The Impact of Impulsivity on Weight Loss Four Years after Bariatric Surgery

Nutrients

Maximilian von Feilitzsch¹  Eva-Maria Skoda²  Martin Teufel²  Stephan Zipfel²  Katrin E. Giel²  Kathrin Schag²  Sabrina Ölschläger²  Isabelle Mack² 

[1] Department of General, Visceral and Transplant Surgery, University of Tübingen, 72076 Tübingen, Germany;Medical Hospital, Department of Psychosomatic Medicine and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany;

关键词: weight loss;    bariatric surgery;    impulsivity;    depression;    eating behavior;   

DOI  :  10.3390/nu8110721

来源: DOAJ

【 摘 要 】

Bariatric surgery has serious implications on metabolic health. The reasons for a failure of bariatric surgery, i.e., limited weight loss, are multifactorial and include psychological factors. We established a theoretical model of how impulsivity is related to weight loss outcome. We propose that depressive symptoms act as a mediator between impulsivity and pathological eating behavior, and that pathological eating behavior has a direct impact on weight loss outcome. We calculated excessive weight loss (%EWL) and assessed self-reported impulsivity (using the Baratt Impulsiveness Scale (BIS-15) total score), depressive symptoms (the Patient Health Questionnaire (PHQ-9) score), and pathological eating behavior (the Eating Disorder Inventory 2 (EDI-2) total score) in 65 patients four years after laparoscopic sleeve gastrectomy. Regression and mediation analyses were computed to validate the theoretical model. The BIS-15, PHQ-9, and EDI-2 have medium to high correlations between each other, and EDI-2 correlated with %EWL. The mediation analysis yielded that the PHQ-9 represents a significant mediator between BIS-15 and EDI-2. The regression model between EDI-2 and %EWL was also significant. These results support our theoretical model, i.e., suggest that impulsivity has an indirect impact on weight loss outcome after bariatric surgery, mediated by depression and transferred through pathological eating behavior. Thus, the underlying psychological factors should be addressed in post-operative care to optimize weight loss outcome.

【 授权许可】

Unknown