Association of Perceived Contributors to Weight Gain with Weight Loss After Metabolic and Bariatric Surgery

Metabolic and bariatric surgery (MBS) is the most effective and reliable treatment for weight loss and resolution of associated medical problems. However, postoperative weight loss outcomes vary, and psychological factors may contribute to these differences. In our practice, clinical psychologists assess patients' perceptions of major contributors to their weight gain prior to surgery, but limited research has examined how these perceptions relate to postoperative outcomes. Understanding this relationship may inform perioperative counseling and support individualized care plans.

This retrospective study included patients who underwent MBS at a single institution in 2019 and 2020. Patient responses describing perceived contributors to weight gain were coded using a combined inductive-deductive approach. Chi-square tests examined associations between perceived contributor categories. Univariate and multivariable regression models assessed the relationship between perceived contributors and percent total body weight loss (%TBWL) at 36 months post-surgery. Analyses were conducted in Stata 18.0 with p < 0.05 for significance.

The study included 73 patients with a mean baseline age of 44 years (SD = 13). Most participants were female, non-Hispanic, and identified as White. The mean %TBWL at 36 months post-surgery was 23.7 (SD = 11.7). In univariate regression analyses, perceived contributors such as genetics, environmental/occupational factors, and reporting more than 1 contributor were significantly or marginally associated with %TBWL. These associations were not significant in the multivariable model.

Prospective studies with larger, more diverse cohorts across multiple sites are needed to better clarify the relationship between perceived contributors to weight gain and MBS outcomes.