Psychological functioning and well-being before and after bariatric surgery; what is the benefit of being self-compassionate?

Johanna Eveliina Pyykkö,Ömrüm Aydin,Max Nieuwdorp,Robbert Sanderman,Albert K Groen,Arnold W Van De Laar,Victor E A Gerdes,Mariët Hagedoorn,Yaïr I Z Acherman

doi:10.1111/bjhp.12532

Abstract

ObjectiveTo investigate whether patients’ psychological well‐being (depression, quality of life, body image satisfaction) and functioning (self‐efficacy for eating and exercising behaviours and food cravings) improve 12 months after bariatric surgery and whether self‐compassion is associated with better psychological outcomes and lower weight after bariatric surgery.DesignLongitudinal, prospective observational study.MethodsBariatric patients (n = 126, 77.8% female, 46.4 ± 10.8 years) completed the Self‐compassion Scale, Center for Epidemiology Studies Depression Scale, Impact of Weight on Quality‐of‐Life questionnaire, Body Image Scale, Weight Efficacy Lifestyle Questionnaire, Spinal Cord Injury Exercise Self‐Efficacy Scale, and G‐Food Craving Questionnaire pre‐operatively and 12 months post‐operatively. A medical professional measured patients’ weight during each assessment. Data were analysed using repeated measures t‐tests and multivariate regression analyses with Benjamini–Hochberg correction for multiple testing.ResultsPatients’ BMI, depression, and food cravings decreased significantly after surgery while quality of life, body image satisfaction, and self‐efficacy to exercise improved. Higher self‐compassion was associated with lower post‐operative depression, greater quality of life, higher body image satisfaction, and better self‐efficacy for eating behaviours (p‐values <.05) but not with post‐operative BMI, self‐efficacy to exercise, or food cravings.ConclusionsEven though pre‐operative self‐compassion was not directly associated with a lower 12‐month post‐operative BMI, it had a positive relationship with patients’ post‐operative well‐being and self‐efficacy for controlling eating behaviour. In turn, this could help patients to manage their health long after bariatric surgery. Further work regarding the role of self‐compassion on long‐term health outcomes would be worthwhile.

Highlights

Bariatric surgery is an effective treatment method for severe obesity, leading to an average of 25% loss of patients’ initial weight at 10 years after the surgery (Maciejewski et al, 2016; Sjostrom, 2013)
To understand why some patients seem to benefit less from bariatric surgery than other patients, this study examined the predictive role of self-compassion on psychological health outcomes and body mass index (BMI) after bariatric surgery
The laparoscopic Roux-en-Y gastric bypass was performed on 120 patients, and the laparoscopic omega-loop gastric bypass for the remaining six patients included in this study

Summary

Introduction

Bariatric surgery is an effective treatment method for severe obesity, leading to an average of 25% loss of patients’ initial weight at 10 years after the surgery (Maciejewski et al, 2016; Sjostrom, 2013). Insufficient weight loss or even weight regain can occur as early as 6 months post-surgery (Courcoulas et al, 2013; King, Hinerman, Belle, Wahed, & Courcoulas, 2018; Sjostrom, 2013), with 20–34% of patients reaching suboptimal weight loss 5 years after bariatric surgery (de Hollanda et al, 2015; Hsu et al, 1998). To understand why some patients seem to benefit less from bariatric surgery than other patients, this study examined the predictive role of self-compassion on psychological health outcomes and BMI after bariatric surgery

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Results

Discussion

Conclusion