Background

Patients with severe obesity often have medical conditions impacting longevity and quality of life. Bariatric surgery is the most effective obesity treatment. Patients lose up to 60% of their excess weight over long-term followup. However, patients respond differently to the procedures and response variability is poorly understood, especially from a psychological perspective.

Methods

124 bariatric patients at the St. Vincent Bariatric Center completed questionnaires on weight, medical, and psychological functioning a mean of 7.7 and 13.7 years after surgery. Psychological functioning was assessed by the IPIP-conscientiousness scale (Goldberg, 1992), UPPS-P (impulsivity under positive/negative emotions), PANAS (affect, Watson et al., 1988), and YFAS (food addiction; Gearhardt et al., 2008). Correlations were calculated between measures and with weight loss and physical activity. Finally, correlations and independent sample t-tests were calculated between those in the lowest and highest quartile of excess weight loss (EWL).

Results

Participants were primarily married (75%), Caucasian (96%) females (81.5%) who had Roux-en-Y gastric bypass (90.3%) surgery. Current mean age was 64 years. Mean weight and BMI at surgery were 316.7 pounds and 51.0 kg/m2, respectively. Current weight and BMI were 210.3 pounds and 34.1 kg/m2 (66.5% EWL), similar to six years ago (209.7 pounds, 33.7 kg/m2).EWL was significantly correlated with regular exercise, conscientiousness, food addiction, and positive affect. These correlations were more robust when examined in the highest and lowest quartile EWL (range r= .39 - .46). T-tests revealed a similar pattern between those maintaining the most and least weight loss over time.

Conclusions

Long-term weight loss after bariatric surgery is related to affect, conscientiousness, physical activity, and addictive-type relationships with food. Future studies should explore these relationships and develop approaches to deal with dispositional tendencies and lifestyle factors.