Preoperative psychological assessment as a predictor of obesity relapse after sleeve gastrectomy

Abstract

Introduction. Obesity is a chronic disease characterized by excessive accumulation of adipose tissue in the body, posing a health hazard and being a major risk factor for several other chronic diseases. Bariatric surgery is currently considered one of the most effective methods of treating obesity. However, studies by various authors indicate that obesity recurrence in the late postoperative period occurs on average in 20% of cases. Predictors of poor response to laparoscopic sleeve gastrectomy can help adjust patient management tactics, while psychological assessment of impulsivity level, compliance, and depression can assist in predicting patient behavior after surgery. Aim. To determine whether preoperative psychological assessment of the patient, as well as the level of patient compliance, are predictors of obesity relapse in the long-term postoperative period after laparoscopic sleeve gastrectomy. Materials and methods. The study included 79 patients, with mean age of 44 years; 27% were male, 73% female. In all cases, laparoscopic sleeve gastrectomy was performed. Patients were followed up for five years, after which they were divided into two groups: 78.5% without relapse, 21.5% with relapse. When analyzing%EBMIL one year after laparoscopic sleeve gastrectomy, all surgical interventions were found to be effective (%EBMIL>50%). Before hospitalization, patients were questioned using DEBQ questionnaires, the level of compliance, and the Beck Depression Scale. Results. 19.76% of patients have no eating behavior disorders (EBD), 80.24% have different types of EBD. 62.96% of the patients had no signs of depression, 24.69% had mild depression, and 12.35% had moderate depression. All patients included in this study showed a high level of overall compliance. There was no statistically significant difference between the groups with and without obesity relapse after laparoscopic sleeve gastrectomy in terms of DEBQ questionnaires, «compliance level», and Beck Depression Scale measured before surgery. Conclusions. Determining the level of compliance, depression, type of eating behavior disorder before surgery is not predictive when assessing the risk of obesity relapse after laparoscopic sleeve gastrectomy.