1
|
Maki S, Leon M, Glenn E, Tanner T, Krause C. Use of Broadband Personality Tests in Bariatric Surgery: A Scoping Review. J Surg Res 2024; 293:717-726. [PMID: 37857114 DOI: 10.1016/j.jss.2023.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 08/04/2023] [Accepted: 09/01/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Studies have reported significant associations between personality scales of broadband psychometric testing to bariatric surgical outcomes; however, the literature falls short in outlining how these instruments can be best utilized to optimize weight loss milestones after surgery. The purpose of this scoping review is to analyze the literature utilizing broadband personality tests in the bariatric surgical population with relation to weight loss outcomes to identify gaps in research and summarize results to guide American Society for Metabolic and Bariatric Surgery practices and future research. METHODS Six databases were searched for broadband personality assessments, bariatric surgery, and weight loss outcomes terms. Studies included were peer-reviewed, published in English, and compared psychological assessments and weight loss outcomes. RESULTS Five hundred nineteen studies were reviewed, with 20 included in the full-text analysis. Studies used at least one of six defined broadband personality assessments. Elevated scores for depression were associated with lower weight loss with three of the assessments. Anxiety was inconsistently associated with postoperative weight loss, but this may be dependent on follow-up time CONCLUSIONS: Preoperative broadband personality assessments may support identifying behaviors that help patients reach their postoperative weight loss goals. Inconsistencies in the reporting of weight loss outcome measures across the literature make it difficult to draw significant conclusions. The American Society for Metabolic and Bariatric Surgery recommends standardization of outcome reporting, further highlighting a need in research to identify scales that are consistent predictors of weight loss outcomes.
Collapse
Affiliation(s)
- Sarah Maki
- University Of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
| | - Melissa Leon
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska
| | - Emily Glenn
- University Of Nebraska Medical Center, College of Medicine, Omaha, Nebraska
| | - Tiffany Tanner
- University Of Nebraska Medical Center, College of Medicine, Omaha, Nebraska; Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska
| | - Crystal Krause
- Center for Advanced Surgical Technology, University of Nebraska Medical Center, Omaha, Nebraska; Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska.
| |
Collapse
|
2
|
Benítez-Andrades JA, Prada-García C, García-Fernández R, Ballesteros-Pomar MD, González-Alonso MI, Serrano-García A. Application of machine learning algorithms in classifying postoperative success in metabolic bariatric surgery: Acomprehensive study. Digit Health 2024; 10:20552076241239274. [PMID: 38559583 PMCID: PMC10981264 DOI: 10.1177/20552076241239274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
Objectives Metabolic bariatric surgery is a critical intervention for patients living with obesity and related health issues. Accurate classification and prediction of patient outcomes are vital for optimizing treatment strategies. This study presents a novel machine learning approach to classify patients in the context of metabolic bariatric surgery, providing insights into the efficacy of different models and variable types. Methods Various machine learning models, including Gaussian Naive Bayes, Complement Naive Bayes, K-nearest neighbour, Decision Tree, K-nearest neighbour with RandomOverSampler, and K-nearest neighbour with SMOTE, were applied to a dataset of 73 patients. The dataset, comprising psychometric, socioeconomic, and analytical variables, was analyzed to determine the most efficient predictive model. The study also explored the impact of different variable groupings and oversampling techniques. Results Experimental results indicate average accuracy values as high as 66.7% for the best model. Enhanced versions of K-nearest neighbour and Decision Tree, along with variations of K-nearest neighbour such as RandomOverSampler and SMOTE, yielded the best results. Conclusions The study unveils a promising avenue for classifying patients in the realm of metabolic bariatric surgery. The results underscore the importance of selecting appropriate variables and employing diverse approaches to achieve optimal performance. The developed system holds potential as a tool to assist healthcare professionals in decision-making, thereby enhancing metabolic bariatric surgery outcomes. These findings lay the groundwork for future collaboration between hospitals and healthcare entities to improve patient care through the utilization of machine learning algorithms. Moreover, the findings suggest room for improvement, potentially achievable with a larger dataset and careful parameter tuning.
Collapse
Affiliation(s)
| | - Camino Prada-García
- Department of Preventive Medicine and Public Health, University of Valladolid, Valladolid, Spain
- Dermatology Service, Complejo Asistencial Universitario de León, León, Spain
| | - Rubén García-Fernández
- Department of Electric, Systems and Automatics Engineering, Escuela de Ingenierías Industrial, Informática y Aeroespacial, Universidad de León, León, Spain
| | | | - María-Inmaculada González-Alonso
- Department of Electric, Systems and Automatics Engineering, Escuela de Ingenierías Industrial, Informática y Aeroespacial, Universidad de León, León, Spain
| | - Antonio Serrano-García
- Psychiatry Service, Department of Psychosomatic, Complejo Asistencial Universitario de León, León, Spain
| |
Collapse
|
3
|
Montorio I, Izal M, Bellot A, Rodríguez J, de Iceta M. Personality Profiles Associated with Long-Term Success in Bariatric Surgery: 24-Month Follow-Up. Behav Sci (Basel) 2023; 13:797. [PMID: 37887447 PMCID: PMC10603863 DOI: 10.3390/bs13100797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Bariatric surgery (BS) is highly effective for treating severe obesity in the long term. However, studies investigating predictors and personality profiles linked to BS success yield inconsistent results due to varying methodologies and limited research. This paper aims to identify personality profiles associated with BS success. (2) Method: The study involved 67 patients undergoing bariatric surgery, evaluated through clinical and personality measures. Weight loss was monitored at 6, 12, and 24 months post-surgery. Hierarchical case cluster analysis and iterative k-means cluster analysis identified distinct groups based on excess body mass index loss (%EBL) at these intervals. ANOVA was employed to compare personality profiles between groups. (3) Results: Average weight loss after 24 months was 67.2%. Two success profiles emerged: 46.5% showed very good success, achieving 90% EBL in 24 months, while 55% in the second cluster had less than 40% EBL throughout follow-up. The successful profile correlated with greater self-efficacy and improved emotional adjustment. (4) Conclusions: Successful BS outcomes were linked to personality traits promoting sustained weight loss post-surgery.
Collapse
Affiliation(s)
- Ignacio Montorio
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - María Izal
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Ana Bellot
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Javier Rodríguez
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
| | - Mariano de Iceta
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
| |
Collapse
|
4
|
Makarawung DJS, Dijkhorst PJ, de Vries CEE, Monpellier VM, Wiezer MJ, van Veen RN, Geenen R, Mink van der Molen AB. Body Image and Weight Loss Outcome After Bariatric Metabolic Surgery: a Mixed Model Analysis. Obes Surg 2023; 33:2396-2404. [PMID: 37354307 DOI: 10.1007/s11695-023-06690-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/10/2023] [Accepted: 06/16/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE As in nonsurgical weight loss populations, body image may partly explain differences in weight loss outcomes after surgery. The aim of this study was to determine the prospective association between body image and weight loss in a longitudinal cohort of patients up to 3 years after bariatric metabolic surgery. MATERIALS AND METHODS The BODY-Q self-report questionnaire was used to assess body image. Linear mixed models evaluated associations of baseline body image with weight loss in the first year as well as associations of body image at 12 months and first-year change in body image with weight loss 12 to 36 months after surgery. RESULTS Available body image data included 400 (100%), 371 (93%), 306 (77%), 289 (72%), and 218 (55%) patients at baseline and 4, 12, 24, and 36 months, respectively. Body image scores improved significantly until 12 months, followed by a gradual decline. Scores remained improved in comparison to baseline (β = 31.49, 95% CI [27.8, 35.2], p < .001). Higher baseline body image was associated with less weight loss during the first year, and the effect size was trivial (ß = -0.05, 95% CI [-0.09, -0.01], p = .009). Body image and change in body image were not associated with weight loss 12 to 36 months after surgery. CONCLUSION Body image improved after bariatric metabolic surgery. Although no clinically relevant associations of body image with weight loss were demonstrated, the gradual decline in body image scores underlines the importance of long-term follow-up with regular assessment of this aspect of quality of life.
Collapse
Affiliation(s)
- Dennis J S Makarawung
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435, CM, Nieuwegein, the Netherlands.
- Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands.
| | - Phillip J Dijkhorst
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Claire E E de Vries
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Valerie M Monpellier
- Dutch Obesity Clinic (Nederlandse Obesitas Kliniek), Amersfoortseweg 43, 3712 BA, Huis ter Heide, the Netherlands
| | - M J Wiezer
- Department of Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435, CM, Nieuwegein, the Netherlands
| | - Ruben N van Veen
- Department of Surgery, OLVG, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Heidelberglaan 1, 3584 CS, Utrecht, the Netherlands
| | - Aebele B Mink van der Molen
- Department of Plastic, Reconstructive and Hand Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, the Netherlands
| |
Collapse
|
5
|
Lüscher A, Vionnet N, Amiguet M, Chartoumpekis D, Mantziari S, Frantz J, Favre L. Impact of Preoperative Psychiatric Profile in Bariatric Surgery on Long-term Weight Outcome. Obes Surg 2023; 33:2072-2082. [PMID: 37145292 PMCID: PMC10289928 DOI: 10.1007/s11695-023-06595-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Conflicting results have been reported regarding the predictive value of preoperative psychological assessment and weight outcome after bariatric surgery. This might be attributed to different factors affecting early weight loss and long-term weight loss. Herein, we investigated whether preoperative psychiatric profile was associated with preoperative BMI and with both early (1 year) and long-term (5 years) weight loss after Roux-en-Y gastric bypass (RYGB). METHODS Prospective observational cohort study of patients undergoing RYGB between 2013 and 2019. Symptoms related to anxiety, depression, eating disorder, and alcohol use disorders were assessed by employing validated, specific psychometric tests (STAI-S/T, BDI-II, BITE, AUDIT-C) prior to surgery. Pre-operative BMI, early weight loss (1 year), and long-term weight evolution (up to 5 years) were registered. RESULTS Two hundred thirty six patients (81% women) were included in the present study. Linear longitudinal mixed model showed a significant effect of preoperative high anxiety (STAI-S) on long-term weight outcome, after controlling for gender, age and type 2 diabetes. Patient with high preoperative anxiety score regained weight faster than those experiencing low anxiety (each year percent excess BMI loss (%EBMIL) - 4.02%, ± 1.72, p = 0.021). No other pre-operative psychiatric symptoms have been shown to have an impact on long-term weight loss. In addition, no significant association was found between any of the pre-operative psychiatric variables and pre-operative BMI, or early weight loss (%EBMIL) at 1-year post-RYGB. CONCLUSION Herein we identified high anxiety score (STAI-S) as a predictor for long-term weight regain. Thus, long-term psychiatric surveillance of these patients and the development of tailored management tools could serve as a means to prevent weight regain.
Collapse
Affiliation(s)
- Anouk Lüscher
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Vionnet
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Michael Amiguet
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Dionysios Chartoumpekis
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Styliani Mantziari
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Johanna Frantz
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Lucie Favre
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
- Centre Hospitalier Universitaire Vaudois, CHUV, Division of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Rue St Martin 3, CH-1003, Lausanne, Switzerland.
| |
Collapse
|
6
|
Carter J, Chang J, Birriel TJ, Moustarah F, Sogg S, Goodpaster K, Benson-Davies S, Chapmon K, Eisenberg D. ASMBS position statement on preoperative patient optimization before metabolic and bariatric surgery. Surg Obes Relat Dis 2021; 17:1956-1976. [PMID: 34629296 DOI: 10.1016/j.soard.2021.08.024] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/11/2021] [Accepted: 08/27/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Jonathan Carter
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California.
