Abstract
Objective:
A growing number of patients require revisional procedure due to inadequate weight loss after primary bariatric surgery. Psychological factors and eating disorder are frequently blamed to be responsible for poor weight loss results after both primary and revisional surgery. The aim of our study was to determine whether preoperative psychological factors, personality disorders (PDs), and eating behaviors of revisional surgery candidates differ from primary bariatric surgery candidates.
Methods:
From November 2013 to June 2015, 122 candidates to bariatric surgery had an extensive psychological assessment and were included in the study. Patients were evaluated using different autoquestionnaires to assess psychological factors (13-item Short Beck Depression Inventory, Hospital Anxiety and Depression Scale, Cohen Perceived Stress Scale, Rathus Assertiveness Schedule, Rosenberg Self-Esteem Scale), eating behaviors (Bulimic Investigatory Test, Edinburgh, Yale Food Addiction Scale), and PD (SCID-II). Data were compared between both groups (primary vs. revisional procedures).
Results:
Eighty-nine (73%) subjects were candidates for primary bariatric surgery and 33 (27%) subjects for revisional procedure due to insufficient weight loss. Preoperative psychological factors and also eating behaviors did not differ significantly between primary and revisional surgery candidates. The borderline personality disorder (BDL PD) appeared to be twice as frequent in revisional surgery candidates (37% vs. 19%, respectively, p = 0.02).
Discussion:
Unexpectedly, we found that eating habits did not make the difference. Looking for BDL disorders and especially impulsivity personality traits seems relevant, as it appears to be a special trait of candidates for revisional procedure and could compromise further weight loss.
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