Determinants of Weight Loss following Laparoscopic Sleeve Gastrectomy: The Role of Psychological Burden, Coping Style, and Motivation to Undergo Surgery
Table 2
Sociodemographics, comorbidities, and psychological characteristics before laparoscopic sleeve gastrectomy (LSG).
Postoperative excess weight loss (EWL) in %
Group 1
Group 2
Group 3
Low %EWL
Moderate %EWL
High %EWL
M (SD)
M (SD)
M (SD)
%EWL Range
30.3 (7.5) 14–39
48.6 (6.0) 40–59
80.9 (17.8) 60–115
Preoperative
Sociodemographics
Age in years
48.4 (11.7)
44.7 (11.5)
43.6 (8.8)
1.2
0.324
0.4
Female sex (%)
13 (61.9%)
15 (68.2%)
18 (85.7%)
3.2
0.205
0.2
Years of education
12.5 (2.3)
13.2 (2.6)
14.7 (2.0)
4.9
0.011
0.8
In partnership n (%)
12 (57.1%)
16 (72.7%)
17 (81.0%)
2.9
0.229
0.2
Employed (%)
11 (52.4%)
9 (40.9%)
13 (61.9%)
1.9
0.386
0.2
Comorbidities, clinical diagnosis
Metabolic syndrome (%)
18 (85.7%)
20 (90.9%)
18 (85.7%)
—
Type 2 diabetes mellitus (%)
9 (42.9%)
13 (59.1%)
9 (42.9%)
1.5
0.467
0.2
Mental disorder (%)
9 (42.9%)
5 (22.7%)
9 (42.9%)
2.5
0.281
0.2
Depression (%)
7 (33.3%)
2 (9.1%)
5 (23.8%)
3.8
0.152
0.2
Eating disorder (%)
21 (100.0%)
21 (95.5%)
20 (95.2%)
—
Hyperphagia (%)
8 (38.1%)
15 (68.2%)
14 (66.7%)
5.0
0.082
0.3
Binge eating disorder (%)
3 (14.3%)
1 (4.5%)
2 (9.5%)
—
Psychotherapy (%)
13 (61.9%)
4 (18.2%)
8 (38.1%)
8.6
0.013
0.4
Psychological variables
Psychological burden
Perceived stress (PSQ-20)
0.5 (0.2)
0.4 (0.2)
0.5 (0.2)
1.1
0.337
0.4
Depression (PHQ-9)
8.8 (5.7)
6.5 (5.2)
8.8 (5.4)
1.3
0.272
0.4
Anxiety (GAD-7)
8.8 (5.4)
5.5 (5.1)
7.3 (5.4)
2.1
0.137
0.5
Mental impairment (ISR)
1.1 (0.6)
0.8 (0.4)
1.1 (0.7)
1.9
0.162
0.5
Coping style (Brief COPE)
Avoidant coping
2.1 (0.4)
2.0 (0.4)
2.1 (0.5)
0.8
0.456
0.3
Seeking support
2.0 (0.6)
2.1 (0.4)
2.3 (0.6)
1.8
0.173
0.5
Positive reframing
2.0 (0.4)
2.0 (0.4)
2.0 (0.6)
0.1
0.934
0.1
Active coping
3.1 (0.6)
3.1 (0.7)
3.6 (0.4)
5.0
0.010
0.8
Motivation to lose weight
Social environment
2.2 (1.1)
2.3 (0.8)
2.4 (1.1)
0.3
0.752
0.2
Treatment environment
2.4 (1.0)
1.9 (0.6)
2.2 (1.0)
1.9
0.163
0.5
Self-motivation
4.2 (1.2)
4.6 (0.7)
4.6 (0.9)
0.9
0.423
0.3
Note. Univariate -test statistics are shown. Statistically significant values are marked in boldface. Diagnosis made by an experienced clinical psychologist or physician specialized in psychosomatic medicine according to the International Classification of Diseases (ICD-10, WHO, 2006, 2010). Disorders belonging to the metabolic syndrome along with obesity () included type 2 diabetes mellitus (), high blood pressure (), dyslipidemia (), and hyperuricemia (). Mental disorders included depression (), reaction to severe stress and adjustment disorder (), anxiety (), somatoform disorder (), and bipolar disorder (). Eating disorders included hyperphagia (), binge eating disorder (), night eating syndrome (), sweet eating syndrome (), and eating disorders not otherwise specified (ED-NOS) (). Hyperphagia is a subsyndromal excessive eating behavior and/or increased high-calorie food intake. Binge eating is the regular occurrence of eating binges with a feeling of loss of control over eating without compensatory behaviors. Psychotherapy refers to past or current preoperative mental health treatment by a psychiatrist and/or psychologist. Psychometric measurements employing tablet PCs. Due to ceiling effects in our studied sample of obese patients undergoing bariatric surgery not analyzed statistically; minimum expected cell frequency <5. .
