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Purpose <p>This study aimed to identify trajectories of BMI, obesity-specific health-related quality of life (HR-QoL), and depression trajectories from pre-surgery to 24&#xa0;months post-bariatric metabolic surgery (BMS), and explore their associations, addressing subgroup differences often hidden in group-level analyses.</p> Method <p>Patients with severe obesity (<i>n</i> = 529) reported their HR-QoL and depression before undergoing BMS, and at 12 and 24&#xa0;months post-operation. Latent Class Growth Analysis was used to identify trajectories of BMI, HR-QoL and depression.</p> Results <p>BMI and HR-QoL improved significantly for all patients from pre-surgery to 24&#xa0;months post-operation, though some patients deteriorated in their outcomes after 12&#xa0;months. Three distinct trajectories of BMI were identified: Low (35.4%), Medium (45.5%), and High (19.2%), and of HR-QoL: High (38.4%), Medium (43.4%), and Poor (18.1%). Three trajectories of depression were extracted: Low/none (32.4%), Medium–low (45.3%), and Worsening (22.3%). The association between the trajectories of BMI and depression was significant, but not between the BMI and HR-QoL trajectories. Specifically, the Low BMI trajectory patients were more likely to follow the Worsening depression trajectory and reported poorer preoperative psychological health than the other two BMI trajectories.</p> Conclusion <p>Patients following the most favourable weight loss trajectory may not manifest psychologically favourable outcomes (i.e., Worsening depression), and preoperative characteristics do not consistently describe post-surgical BMI trajectories. Clinicians should tend to patients’ mental wellbeing besides weight loss post-BMS. The study findings emphasize the significance of incorporating psychological health as an essential component of surgical outcomes.</p>

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Relations between trajectories of weight loss and changes in psychological health over a period of 2 years following bariatric metabolic surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年1月29日

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  • Johanna Eveliina Pyykkö,
  • Nienke van Olst,
  • Victor E. A. Gerdes,
  • Josué Almansa,
  • Yaïr I. Z. Acherman,
  • Maurits De Brauw,
  • Albert K. Groen,
  • Max Nieuwdorp,
  • Robbert Sanderman,
  • Mariët Hagedoorn

摘要

Purpose

This study aimed to identify trajectories of BMI, obesity-specific health-related quality of life (HR-QoL), and depression trajectories from pre-surgery to 24 months post-bariatric metabolic surgery (BMS), and explore their associations, addressing subgroup differences often hidden in group-level analyses.

Method

Patients with severe obesity (n = 529) reported their HR-QoL and depression before undergoing BMS, and at 12 and 24 months post-operation. Latent Class Growth Analysis was used to identify trajectories of BMI, HR-QoL and depression.

Results

BMI and HR-QoL improved significantly for all patients from pre-surgery to 24 months post-operation, though some patients deteriorated in their outcomes after 12 months. Three distinct trajectories of BMI were identified: Low (35.4%), Medium (45.5%), and High (19.2%), and of HR-QoL: High (38.4%), Medium (43.4%), and Poor (18.1%). Three trajectories of depression were extracted: Low/none (32.4%), Medium–low (45.3%), and Worsening (22.3%). The association between the trajectories of BMI and depression was significant, but not between the BMI and HR-QoL trajectories. Specifically, the Low BMI trajectory patients were more likely to follow the Worsening depression trajectory and reported poorer preoperative psychological health than the other two BMI trajectories.

Conclusion

Patients following the most favourable weight loss trajectory may not manifest psychologically favourable outcomes (i.e., Worsening depression), and preoperative characteristics do not consistently describe post-surgical BMI trajectories. Clinicians should tend to patients’ mental wellbeing besides weight loss post-BMS. The study findings emphasize the significance of incorporating psychological health as an essential component of surgical outcomes.