| | - Julietta Chang
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - T Javier Birriel
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Fady Moustarah
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Stephanie Sogg
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Kasey Goodpaster
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Sue Benson-Davies
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Katie Chapmon
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| | - Dan Eisenberg
- Clinical Issues Committee, American Society of Metabolic and Bariatric Surgeons; Department of Clinical Surgery, University of California-San Francisco, San Francisco, California
| |
Collapse
|
7
|
Impact of smoking on weight loss outcomes after bariatric surgery: a literature review. Surg Endosc 2021; 35:5936-5952. [PMID: 34319440 DOI: 10.1007/s00464-021-08654-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The association between smoking and surgical complications after bariatric surgery has been well-established. However, given that this patient population is inherently weight-concerned, understanding the effects of tobacco use on postoperative weight loss is essential to guiding clinicians in counseling patients. We aimed to summarize the current literature examining the effects of preoperative and postoperative smoking, as well as changes in smoking status, on bariatric surgery weight loss outcomes. METHODS Ovid MEDLINE, PubMed, and SCOPUS databases were queried to identify relevant published studies. RESULTS Overall, 20 studies were included. Preoperative and postoperative smoking rates varied widely across studies, as did requirements for smoking cessation prior to bariatric surgery. Reported preoperative smoking prevalence ranged from 1 to 62%, and postoperative smoking prevalence ranged from 6 to 43%. The majority of studies which examined preoperative and/or postoperative smoking habits found no association between smoking habits and postoperative weight loss outcomes. A minority of studies found relatively small differences in postoperative weight loss between smokers and nonsmokers; these often became nonsignificant with longer follow-up. No studies found significant associations between changes in smoking status and weight loss outcomes. CONCLUSION While smoking has been associated with weight loss in the general population, most current evidence demonstrates that smoking habits are not associated with weight loss outcomes after bariatric surgery. However, due to the heterogeneity in study design and analysis, no definitive conclusions can be made, and more robust studies are needed to investigate any relationship between smoking and long-term weight loss outcomes. Given the established increased risk of surgical complications and mortality in smokers, smoking cessation should be encouraged.
Collapse
|
8
|
Cornejo-Pareja I, Molina-Vega M, Gómez-Pérez AM, Damas-Fuentes M, Tinahones FJ. Factors Related to Weight Loss Maintenance in the Medium-Long Term after Bariatric Surgery: A Review. J Clin Med 2021; 10:jcm10081739. [PMID: 33923789 PMCID: PMC8073104 DOI: 10.3390/jcm10081739] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/27/2021] [Accepted: 04/09/2021] [Indexed: 12/15/2022] Open
Abstract
Despite bariatric surgery being the most effective treatment for obesity, some individuals do not respond adequately, especially in the long term. Identifying the predictors of correct weight maintenance in the medium (from 1 to 3 years after surgery) and long term (from 3 years and above) is of vital importance to reduce failure after bariatric surgery; therefore, we summarize the evidence about certain factors, among which we highlight surgical technique, psychological factors, physical activity, adherence to diet, gastrointestinal hormones or neurological factors related to appetite control. We conducted a search in PubMed focused on the last five years (2015–2021). Main findings are as follows: despite Roux-en-Y gastric bypass being more effective in the long term, sleeve gastrectomy shows a more beneficial effectiveness–complications balance; pre-surgical psychological and behavioral evaluation along with post-surgical treatment improve long-term surgical outcomes; physical activity programs after bariatric surgery, in addition to continuous and comprehensive care interventions regarding diet habits, improve weight loss maintenance, but it is necessary to improve adherence; the impact of bariatric surgery on the gut–brain axis seems to influence weight maintenance. In conclusion, although interesting findings exist, the evidence is contradictory in some places, and long-term clinical trials are necessary to draw more robust conclusions.
Collapse
Affiliation(s)
- Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - María Molina-Vega
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Ana María Gómez-Pérez
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Correspondence: (M.M.-V.); (A.M.G.-P.); Tel.: +34-95-1034-044 (M.M.-V. & A.M.G.-P.)
| | - Miguel Damas-Fuentes
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, 29010 Málaga, Spain; (I.C.-P.); (M.D.-F.); (F.J.T.)
- Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
9
|
Self-Reported Smoking Compared to Serum Cotinine in Bariatric Surgery Patients: Smoking Is Underreported Before the Operation. Obes Surg 2020; 30:23-37. [PMID: 31512159 DOI: 10.1007/s11695-019-04128-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Smoking has been associated with postoperative complications and mortality in bariatric surgery. The evidence for smoking is based on self-report and medical charts, which can lead to misclassification and miscalculation of the associations. Determination of cotinine can objectively define nicotine exposure. We determined the accuracy of self-reported smoking compared to cotinine measurement in three phases of the bariatric surgery trajectory. METHODS Patients in the phase of screening (screening), on the day of surgery (surgery), and more than 18 months after surgery (follow-up) were consecutively selected. Self-reported smoking was registered and serum cotinine was measured. We evaluated the accuracy of self-reported smoking compared to cotinine, and the level of agreement between self-report and cotinine for each phase. RESULTS In total, 715 patients were included. In the screening, surgery, and follow-up group, 25.6%, 18.0%, and 15.5%, respectively, was smoking based on cotinine. The sensitivity of self-reported smoking was 72.5%, 31.0%, and 93.5% in the screening, surgery, and follow-up group, respectively (p < 0.001). The specificity of self-report was > 95% in all groups (p < 0.02). The level of agreement between self-report and cotinine was 0.778, 0.414, and 0.855 for the screening, surgery, and follow-up group, respectively. CONCLUSIONS Underreporting of smoking occurs before bariatric surgery, mainly on the day of surgery. Future studies on effects of smoking and smoking cessation in bariatric surgery should include methods taking into account the issue of underreporting.
Collapse
|
10
|
Tayefi A, Pazouki A, Alavi K, Salehian R, Soheilipour F, Ghanbari Jolfaei A. Relationship of personality characteristics and eating attitude with the success of bariatric surgery. Med J Islam Repub Iran 2020; 34:89. [PMID: 33306062 PMCID: PMC7711033 DOI: 10.34171/mjiri.34.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Obesity is a chronic disease that causes several medical and psychiatric complications. There are plenty of pharmacological and non-pharmacological therapies for obesity treatment. Bariatric surgery is one of the most efficient nonpharmacological treatment for morbid obesity; however, several psychological factors affect the success of bariatric surgery. This study aims to evaluate personality characteristics and eating attitude relationship with the success of bariatric surgery. Methods: This study was carried out on 75 patients with obesity who were candidates of bariatric surgery in the obesity clinic of Rasoul-e-Akram Hospital in Tehran. The patients were asked to fill the TCI and EAT-26 questionnaires before and after the surgery. Statistical analyses were performed using the SPSS-23 applying T-test, Mann-Whitney tests and Pearson and Spearman's correlation coefficient. The significance level was set at 0.05. Results: Seventy-five patients, including 13 men and 62 women, were assessed through this study. The mean of the BMI of the participants was 44.7 prior to the surgery and 30 after the operation. Personality characteristics and eating attitudes had no significant relationship with the success of bariatric surgery. Conclusion: Although the eating attitude and personal characteristics of the bariatric surgery candidates before the surgery was not related to the outcome of the surgery, they should be considered in post-operational psychological assessments.
