Personality trait associations with quality-of-life outcomes following bariatric surgery: a systematic review

Health-Related Quality of Life and the Role of the Big Five Personality Traits in Postlingually Deaf Cochlear Implant Users

PURPOSE

This study aimed to investigate the relationships between generic health-related quality of life (HRQoL), the Big Five personality traits, speech understanding, and sociodemographic factors in a group of postlingually deaf cochlear implant (CI) users.

METHOD

The study group included 81 participants who met the inclusion criteria: profound sensorineural hearing loss, 18 years of age or more, and using at least one CI implanted after 18 years of age. Some 18% were bilateral CI users. The mean age of the participants was 60 ± 11 years. They completed the Assessment of Quality of Life (AQoL-8D) and the Short Form IPIP-BFM-20 (shortened version of the 50-item Big Five Markers Questionnaire from the International Personality Item Pool). The response rate was 57%.

RESULTS

The HRQoL was lower in the study group than in the general population. Moreover, all Big Five personality characteristics were significantly lower than the Polish norm. The personality traits of intellect/imagination, emotional stability, and extraversion contributed to higher overall HRQoL scores, particularly for most psychosocial AQoL-8D dimensions. Higher agreeableness predicted higher HRQoL in the Independent Living, Pain, Coping, and Relations dimensions, whereas higher extraversion predicted higher physical HRQoL in the Senses dimension. Better speech understanding in quiet and noisy environments correlated with better physical HRQoL. Additionally, male gender and higher education were linked to higher global HRQoL. Conversely, being female was associated with lower global psychosocial and physical HRQoL, particularly in Pain. Higher education also contributed to improved physical HRQoL.

CONCLUSIONS

In general, CI users have lower physical and psychosocial HRQoL as well as in measures that depend on personality traits. In terms of physical HRQoL, speech understanding plays an important role. It might prove useful if CI candidates and users were given a Big Five personality evaluation and an HRQoL assessment based on which they might be offered counseling or psychological intervention.

Does Patient's Metabolic and Bariatric Surgery Knowledge Predict Optimal Clinical Outcomes?

PURPOSE

Preoperative evaluation and educational training are required before metabolic and bariatric surgery. This study evaluates patient's comprehension prior to the operation and identifies the relationship between certain sociodemographic parameters and surgery outcomes.

MATERIALS AND METHODS

An analysis of patients who completed a preoperative questionnaire and underwent metabolic and bariatric surgery between 2019 and 2021 was performed. The questionnaire evaluated surgery preparation and factors influencing weight loss after surgery.

RESULTS

In total, 81 patients completed the preoperative questionnaire. Mean age was 44 ± 11.69 years, 63 females (77%). Mean BMI was 42.85 ± 5.72 kg/m2. Roux-en-Y gastric bypass, sleeve gastrectomy, and one anastomosis gastric bypass was performed in 10 (12.3%), 28 (34%), and 43 (53%) patients respectively. Out of the patients, 38 (47%) were Israeli born Jews, 14 (17.3%) were Russian born Jews, and 29 (35.8%) were Israeli born Arabs. Mean follow-up was 30.71 ± 8.66 months. Questionnaire scores average was 67.7 ± 16.15. Based on univariate analysis, younger, single, higher educated, fewer offspring, and Israeli born Jews significantly scored higher in the questionnaire (p = 0.03, 0.05, 0.01, 0.0002, 0.02 respectively). Postoperational weight loss was significantly inferior among older patients, revisional procedures, and patients with lower educational levels (p = 0.02, 0.006, 0.05 respectively). Patients with a higher BMI, and fewer offspring had a significantly higher weight loss postoperatively (p = 0.0001, 0.02 respectively).

CONCLUSION

The number of factors can influence optimal weight loss following metabolic and bariatric surgery. Identifying groups with certain characteristics and addressing their weaknesses may improve weight loss outcomes.

Longitudinal trajectories and psychological predictors of weight loss and quality of life until 3 years after metabolic and bariatric surgery

OBJECTIVE

This study aimed to describe longitudinal trajectories of Total Weight Loss (%TWL), and mental and physical health related quality of life (HRQOL), as well as to identify preoperative psychological predictors of these trajectories.

METHODS

A prospective observational study including Dutch patients treated with metabolic and bariatric surgery (n = 420, age 44.8 ± 10.3 years, 78.6% females) was performed. Trajectories of %TWL and HRQOL from screening to 1-, 2-, and 3-years post-surgery were described using growth mixture modelling. Multivariable and lasso regression models were used to identify predictors.

RESULTS

Three trajectories described %TWL, varying in the degree of first-year weight loss. No pre-surgical psychological factors were associated with %TWL trajectories. We identified four physical and five mental HRQOL trajectories. Approximately 25-30% of patients exhibited patterns of initial improvements followed by decline, or persistently low levels of HRQOL. Higher depressive symptoms were associated with these unfavourable physical HRQOL trajectories (OR 1.20, 95%CI 1.04-1.39), adjusted for confounders. Unfavourable mental HRQOL trajectories were predicted by depressive and anxiety symptoms, neuroticism, insecure attachment, and maladaptive coping. In contrast, self-esteem, extraversion, and conscientiousness were associated with favourable mental HRQOL trajectories.

DISCUSSION

Psychological factors did not predict weight loss, but they significantly impacted patient's HRQOL after metabolic and bariatric surgery. A subgroup with unsuccessful HRQOL after surgery was identified, who would benefit from tailored preoperative counselling to optimize surgery outcomes. Metabolic and bariatric surgery may not be universally beneficial for all patients, challenging the conventional approach to surgical interventions for severe obesity and advocating for a more nuanced, individualized assessment of potential candidates.

Personality Profiles Associated with Long-Term Success in Bariatric Surgery: 24-Month Follow-Up

(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.

Long-term effectiveness, outcomes and complications of bariatric surgery

Dietary imbalance and overeating can lead to an increasingly widespread disease - obesity. Aesthetic considerations aside, obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases, including diabetes; hypertension; atherosclerosis; coronary artery disease and stroke; obstructive sleep apnea; depression; weight-related arthropathies and endometrial and breast cancer. A body weight 20% above ideal for age, gender and height is a severe health risk. Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet, increased physical activity, behavioral changes and drugs have failed. The two most common procedures currently used are sleeve gastrectomy and gastric bypass. This procedure has gained popularity recently and is generally considered safe and effective. Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved, more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures. This review aims to synthesize and summarize the growing evidence on the long-term effectiveness, outcomes and complications of bariatric surgery.