A preoperative relational screener and associations with weight loss: A pilot feasibility study

Family factors and stressful life events are reasons for not proceeding immediately with metabolic and bariatric surgery, yet there is no formal screening for these factors during routine preoperative psychological evaluation. This pilot study determined the feasibility of implementing a preoperative relational screener and referral to a behavioral health consultation, and associations between relational factors with 12-month weight loss.

Preoperative patients (N = 137) were asked to participate. Feasibility was noted by interest, completion of screener, screening as impaired on the relational measures, and completion of consultation. For patients proceeding to surgery, five models were conducted to determine changes in percent total weight loss (%TWL) over 12 months, based on the interaction with visits and screening as impaired, family functioning, stressful life events, death of a close friend or relative, and major financial crisis.

Sixty-seven patients were interested; 57 completed the screener (85.1%, 79% female, 72% White); 43 screened (75.4%) as impaired on ≥ 1 assessment and were eligible for the consultation, 21 patients (48.8%) completed the consultation. Patients who screened as impaired had poorer %TWL (p = .013) compared to patients who did not. Patients with ≥ 1 stressful life event had poorer %TWL compared to those who did not experience any (p = .008), including the top two endorsed events-death of a close friend (p ≤ .001) or a major financial crisis (p = .009).

The relational screener provides additional information about patients' psychosocial needs and challenges before surgery. This is critical considering the majority of participants screened as impaired on at least one assessment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).