Collapse
Affiliation(s)
- Ahmad Tayefi
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolreza Pazouki
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Kaveh Alavi
- Mental Health research center, Iran University of Medical Sciences, Tehran, Iran
| | - Razieh Salehian
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fahimeh Soheilipour
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Atefeh Ghanbari Jolfaei
- Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
11
|
Internalizing, Externalizing, and Interpersonal Components of the MMPI-2-RF in Predicting Weight Change After Bariatric Surgery. Obes Surg 2019; 30:127-138. [DOI: 10.1007/s11695-019-04133-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
12
|
Monteleone AM, Cascino G, Solmi M, Pirozzi R, Tolone S, Terracciano G, Parisi S, Cimino M, Monteleone P, Maj M, Docimo L. A network analysis of psychological, personality and eating characteristics of people seeking bariatric surgery: Identification of key variables and their prognostic value. J Psychosom Res 2019; 120:81-89. [PMID: 30929713 DOI: 10.1016/j.jpsychores.2019.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The interplay among personality traits, anxiety and eating symptoms in candidates for bariatric surgery has never been investigated through the network analysis approach. Thus, we aimed to use this method to identify the key psychological traits that characterize these individuals and to assess their role as predictors of surgical outcomes. METHODS One-hundred-eighty-five candidates for bariatric surgery filled in the State Trait Anxiety Inventory (STAI), the Revised Restraint Scale, the Power of Food Scale and the Temperament and Character Inventory-Revised (TCI-R) questionnaires. All these variables were included in a network analysis. Then, the most central network nodes were entered as independent variables in a regression model that included 9-month follow-up weight outcomes as the dependent variable. RESULTS The network has showed a good stability. TCI-self directedness and harm avoidance scores and STAI state and trait anxiety scores were the nodes with the highest centrality in the network. Weight outcomes were assessed in 64 patients at follow-up. Among central nodes, low TCI-self directedness was found to be the only significant independent predictor of worse weight outcome. CONCLUSIONS Our findings show for the first time the interplay between personality traits and symptoms in candidates for bariatric surgery combining the network approach with a follow-up evaluation. Low self-directedness has been proved to be the node with highest centrality and the only predictor of short-term weight outcome. These data suggest the importance to take into consideration personality and psychological variables either in the pre-surgery assessment or as possible targets for pre or post-surgery psychotherapeutic interventions. ORCID 0000-0002-6786-4458.
Collapse
Affiliation(s)
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy
| | - Marco Solmi
- Department of Neurosciences, University of Padua, Padua, Italy
| | - Raffaele Pirozzi
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Tolone
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - Gianmattia Terracciano
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Simona Parisi
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Monica Cimino
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', Section of Neurosciences, University of Salerno, Salerno, Italy.
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovico Docimo
- Advanced Medical and Surgical Sciences Department, University of Campania "Luigi Vanvitelli", Naples, Italy.
| |
Collapse
|
13
|
Abstract
PURPOSE OF THE REVIEW To update the recent findings on the influence of personality features on postoperative weight loss in patients undergoing bariatric surgery. RECENT FINDINGS Several studies investigated the influence of pre-surgical psychological variables on the outcome of bariatric surgery, but the effective role of personality factors (i.e., both normal personality traits and personality disturbances) in shaping bariatric surgery outcome is still unclear. We analyzed nine recent papers that examined the impact of pre-operative personality traits on postoperative weight loss among individuals undergoing surgery for severe obesity. A personality pattern denoting the ability to self-regulate in spite of the urges or demands of the moment emerged as a robust predictor of good outcome across studies, independently from baseline psychiatric comorbidity and personality disorders.
Collapse
Affiliation(s)
- Irene Generali
- School of Psychiatry, Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43126, Parma, Italy.
| | - Chiara De Panfilis
- Unit of Neuroscience, Department of Medicine and Surgery, University of Parma, Parma, Italy
| |
Collapse
|
14
|
Ivezaj V, Grilo CM. The complexity of body image following bariatric surgery: a systematic review of the literature. Obes Rev 2018; 19:1116-1140. [PMID: 29900655 PMCID: PMC6296375 DOI: 10.1111/obr.12685] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/30/2018] [Accepted: 02/03/2018] [Indexed: 12/16/2022]
Abstract
Poor body image is common among individuals seeking bariatric surgery and is associated with adverse psychosocial sequelae. Following massive weight loss secondary to bariatric surgery, many individuals experience excess skin and associated concerns, leading to subsequent body contouring procedures. Little is known, however, about body image changes and associated features from pre-to post-bariatric surgery and subsequent body contouring. The objective of the present study was to conduct a comprehensive literature review of body image following bariatric surgery to help inform future clinical research and care. The articles for the current review were identified by searching PubMed and SCOPUS and references from relevant articles. A total of 60 articles examining body image post-bariatric surgery were identified, and 45 did not include body contouring surgery. Overall, there was great variation in standards of reporting sample characteristics and body image terms. When examining broad levels of body image dissatisfaction, the literature suggests general improvements in certain aspects of body image following bariatric surgery; however, few studies have systematically examined various body image domains from pre-to post-bariatric surgery and subsequent body contouring surgery. In conclusion, there is a paucity of research that examines the multidimensional elements of body image following bariatric surgery.
