Psychological and behavioral aspects of primary and reoperative surgery: a 6-month longitudinal study

Background: Problematic eating behaviors and general psychopathology have been associated with poor weight loss after bariatric surgery. However, little is known about how these aspects impact weight loss outcomes for the increasing number of patients undergoing reoperative surgeries. This study compares disordered eating and weight-related outcomes before and 6months after surgery in patients undergoing primary (P-Group) and reoperative bariatric surgery (R-Group).MethodsThis longitudinal study assessed 122 P-Group and 116 R-Group patients before and 6months after surgery. The assessment included the eating disorder examination diagnostic items, and a set of self-report measures assessing eating disorder symptomatology, grazing, depression, anxiety, and negative urgency.ResultsPreoperatively, no differences were found between the R- and P-Groups in terms of disordered eating-related variables (except for shape concern, which was higher for the R-Group). At 6months after surgery, the R-Group revealed significantly higher values for restraint (F(1,219)=5.84, p=0.016), shape (F(1,219)=5.59, p=0.019), weight concerns (F(1,219)=13.36, p=0.000), depression (F(1,219)=7.17, p=0.008), anxiety (F(1,219)=6.94, p=-0.009), and compulsive grazing (F(1,219)=6.13, p=0.014). No significant pre- or post-surgery predictors of weight loss were found for the P-Group (2=0.70, p=0.872). In the R-Group, post-surgery anxiety (Wald(2)(1)=6.19, p=0.01) and the post-surgery number of days with grazing in the previous month (Wald(2)(1)=3.90, p=0.04) were significant predictors of weight loss.ConclusionAt 6months after surgery, the R-Group presented more problematic eating and general psychological distress, which may put these patients at greater risk of poorer long-term weight outcomes.
This study was partially conducted at Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds, and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653), by the following grants to Eva Conceicao (IF/01219/2014 and POCI-01-0145-FEDER-028209), and doctoral scholarship to Ana Pinto-Bastos (SFRH/BD/104159/2014). The funding body had no role in the design, collection, analysis, and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication.