The relationship of presurgical Personality Assessment Inventory scales to BMI following bariatric surgery.

Abstract

Objective: Notwithstanding the efficacy of bariatric surgery in reducing the negative sequelae of obesity, psychological factors may play a significant role in long-term weight maintenance following surgery. Previous research on these factors has shown mixed outcomes, indicating the need for further study in samples undergoing bariatric surgery. Method: This study evaluated archival data for 194 patients from a single-payer system for a 60-month period following bariatric surgery to examine how presurgical scores on the Personality Assessment Inventory predict body mass index (BMI) over time. Follow-up data was available on 97% of these patients at 12 months and 62% of these patients at 60 months. Hierarchical linear modeling was used to predict BMI based on demographic and psychopathology factors using linear and nonlinear coefficients while controlling for initial BMI. Results: Results showed that Personality Assessment Inventory scales assessing anxiety-related disorders, mania, and alcohol problems showed a relationship to BMI outcomes over time. Contrary to expectations, moderate elevations on anxiety-related disorders and mania were associated with a greater initial linear trend for BMI decrease, with a steeper slope for weight regain after approximately 3 years. Patients endorsing any scores above the minimum on the alcohol problems scale showed poorer BMI outcomes. Conclusions: This study extends previous research on psychological factors and weight outcomes over time among patients undergoing bariatric surgery. In contrast to a focus on clinical elevations when using broadband measures of psychopathology, these results suggest a more nuanced pattern of weight loss and subsequent regain associated with certain subclinical elevations.

Trending Weight Loss Between Usual Care and Bariatric Surgery Among Higher Weight Persons With Obstructive Sleep Apnea

“…Our results coincide with previously published weight reduction studies. In particular, Hoyt and Walter [ 10 ] found that initial BMI was the best predictor of subsequent BMIs across time. A randomized controlled trial followed diabetic patients with OSA on dietary weight loss for 10 years [ 11 ].…”

Prevention and management of postinterventional weight regain

“…Zusätzlich mindestens 2 Einheiten mit muskelkräftigender Bewegung (je mindesten 10 min) Reduktion der sitzenden Tätigkeiten Erhöhung der Alltagsaktivität 2.5. Psychologische Maßnahmen [ 40 ] Eingeübte Verhaltensänderungsstrategien [ 41 ] und Zielorientierung [ 42 ] evaluieren Reflexion von individuellem Emotions- und Stressmanagement [ 42 ] sowie Evaluierung der Copingstrategien (u. a. Entspannungstraining, Achtsamkeitsübungen) und der Rückfallprophylaxe Intrinsische Motivation [ 24 ], Selbstführsorge und Selbstwirksamkeit fördern und stärken Spezielle Aspekte, die bei PatientInnen nach bariatrischer Operation besonders berücksichtigt werden sollten: – Jegliche Psychopathologie kann das Outcome beeinflussen [ 43 – 45 ] – Abklärung der Suizidalität [ 44 , 46 – 48 ] – Suchtverlagerung [ 36 ], Substanzmissbrauch und selbstschädigendes Verhalten [ 43 , 46 – 50 ] – Förderung des positiven Einflusses von psychosozialen Interventionen [ 48 ] – Abklärung traumatischer Erlebnisse [ 25 ] – Längerfristige postoperative Begleitung begünstigt den Erhalt der Gewichtsreduktion [ 51 ] Bei Vorhandensein von psychischen Erkrankungen und/oder psychopharmakologischer Medikation empfiehlt sich bereits präinterventionell und insbesondere bei Auftreten einer postinterventionellen Gewichtszunahme und/oder Verschlechterung des psychischen Befindens eine rasche Kontaktaufnahme mit der/dem behandelnden PsychologIn und FachärztIn Exploration psychischer Befindlichkeiten und klinischer Symptome (Entwicklung von psychischen Störungen, Suchtverlagerung hin zu substanzgebundenen und -ungebundenen Süchten) [ 52 ] Auffälligkeiten im Ess- und Trinkverhalten, die eine Gewichtszunahme begünstigen, abklären und bearbeiten (u. a. Craving, Grazing, Nibbling, Loss of Control Eating, Overeating, Emotional Eating, Chewing and Spitting, Night-Eating-Syndrom) 2.6. Medizinische Maßnahmen Anpassung der Medikation an den Therapieverlauf und Begleiterkrankungen Fortführung bzw.…”

Multimethod psychological assessment of women undergoing bariatric surgery

“…Current assessment practices rely greatly on assessing psychopathology. Still, consistent evidence implicates that self-regulatory and personality processes are straightly related to obesity development and severity and might mediate the relationship between obesity and psychopathology (Claudon et al, 2012;Federico et al, 2019;Hoyt & Walter, 2022;Micanti et al, 2017;Monell et al, 2020;Parcet et al, 2020;Schäfer et al, 2017;Stapleton et al, 2020;Strimas, 2021;Wolz et al, 2015). Similarly, many studies with patients submitted to surgery provide evidence that the individuals' ability to adapt to changes after surgery and adhere to behavioral and clinical interventions are better predictors of weight-loss maintenance than specific psychopathology (Carlson, 2017;Eynde et al, 2021;Hout et al, 2005Hout et al, , 2009Raman et al, 2013;Robitzsch et al, 2020).…”

“…Additionally, several behavioral aspects are considered important contributors to WR, especially concerning insufficient physical activity and disordered eating behaviors. These factors are directly connected to psychological factors that increase the risk for weight recidivism, such as the presence of psychiatric disorders (Freire et al, 2021), personality features (Hoyt & Walter, 2022;Neff et al, 2021), cognitive and emotional functioning (Efferdinger et al, 2017;Manderino et al, 2015;Spitznagel, Garcia, et al, 2013;Spitznagel et al, 2014).…”

“…that self-confidence, ambitiousness, and better coping strategies to deal with negative affects have better outcomes (Hoyt & Walter, 2022).…”