Collapse
Affiliation(s)
- V Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - C M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
15
|
Dalle Grave R, Calugi S, El Ghoch M. Are Personality Characteristics as Measured by the Temperament and Character Inventory (TCI) Associated with Obesity Treatment Outcomes? A Systematic Review. Curr Obes Rep 2018; 7:27-36. [PMID: 29427047 DOI: 10.1007/s13679-018-0294-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE OF REVIEW Some personality traits seem to be associated with obesity, but there is little information available regarding their association with obesity treatment outcomes. The aim of this systematic review was therefore to assess the associations between personality traits-evaluated by means of the Temperament and Character Inventory (TCI)-and outcomes of obesity treatment, including attrition, weight loss, and weight loss maintenance. The PubMed database was searched, and studies were screened as per the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, and data were collated using a narrative approach. RECENT FINDINGS Of the 886 articles retrieved, 9 studies assessing personality traits by means of the TCI in participants with obesity met the inclusion criteria and were reviewed. This approach revealed three main findings: (i) only one study found that attrition rate-during a 6-month behavioral weight loss program-is predicted by low reward dependence scores at baseline; (ii) two studies found that lower novelty-seeking and higher self-directedness scores at baseline positively predict short-term weight-loss magnitude; and (iii) four studies found that higher persistence and lower novelty-seeking scores at baseline predicted weight maintenance at 12 and 24 months. Novelty-seeking and self-directedness traits appear to be predictors of short-term weight loss (≤ 6 months), and persistence and novelty-seeking traits may be related to long-term weight loss maintenance (≥ 12 months), although great uncertainty still exists regarding predictors of attrition.
Collapse
Affiliation(s)
- Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, VR, Italy.
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, VR, Italy
| | - Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016, Garda, VR, Italy
| |
Collapse
|
16
|
Peterhänsel C, Linde K, Wagner B, Dietrich A, Kersting A. Subtypes of Personality and ‘Locus of Control’ in Bariatric Patients and their Effect on Weight Loss, Eating Disorder and Depressive Symptoms, and Quality of Life. EUROPEAN EATING DISORDERS REVIEW 2017; 25:397-405. [DOI: 10.1002/erv.2534] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/31/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Carolin Peterhänsel
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
| | - Katja Linde
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
| | | | - Arne Dietrich
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery; University Hospital Leipzig; Leipzig Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy; University Hospital Leipzig; Leipzig Germany
- Integrated Research and Treatment Center (IFB) Adiposity Diseases; Leipzig University Medical Center; Leipzig Germany
| |
Collapse
|
17
|
Bordignon S, Aparício MJG, Bertoletti J, Trentini CM. Personality characteristics and bariatric surgery outcomes: a systematic review. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:124-134. [PMID: 28614435 DOI: 10.1590/2237-6089-2016-0016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 01/24/2017] [Indexed: 12/11/2022]
Abstract
Introduction: Numerous studies have focused on psychological assessment of bariatric surgery candidates, aiming to identify which psychological variables, including personality characteristics, are related to successful surgical prognosis. Objective: To analyze, by means of a systematic literature review, longitudinal studies that investigated personality traits and disorders as possible predictors of outcomes in bariatric surgery. Method: PsycInfo, PubMed, and Scopus databases were searched for studies published between 2005 and 2015, using the keywords "bariatric" AND "personality." Quantitative longitudinal studies in English, Portuguese, or Spanish were selected for review if they assessed personality as an outcome predictor of BS in people aged 18 years or older. Results: Sixteen articles were analyzed. The results of this review suggest that externalizing dysfunctions might be associated with less weight reduction, while internalizing dysfunctions appear to be associated with somatic concerns and psychological distress. The persistence dimension (of temperament in Cloninger's model) was positively associated with greater weight loss, while neuroticism (Five Factor Model) and the occurrence of personality disorders were not predictive of weight loss. Furthermore, the results indicate a tendency towards a reduction in personality disorders and neuroticism scores, and an increase in extroversion scores, after BS. Conclusions: Assessment of personality characteristics, whether to identify their predictive power or to detect changes during the BS process, is important since it can provide grounds for estimating surgical prognosis and for development of interventions targeting this population.
