Steven D Schwaitzberg, MD, Muhammed Nadeem, MBBS, Jeffrey M Lackner, PsyD, Alan R Posner, MD, Gabrielle N Yee, MS. Jacobs School of Medicine and Biomedical Sciences
Introduction: When severe obesity remains refractive to medical management, bariatric surgery can provide the most rapid relief. However, long-term weight and body fat loss following bariatric surgery in relation to psychiatric variables is unclear. Identifying patients at risk for postoperative failure can provide opportunities for targeted intervention. We hypothesized that higher levels of social support in bariatric surgery patients would correlate positively with postoperative weight loss, body fat loss, and realistic outcomes.
Methods: We performed a retrospective chart review of 60 patients who completed preoperative psychiatric interviews and underwent laparoscopic sleeve gastrectomy, band, or bypass surgery for morbid obesity at Buffalo General Medical Center. Patients who received previous bariatric surgery or intravenous nutrition within one year postoperatively were excluded. We used linear regression analyses to compare levels of reported preoperative social support and weight loss expectations with 1, 3, 6, and 12 month postoperative weight loss, body fat loss, and ratio of actual to expected weight loss.
Results: Preoperative patient expectations were not significantly associated with postoperative weight loss, body fat loss, or ratio of actual to expected outcomes at 1, 3, 6, or 12 months. Additionally, social support was not significantly associated with postoperative weight loss or ratio of actual to expected outcomes at these same time points. Social support was not correlated with body fat loss at 3, 6, or 12 months postoperative. However, the number of people that patients reported being able to talk to when upset about their weight was a positive predictor of body fat loss immediately following bariatric surgery. Patients who reported higher numbers of social support lost significantly more body fat 1 month postoperative compared to those who had fewer people to talk to (p = 0.012). After accounting for age and gender, this relationship was no longer significant.
Conclusions: The finding that preoperative patient expectations are not a function of bariatric surgery outcomes is consistent with the current literature. However, higher levels of social support are a clear health promotion benefit for immediate postoperative body fat loss outcomes. Cognitive meaning associated with larger support systems may allow healthcare providers to identify bariatric surgery candidates at risk of postoperative failure. Preoperative protocols to encourage identification and maintenance of social support systems should be considered to reduce the likelihood of bariatric postoperative failure and improve patient outcomes.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77709
Program Number: P657
Presentation Session: Poster (Non CME)
Presentation Type: Poster