TDNet Discover

Background: Bariatric surgery is the recommended weight loss method for those suffering from obesity with a BMI >40 or BMI >35 with comorbidities. Screening for weight loss predictors in bariatric surgery patients typically focuses on preoperative factors, however many patients still do not achieve the desired outcomes of surgery. There is ample evidence that postoperative factors affect weight loss maintenance in the long term. Objective: To conduct a systematic review to determine the impact of postoperative psychosocial factors on weight loss maintenance in bariatric surgery patients. Methods: A systematic review of literature related to bariatric surgery weight loss maintenance was performed through four databases: The Cumulative Index to Nursing and Allied Health, PubMed, Cochrane, and Medline Complete. Final article selection was dependent on full text review, adherence to inclusion and exclusion criteria, and agreement between three independent researchers. In total, 9 articles were chosen, and results were categorized based on presence postoperatively and correlation to weight loss and maintenance outcomes. Results: Database searches resulted in 9 viable studies pertaining to psychosocial factors affecting weight loss maintenance in bariatric surgery patients. These studies included a total of 37,653 patients alongside 2 systematic reviews that looked at 69 additional studies. Eating behaviors, especially the presence of disordered eating, and mental illness postoperatively play a large role in the ability for patients to maintain weight loss in the long term. Binge eating is an especially common struggle for patients who undergo bariatric surgery, and the ability to combat postoperative eating disorders plays a large role in the weight loss patients will see. The presence of mental illness postoperative, specifically depression and body dysmorphia, is also a key factor in the ability to maintain weight loss long term. Postoperative follow-up appointment attendance and opioid use play a minor role in long-term weight loss. Conclusion: There are no definitive psychosocial factors that guarantee success after bariatric surgery for weight loss, however, there are multiple postoperative factors that have greater correlation to weight loss outcomes and maintenance than others. Generally, postoperative management should focus on a patient's mental well-being and eating behaviors long-term, rather than continuing to focus on preoperative screenings to find the ideal candidate for bariatric surgery.