Collapse
Affiliation(s)
- Suelen Bordignon
- Instituto de Psicologia, Programa de Pós-Graduação em Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Mayra Juliana Galvis Aparício
- Instituto de Psicologia, Programa de Pós-Graduação em Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Juliana Bertoletti
- Instituto de Psicologia, Programa de Pós-Graduação em Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Clarissa Marceli Trentini
- Instituto de Psicologia, Programa de Pós-Graduação em Psicologia, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
18
|
Sharples AJ, Charalampakis V, Daskalakis M, Tahrani AA, Singhal R. Systematic Review and Meta-Analysis of Outcomes After Revisional Bariatric Surgery Following a Failed Adjustable Gastric Band. Obes Surg 2017; 27:2522-2536. [DOI: 10.1007/s11695-017-2677-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
19
|
Queiroz CD, Sallet JA, DE Barros E Silva PGM, Queiroz LDGPDS, Pimentel JA, Sallet PC. Application of BAROS' questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution. ARQUIVOS DE GASTROENTEROLOGIA 2017; 54:60-64. [PMID: 28079242 DOI: 10.1590/s0004-2803.2017v54n1-12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/10/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND: -In recent decades, the high prevalence of obesity in the general population has brought serious concerns in terms of public health. Contrarily to conventional treatment involving dieting and physical exercising, often ineffective in generating long term results, bariatric opera-tions have been an effective method for sustained weight loss in morbidly obese individuals. The Bariatric Analysis and Reporting Outcome System (BAROS) is an objective and recognized system in the overall evaluation of results after bariatric surgery. OBJECTIVE - To investigate results concerning a casuistic of morbidly obese patients undergoing bariatric surgery over a 2-year follow-up in terms of weight loss, related medical conditions, safety and changes in quality of life. METHODS - A total of 120 obese (17 male and 103 female) patients, who underwent bariatric surgery, were assessed and investigated using the BAROS system after a 2- year follow-up. RESULTS - Patients obtained a mean excess weight loss of 74.6 (±15.9) % and mean body mass index reduction of 15.6 (±4.4) Kg/m2. Pre-surgical comorbidities were present in 71 (59%) subjects and they were totally (86%) or partially (14%) resolved. Complications resulting specifically from the surgical procedure were observed in 4.2% of cases (two bowel obstructions requiring re-operation, and three stomal stenosis treated with endoscopic dilation). Sixteen subjects (13% of total number of patients) presented minor clinical complications managed through outpatient care. The final scores for the BAROS questionnaire showcased excellent to good results in 99% of cases (excellent 44%, very good 38%, good 23%, acceptable 1%). CONCLUSION - According to the BAROS questionnaire, bariatric surgery is a safe and effective method for managing obesity and associated clinical comorbidities, allowing for satisfactory results after a 2-year follow-up. Future studies should address other clinical and psychosocial variables that impact outcome as well as allow for longer follow-ups.
Collapse
|
20
|
Sogg S, Lauretti J, West-Smith L. Recommendations for the presurgical psychosocial evaluation of bariatric surgery patients. Surg Obes Relat Dis 2016; 12:731-749. [DOI: 10.1016/j.soard.2016.02.008] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 12/20/2022]
|
21
|
Claes L, Müller A. Temperament and Personality in Bariatric Surgery-Resisting Temptations? EUROPEAN EATING DISORDERS REVIEW 2015; 23:435-41. [DOI: 10.1002/erv.2398] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 07/30/2015] [Indexed: 12/21/2022]
Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
- Faculty of Medicine and Health Sciences (CAPRI); University Antwerp; Antwerp Belgium
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| |
Collapse
|