Life after bariatric surgery: psychosocial and behavioural characteristics and their effect on weight and well-being

Background: Bariatric surgery (BS) is an effective weight-loss treatment for severe obesity, leading to great weight reduction and long-term improvement in physical and psychological health. A subgroup of patients, however, reach unsatisfactory weight loss results. The aims of this research are to investigate: 1. The impact of BS on psychological well-being [e.g. health-related quality of life (HR-QoL), depression] over time, and 2. psychological factors (e.g. food craving, body image satisfaction, self-efficacy, attachment style and neuroticism) which may predict short- and long-term surgical outcomes. Currently, the field lacks testable hypotheses as well as conclusive findings about predictors of surgical outcomes.
Method: Medical, psychosocial and behavioural factors are measured from obese patients admitted to Roux-en-Y gastric bypass before and 6-, 12- and 24-months after the surgery. Multivariate regression analyses will be used to answer the research questions.
Expected results: We expect HR-QoL to improve and depressive symptoms to ameliorate as weight decreases. Furthermore, we expect higher food craving, body image satisfaction and negative affect to be important predictors of small weight loss, but which will also change for better as weight decreases.
Current stage of work: A prospective, longitudinal study involving a multidisciplinary research team was initiated in September 2016 in Amsterdam and over 200 patients have been included so far.
Discussion: This study will contribute in constructing a theory about weight loss after BS. Knowledge about psychological predictors of surgical outcomes will aid in patient screening and designing additional interventions aimed at supporting long-term weight maintenance after BS (e.g. eHealth).