Abstract
Background
To investigate the predictability and sustainability of weight loss in gastric bypass (GBP) surgery after the first year, we conducted a 3-year follow-up of patients who had already been comprehensively studied preoperatively and after 1 year.
Methods
Preoperative data had been obtained for 131 morbidly obese patients on a 273-item interview and five psychological assessment instruments, and some of these data had been obtained again after a mean of 12.8 months. For this study, weight data were obtained on 79 patients at a mean of 3.2 years postoperatively.
Results
Over the 1–3 year interval, mean simple weight loss and simple BMI decrease were essentially zero, compared with 45.61 kg and 16.52 respectively over the 0–1 year interval. Further, the 0–1 year and 1–3 year losses were uncorrelated. Optimal predictor variables for 1–3 year loss included three preoperative measures (expectation of increased self-confidence, amount of informational support, and total coping skills) plus functional eating behaviors after 1 year. Together they showed a multiple correlation of .55 with weight loss and .55 with BMI change. These predictors differed from the predictors of change over 0–1 year, and they continued to be significant after controlling for several preoperative characteristics.
Conclusions
The factors influencing long-term continuing weight loss after GBP are different from those influencing initial loss, and involve positive characteristics such as skills, information, and expectations. The results suggest the importance of actively teaching such skills during the first postoperative year.
Similar content being viewed by others
References
Powell LH, Calvin JE III, Calvin JE Jr. Effective obesity treatments. Amer Psychol. 2007;62:234–46.
Lanyon RI, Maxwell B. Predictors of outcome after gastric bypass surgery. Obes Surg. 2007;17:321–8.
Herpertz S, Kielmann R, Wolf AM, et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obesity Res. 2004;12:1554–69.
van Hout GCM, Verschure KM, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg. 2005;15:552–60.
Butcher JN, Dahlstrom WG, Graham J, et al. MMPI-2: manual for administration and scoring. Minneapolis: University of Minnesota Press; 1989.
Jackson DN. Basic Personality Inventory: manual. Port Huron: Sigma Assessment Systems; 1989.
Beck AT, Steer RS, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77–100.
Ruehlman LS, Lanyon RI, Karoly P. Multidimensional Health Profile: professional manual. Odessa: Psychological Assessment Resources; 1998.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders-IV-TR. Washington, DC: APA; 1964.
West SG, Finch JF, Curran PJ. Structural equation models with nonnormal variables: problems and remedies. In: Hoyle RH, editor. Structural equation modeling: concepts, issues, and applications. Thousand Oaks: Sage; 1995.
Bandura A. Self-efficacy: the exercise of control. New York: Freeman; 1997.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lanyon, R.I., Maxwell, B.M. & Kraft, A.J. Prediction of Long-term Outcome after Gastric Bypass Surgery. OBES SURG 19, 439–445 (2009). https://doi.org/10.1007/s11695-008-9740-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-008-9740-3