The Bariatric Interprofessional Psychosocial Assessment of Suitability Scale (BIPASS): Predictive Validity for Outcomes 1 and 2 Years Following Bariatric Surgery

Molly Atwood

doi:10.32920/ryerson.14643789

Abstract

Bariatric surgery is the most effective intervention for severe obesity; however, many patients demonstrate insufficient and/or unsustained weight loss, and unsatisfactory psychosocial functioning in the longer-term. Although it is well established that attendance at postsurgical follow-up appointments is integral to sustained weight loss, nonadherence to follow-up is common. Consequently, presurgical psychosocial evaluations are conducted in order to identify patients at high risk of poor outcomes. Yet, no consensus has been established regarding a standardized protocol for the assessment of variables relevant to surgical outcomes, and bariatric programs vary widely in their interpretation of psychosocial risk. In addition, there is a paucity of research examining the predictive utility of psychosocial evaluations. The Bariatric Interprofessional Psychosocial Assessment of Suitability Scale (BIPASSTM), a novel psychosocial evaluation tool, was developed to address these issues. The purpose of the present study was to contribute to the validation of the BIPASS tool via two aims: 1) by examining the psychometric properties of the BIPASS, and; 2) by examining the ability of the BIPASS tool to predict outcomes 1 and 2 years following bariatric surgery, including weight loss and weight regain, quality of life, psychiatric symptoms, and adherence to postsurgical follow-up appointments. The BIPASS was applied retrospectively to the charts of 200 consecutively referred patients of the Toronto Western Hospital Bariatric Surgery Program (TWH-BSP). Factor analysis of BIPASS items revealed a two-factor structure, reflecting “Mental Health” and “Patient Readiness” subscales. Internal consistency for the BIPASS Total and subscale scores ranged from poor to good, and inter-rater reliability was excellent. Higher BIPASS scores significantly predicted higher binge eating symptomatology, and lower physical and mental health-related quality of life at 1 year postsurgery. The BIPASS did not predict any outcome variables at 2 years postsurgery, or adherence to postsurgical follow-up appointments. Findings suggest that the BIPASS can be used to identify patients at increased risk of problematic eating and poor health-related quality of life early in the postsurgical course, thereby facilitating appropriate interventions.

Highlights

Overview of Obesity: Prevalence, Classification, and Associated ConsequencesWithin the medical field, obesity is considered a chronic medical condition characterized by the accumulation of excess adipose tissue, to the extent that it might have detrimental effects on health
The purpose of the present study was to contribute to the validation of the Bariatric Interprofessional Psychosocial Assessment of Suitability Scale (BIPASS) tool via two aims: 1) by examining the psychometric properties of the BIPASS, and; 2) by examining the ability of the BIPASS tool to predict outcomes 1 and 2 years following bariatric surgery, including weight loss and weight regain, quality of life, psychiatric symptoms, and adherence to postsurgical follow-up appointments
The purpose of the present study was to contribute to the validation of the BIPASS, a novel presurgical psychosocial assessment tool, by: 1) examining the psychometric properties of the BIPASS, and; 2) examining the ability of the BIPASS to predict weight, quality of life, psychiatric symptom, and adherence outcomes 1 and 2 years following bariatric surgery

Summary

Introduction

Overview of Obesity: Prevalence, Classification, and Associated ConsequencesWithin the medical field, obesity is considered a chronic medical condition characterized by the accumulation of excess adipose tissue, to the extent that it might have detrimental effects on health. Rates of obesity have steadily increased worldwide over the past several decades (Ng et al, 2014). The most recent estimates of national prevalence indicate that approximately 35% of adults in the United States are obese (Ogden, Carroll, Kit & Flegal, 2014). Approximately 18% of the adult population in Canada is obese, a number that is projected to continue rising over the few years (Twells, Gregory, Reddigan, & Midodzi, 2014). According to the National Institute for Health and Care Excellence (NICE, 2014) guidelines, Body Mass Index (BMI) determines weight categories. “healthy weight” is defined as a BMI between 18.5 kg/m2 and 24.9 kg/m2. The prevalence of class I and class II obesity in the United States has stabilized over the past decade, the prevalence rate of class III obesity continues to increase (Sturm & Hattori, 2013)

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