SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods

Abstract

Purpose This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods. Methods Adult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3–6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs. Results Factor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome. Conclusions SCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI. Level of evidence III, well-designed cohort.

Body Uneasiness, Body Figure Perception, and Body Weight: Factor Structure and Longitudinal Measurement Invariance of a Set of Attitudinal and Perceptual Body Image Assessment Tools in Adolescents

“…Regarding the discrepancy between ideal and normative weight, our findings are consistent with studies drawing attention to individuals, whether they clinically are obese or excessively underweight, who concurrently report a subjective ideal weight in the range of respectively unhealthy over-or under-weight, with potentially significant health consequences (Albert et al, 2022;Buscemi et al, 2018;Caterson et al, 2019;MacNeill & Best, 2015;Naghshizadian et al, 2014;Yaemsiri et al, 2011). Clinically, these studies suggest that individuals who tend to misperceive the ideal/health discrepancy of body weight are vulnerable to dysfunctional eating habits, to poor or excessive concern for their body weight (Caterson et al, 2019;MacNeill & Best, 2015;Yaemsiri et al, 2011) as well as to procrastinate in asking for professional help (Caterson et al, 2019;Yaemsiri et al, 2011).…”

Analysis of the mental health status of hospital staff during the COVID-19 pandemic

“…Symptom Checklist 90 (SCL-90) is a 90-item neuropsychological assessment tool which is frequently used both domestically and abroad [16]. This scale is the most frequently used screening scale for the examination of mental disorders and psychological disorders and has good reliability and validity [17,18]. The SCL-90 covers items involving psychiatric symptomatology such as sensation, emotion, thinking, consciousness, behaviour and lifestyle habits.…”

Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study

“…In fact, people suffering from obesity generally report a lower quality of life, higher stigmatization, higher psychological as well as psychiatric disturbances, worse body images, lower self-esteem, more eating disordered habits, and all these individual domains tend to improve after bariatric surgery, though leaving scars [ 3 , 10 , 11 , 19 ]. Nevertheless, there still need for empirical research on their effects on bariatric surgery outcome, because current findings tend to be not fully consistent in relation to how these pre-operative risk factors help predict post-intervention outcome [ 6 , 7 , 11 , 20 ]. In the current study, we focused our attention on individual attitudes towards body appearance, that is, a basic component of the higher order construct of body image, which also includes body perception and body-related behaviors [ 21 , 22 ].…”

“…Surgery, however, does not guarantee that bariatric patients reach and maintain a healthy weight over time. Indeed, post-bariatric weight loss depends on several pre-and post-operative factors, which include medical conditions, eating and physical habits, psychopathological profiles, interpersonal relationships, and body image [6][7][8][9][10][11][12].…”