postbariatric subtypes which were significantly associated with different levels of general and eating disorder psychopathology. Post- versus prebariatric subtypes explained more variance regarding eating disorder psychopathology, depression, and quality of life assessed 3 years postoperatively, whereas neither pre- nor postbariatric subtypes predicted postbariatric weight loss. Patients with prebariatric deficits in self- and emotional control had an increased risk for showing these deficits postoperatively. CONCLUSIONS: A re-evaluation of patients' psychological status after bariatric surgery is recommended to detect patients with potential risk for adverse psychological surgery outcomes in the long term.
Entities:
Keywords:
Bariatric surgery outcome; Cluster; Emotion regulation; Impulsivity; Predictors; Temperament
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