Abstract
BackgroundWhile bariatric surgery is an effective therapy for patients with severe obesity, not all patients benefit equally. An explanation might be that psychosocial risk factors hamper outcome. The study aimed to evaluate if biopsychosocial case complexity predicts evolution of BMI over 10 years after bariatric surgery.MethodsCharts of patients (N = 236) of the Cohort of Obesity Lausanne (COOL) were retrospectively reviewed and rated with the INTERMED, a reliable and validated instrument, which assesses biopsychosocial case complexity and has been proven to predict outcome of medical treatments in different patient populations. The sample was stratified into BMI quartiles, computed from the patients’ baseline BMI. For each quartile, BMI evolution was analyzed using individual growth curve analysis.ResultsGrowth curve analyses showed that in quartiles 1, 2, and 3, none of the INTERMED domain scores significantly predicted the BMI evolution after surgery. However, in the fourth quartile—including patients with the highest pre-surgical BMI—the social domain score of the INTERMED significantly predicted BMI evolution: patients with more social complexity showed higher increase in BMI.ConclusionEffectiveness of interventions targeted at social complexity, especially when patients suffer from severe obesity, may therefore be evaluated in future studies.Graphical abstract
Highlights
Obesity, defined as excessive fat accumulation that may impair health, concerns 650 million of adult aged 18 years and over [1]
A comparison between the unconditional model and the model including the social domain score as covariate shows that the social domain score explains 9% of the variance in growth rates. This is the first study which uses the INTERMED in a population of patients with obesity
All except the quartile with the highest baseline BMIs showed low outcome variation, which may explain the limits of the INTERMED regarding outcome prediction
Summary
Obesity, defined as excessive fat accumulation that may impair health, concerns 650 million of adult aged 18 years and over [1]. Treatments for obesity include lifestyle interventions, pharmacotherapy, and bariatric surgery [3]. Many individuals struggle to maintain weight loss with lifestyle interventions, and the landscape of obesity pharmacotherapies is rapidly changing, the long-term results of treatments like GLP-1 analogs has yet to be demonstrated [4, 5]. Bariatric surgery achieves sustained reduction in weight, improvement of co-morbidities, and prolonged survival [6]. While bariatric surgery is an effective therapy for patients with severe obesity, not all patients benefit . The study aimed to evaluate if biopsychosocial case complexity predicts evolution of BMI over 10 years after bariatric surgery
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