Shulamit Geller1, Sigal Levy2, Ofra Hyman3, Paul L Jenkins4, Subhi Abu-Abeid5,6, Gil Goldzweig7. 1. School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, 14, Rabenu Yeruham Street, 68182, Tel-Aviv, Israel. shulamit@mta.ac.il. 2. Statistical Education Unit, The Academic College of Tel Aviv-Yaffo, Tel-Aviv, Israel. 3. Outpatient Psychiatry, Bassett Medical Center Cooperstown, Cooperstown, NY, USA. 4. Bassett Healthcare Research Institute, Bassett Medical Center, Cooperstown, NY, USA. 5. General Surgery Division, Bariatric Surgery Unit, The Tel Aviv Sourasky Medical Center, 6, Weizmann Street, 6423906, Tel-Aviv, Israel. 6. Sackler Faculty of Medicine, Tel Aviv University, P.O. Box 39040, 6997801, Tel Aviv, Israel. 7. School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, 14, Rabenu Yeruham Street, 68182, Tel-Aviv, Israel.
Abstract
PURPOSE: Findings concerning the impact of bariatric surgical intervention on both psychological variables and weight loss are often controversial and misconstrued the world over. The aim of this study was to classify bariatric surgery patients according to patterns of preoperative measures that may predict postoperative psychological and physiological outcomes and to compare these patterns between two distinct cultures. METHODS: Of 169 consecutive bariatric surgery candidates from Israel and 81 candidates from the United States, 73 and 35 patients, respectively consented to be included in a follow-up phase. Body image dissatisfaction, emotional eating behaviors, risk of suicide, depressive symptoms, anxious symptoms, and percent excess weight loss were measured. K-means clustering procedure was used to classify bariatric surgery patients according to their preoperative body-related emotional distress, which was composed of body image dissatisfaction and emotional eating. The joint effect of culture and body-related emotional distress cluster on psychological distress was tested. RESULTS: The cluster analysis revealed two preoperative body-related emotional distress patterns: high body-related emotional distress and low body-related emotional distress. Following surgery, US patients showed a higher risk of suicide and lower excess weight loss than Israeli patients within only the high body-related emotional distress cluster (a significant interaction effect). CONCLUSION: Preoperative assessment of body-related emotional distress patterns among bariatric surgery candidates may enable professionals to identify potential postoperative risks of suicide, anxiety, and decreased weight loss. The relationship between the body-related emotional distress cluster and outcome measures is culture dependent. LEVEL III: Case-control analytic study.
PURPOSE: Findings concerning the impact of bariatric surgical intervention on both psychological variables and weight loss are often controversial and misconstrued the world over. The aim of this study was to classify bariatric surgery patients according to patterns of preoperative measures that may predict postoperative psychological and physiological outcomes and to compare these patterns between two distinct cultures. METHODS: Of 169 consecutive bariatric surgery candidates from Israel and 81 candidates from the United States, 73 and 35 patients, respectively consented to be included in a follow-up phase. Body image dissatisfaction, emotional eating behaviors, risk of suicide, depressive symptoms, anxious symptoms, and percent excess weight loss were measured. K-means clustering procedure was used to classify bariatric surgery patients according to their preoperative body-related emotional distress, which was composed of body image dissatisfaction and emotional eating. The joint effect of culture and body-related emotional distress cluster on psychological distress was tested. RESULTS: The cluster analysis revealed two preoperative body-related emotional distress patterns: high body-related emotional distress and low body-related emotional distress. Following surgery, US patients showed a higher risk of suicide and lower excess weight loss than Israeli patients within only the high body-related emotional distress cluster (a significant interaction effect). CONCLUSION: Preoperative assessment of body-related emotional distress patterns among bariatric surgery candidates may enable professionals to identify potential postoperative risks of suicide, anxiety, and decreased weight loss. The relationship between the body-related emotional distress cluster and outcome measures is culture dependent. LEVEL III: Case-control analytic study.
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