Pre- and Postbariatric Subtypes and Their Predictive Value for Health-Related Outcomes Measured 3 Years After Surgery
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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.
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.
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.
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.
KeywordsBariatric surgery outcome Temperament Impulsivity Emotion regulation Predictors Cluster
The authors thank Christine Stroh, M.D.; Wolfgang Tigges, M.D.; Christian Jurowich, M.D.; Sabrina Baldofski; Kathrin Hohl; Martina Pabst, M.D.; Petra Börner; Yvonne Sockolowsky; Marlen Schmidt; and Sylvia Lellwitz for their support in data collection at the study centers, and Ricarda Schmidt, Ph.D., for her editing of the manuscript.
This work was supported by the Federal Ministry of Education and Research (BMBF), Germany, FKZ: 01EO1501.
Compliance with Ethical Standards
The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.
Conflict of Interest
The authors declare that they have no conflicts of interest.
- 4.Courcoulas AP, Christian NJ, Belle SH, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.Google Scholar
- 12.Gray JA. The psychology of fear and stress. Cambridge: Cambridge University Press; 1987.Google Scholar
- 15.Marek RJ, Ben-Porath YS, Merrell J, et al. Predicting one and three month postoperative somatic concerns, psychological distress, and maladaptive eating behaviors in bariatric surgery candidates using the Minnesota multiphasic personality Inventory-2 restructured form (MMPI-2-RF). Obes Surg. 2014;24(4):631–9.CrossRefGoogle Scholar
- 29.Grunert SC. Ein Inventar zur Erfassung von Selbstaussagen zum Ernährungsverhalten [an inventory of the assessment of self-reported eating behavior]. Diagnostica. 1989;35:167–79.Google Scholar
- 32.Fairburn CG, Cooper Z, O’Connor M. Eating disorder examination (17.0D). New York: Guilford Press; 2014.Google Scholar
- 33.Fairburn CG, Beglin SJ. Eating disorder examination questionnaire (6.0). In: Fairburn CG, editor. Cognitive behavior therapy and eating disorders. New York: Guilford Press; 2008. p. 309–14.Google Scholar
- 36.Vermount JK, Madison J. Latent GOLD 4.0 User’s Guide. Belmont: Statistical Innovations Inc; 2005.Google Scholar
- 38.Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988.Google Scholar