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Guiding Patients Toward the Appropriate Surgical Treatment for Obesity: Should Presurgery Psychological Correlates Influence Choice Between Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy?

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ABSTRACT

Background

Helping patients determine which type of bariatric surgery, Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), may be the best treatment can be challenging. This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG.

Methods

Four hundred twenty-two patients (RYGB = 305; VSG = 117) completed screening questionnaires presurgery and underwent surgery between August 2012 and April 2015. Associations between demographics and questionnaires with percentage weight change were evaluated using multivariable linear regression models.

Results

Median age was 48 years and median BMI 45.3 kg/m2 presurgery. Median percentage changes in weight from baseline to years 1 and 2 follow-up were − 31.5% (range − 52.2 to − 9.2%) and − 31.2% (range − 50.0 to − 1.2%) for RYGB and 25.3% (range − 49.8 to − 4.7%) and − 23.3% (range − 58.9 to − 1.6%) for VSG, respectively. Linear regression models revealed that younger patients lost more weight than older patients at years 1 (RYGB p < 0.0001; VSG p = 0.0001) and 2 (RYGB p = 0.005; VSG p = 0.002). No psychological correlates were significantly associated with weight loss outcomes. Post hoc analyses comparing patients who had surgery to those in the same cohort who did not have surgery revealed significantly higher rates of depression (p < 0.001), anxiety (p < 0.001), binge eating (p = 0.003), night eating (p < 0.001), food addiction (p = 0.042), and lower self-efficacy (p < 0.001) among patients who did not have surgery.

Discussion

Patients who are psychologically higher functioning are more likely to complete the evaluation process and undergo bariatric surgery. For patients who had surgery, psychological correlates were not associated with weight loss outcome for either RYGB or VSG. Implications for surgical choice are discussed.

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References

  1. Khorgami Z, et al. Trends in utilization of bariatric surgery, 2010-2014: sleeve gastrectomy dominates. Surg Obes Relat Dis. 2017. doi:10.1016/j.soard.2017.04.010.

  2. Fisher D et al. Mental illness in bariatric surgery: a cohort study from the PORTAL network. Obesity (Silver Spring). 2017;25(5):850–6.

    Article  Google Scholar 

  3. Mitchell JE, et al. Eating behavior and eating disorders in adults before bariatric surgery. Int J Eat Disord. 2014;48(2):215–22.

  4. Belle SH et al. Baseline characteristics of participants in the Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2013;9(6):926–35.

    Article  Google Scholar 

  5. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Spitzer RL et al. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

    Article  PubMed  Google Scholar 

  7. Saunders JB et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption—II. Addiction. 1993;88(6):791–804.

    Article  CAS  PubMed  Google Scholar 

  8. Spitzer RL, Yanovski S, Marcus MD. The questionnaire of eating and weight patterns-revised (QEWP-R). 1993;13(2):137–53.

  9. Gearhardt AN, Corbin WR, Brownell KD. Preliminary validation of the Yale Food Addiction Scale. Appetite. 2009;52(2):430–6.

    Article  PubMed  Google Scholar 

  10. Ames GE et al. Further statistical and clinical validity for the Weight Efficacy Lifestyle Questionnaire-Short Form. Eat Behav. 2015;18:115–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Gretchen E. Ames, Dustin M. Shepherd & Steven P. Bowers

  2. Department of Health Sciences Research, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    Michael G. Heckman & Nancy N. Diehl

  3. Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Allison A. Holgerson, Karen B. Grothe & Matthew M. Clark

  4. Department of Surgery, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Todd A. Kellogg

Authors
  1. Gretchen E. Ames
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  2. Michael G. Heckman
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  3. Nancy N. Diehl
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  4. Dustin M. Shepherd
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  5. Allison A. Holgerson
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  6. Karen B. Grothe
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  7. Todd A. Kellogg
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  8. Steven P. Bowers
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  9. Matthew M. Clark
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Corresponding author

Correspondence to Gretchen E. Ames.

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Funding

This research was supported by an award from the Mayo Clinic Campus in the Florida Comprehensive Focused Research Team (grant number 90085012). The Research Team had no role in the study design; collection, analysis, and interpretation of the data; writing of the manuscript; or the decision to submit the paper for publication.

Conflict of Interest

The authors declare that they have no competing interests.

Statement of Informed Consent

All patients signed the medical center authorization for release of medical information for clinical research purposes prior to undergoing bariatric surgery. For this type of study, formal consent is not required.

Statement of Human and Animal Rights

The study was approved by the medical center institutional review board. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ames, G.E., Heckman, M.G., Diehl, N.N. et al. Guiding Patients Toward the Appropriate Surgical Treatment for Obesity: Should Presurgery Psychological Correlates Influence Choice Between Roux-en-Y Gastric Bypass and Vertical Sleeve Gastrectomy?. OBES SURG 27, 2759–2767 (2017). https://doi.org/10.1007/s11695-017-2876-2

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  • DOI: https://doi.org/10.1007/s11695-017-2876-2

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