Psychological effects and outcome predictors of three bariatric surgery interventions: a 1-year follow-up study

Weight loss surgery efficacy has been demonstrated for morbid obesity. Different outcomes have been hypothesized, according to specific bariatric surgery interventions and psychological characteristics of obese patients. The present study compared three different surgery procedures, namely laparoscopic adjustable gastric band (LAGB), Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD), in terms of weight loss efficacy and psychological outcomes.

Eighty-three subjects seeking bariatric surgery have been evaluated before and 12 months after surgery intervention, by means of a clinical interview and different self-reported questionnaires, including Eating Disorder Examination Questionnaire, Emotional Eating Scale, Binge Eating Scale, Beck Depression Inventory, Symptom Checklist and State-Trait Anxiety Inventory.

BPD group (26 subjects) showed the greatest weight loss, followed by RYGB (30 subjects), and LAGB group (27 subjects). All the treatments were associated with a significant improvement of anxiety, depression, and general psychopathology, and a similar pattern of reduction of binge eating symptomatology. BPD group reported a greater reduction of eating disorder psychopathology, compared to the other groups. Pre-treatment emotional eating severity was found to be a significant outcome modifier for the three treatment interventions.

These results suggest that all the three types of bariatric surgery significantly improved psychopathology and eating disordered behaviors. They also support the importance of a pre-treatment careful psychological assessment in order to supervise the post-surgical outcome.