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Baseline Psychosocial, Environmental, Health, and Behavioral Correlates of 1- and 3-Year Weight Loss After Bariatric Surgery

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Abstract

Purpose

Weight loss surgery is an effective, long-term treatment for severe obesity but individual response to surgery varies widely. The purpose of this study was to test a comprehensive theoretical model of factors that may be correlated with the greatest surgical weight loss at 1–3 years following surgery. Such a model would help determine what predictive factors to measure when patients are preparing for surgery that may ensure the best weight outcomes.

Materials and Methods

The Bariatric Experience Long Term (BELONG) study collected self-reported and medical record-based baseline information as correlates of 1- and 3-year % total weight loss (TWL) in n = 1341 patients. Multiple linear regression was used to determine the associations between 120 baseline variables and %TWL.

Results

Participants were 43.4 ± 11.3 years old, Hispanic or Black (52%; n = 699), women (86%; n = 1149), and partnered (72%; n = 965) and had annual incomes of ≥ $51,000 (60%; n = 803). A total of 1006 (75%) had 3-year follow-up weight. Regression models accounted for 10.1% of the variance in %TWL at 1-year and 13.6% at 3 years. Only bariatric operation accounted for a clinically meaningful difference (~ 5%) in %TWL at 1-year. At 3 years after surgery, only bariatric operation, Black race, and BMI ≥ 50 kg/m2 were associated with clinically meaningful differences in %TWL.

Conclusions

Our findings combined with many others support a move away from extensive screening and selection of patients at the time of surgery to a focus on improving access to this treatment.

Graphical Abstract

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Data Availability

Data may be available to others for research contingent on the following: funding for scientists and researchers at the healthcare system in which the data was collected, data use agreements governing the use of the data, and human subjects approval for data transfer and storage methods to protect the confidentiality of participants.

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Funding

This work was funded by an award from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) No. R01DK108522 and No. R01MD013874 from the National Institute on Minority Health and Health Disparities (NIMHD).

Author information

Authors and Affiliations

  1. College of Nursing, University of South Florida, Tampa, FL, USA

    Ming Ji

  2. Kaiser Permanente Southern California Department of Research and Evaluation, 100 S. Los Robles, Pasadena, CA, 91101, USA

    Sonya L. Negriff, Jeff M. Slezak, Brianna L. Taylor, Silvia R. Paz, Bhumi B. Bhakta, Mayra Macias, Deborah R. Young & Karen J. Coleman

  3. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    David E. Arterburn

  4. Kaiser Permanente Southern California Regional Nursing Research Program, Pasadena, CA, USA

    Cecelia L. Crawford

  5. Center for Public Health Nutrition, University of Washington, Seattle, WA, USA

    Adam Drewnowski

  6. Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA

    Kristina H. Lewis

  7. Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, IL, USA

    Darren D. Moore

  8. Department of Surgery, Center for Obesity Medicine & Metabolic Performance, University of Texas McGovern Medical School, Houston, TX, USA

    Sameer B. Murali

  9. Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA

    Karen J. Coleman

Authors
  1. Ming Ji
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Corresponding author

Correspondence to Karen J. Coleman.

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Ethical Approval

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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All participants gave verbal consent at the time of recruitment.

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Key Points

• One hundred twenty baseline variables accounted for only 13.6% of weight loss at 3 years.

• Only operation type, Black race, and BMI ≥ 50 kg/m2 were clinically meaningful.

• Baseline modifiable characteristics predict small weight loss variations (1–3%).

• This supports less pre-selection of patients and a focus on improving access.

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Ji, M., Negriff, S.L., Slezak, J.M. et al. Baseline Psychosocial, Environmental, Health, and Behavioral Correlates of 1- and 3-Year Weight Loss After Bariatric Surgery. OBES SURG 33, 3198–3205 (2023). https://doi.org/10.1007/s11695-023-06791-0

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  • DOI: https://doi.org/10.1007/s11695-023-06791-0

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