Perceived Postoperative Support Differentiates Responders from Non-Responders 3 Years After Laparoscopic Roux-en-Y Gastric Bypass.

BACKGROUND: Bariatric surgery is an effective intervention for the majority of patients with morbid obesity, but a significant minority fails to achieve substantial weight loss. In the search of possible predictors of weight loss following bariatric surgery, preoperative factors turn out to have limited predictive power. This study will examine the impact of two postoperative factors on weight loss: perceived social support and stressful life events. METHODS: From the entire 2013 cohort that underwent laparoscopic Roux-and-Y gastric bypass (LRYGB) in a general hospital in the Netherlands, a group of 56 non-responders and a matched group of 56 responders were selected, using an alterable weight loss (%AWL)-based percentile chart. Patients from both groups were interviewed by phone to collect data on demographics, medical complications and comorbidities, social support and stressful life events. A total of 61 patients completed the data collection (54% response rate). RESULTS: One-way ANOVA analysis showed that responders and non-responders differed with regard to perceived support (F(1) = 8.60, p = .005). In a model with place of birth, level of education and pre-surgery diabetes mellitus as covariates, perceived social support was able to classify 83.6% of patients correctly as either responder or non-responder (χ 2 = 28.26, p < .001). Stressful life events turned out to be unrelated to weight loss. CONCLUSIONS: Perceived social support differentiates responders from non-responders after LRYGB. When patients present themselves after LRYGB with sub-optimal weight loss, social support should be a focus of attention.

Bariatric surgery in young adults: a multicenter study into weight loss, dietary adherence, and quality of life.

BACKGROUND: Numerous studies have demonstrated that bariatric surgery is an effective intervention for morbid obesity, but study samples are characterized by an underrepresentation of young adult patients. OBJECTIVES: The aim of this study was to evaluate weight loss, dietary adherence, and quality of life (QoL) in a multicenter, young adult sample, in the first 6 years after bariatric surgery. SETTING: Four general hospitals in the Netherlands. METHODS: A total of 184 young adult patients who underwent bariatric surgery between 6 and 74 months previously at the age of 18 to 24 years were included, interviewed by phone, and sent questionnaires assessing postoperative weight, QoL, and lifestyle behaviors including dietary adherence. Complete data were available for those 96 patients who returned the questionnaires. RESULTS: Mean percent weight loss was 30.2 (SD 10.7) for laparoscopic sleeve gastrectomy and 35.6 (SD 6.9) for laparoscopic Roux-en-Y gastric bypass. Adherence to postoperative dietary recommendations declined over the years (r = -.25, P = .02) and explained 8.3% of the variance in weight loss (r = .29, P = .005). QoL scores lagged behind national norms for young adults and were largely unrelated to weight loss. A quarter of patients (25%) turned out to be not in education, employment, or training and 38% had used mental healthcare services since surgery, which occurred independent of weight loss and concurred with poorer QoL. CONCLUSION: Young adult patients achieve weight loss comparable to adult patients after bariatric surgery. However, postoperative adherence to behavioral recommendations and psychosocial functioning clearly demonstrate room for improvement and require adjunctive interventions.