Psychological, behavioral, and weight-related aspects of patients undergoing reoperative bariatric surgery after gastric band: comparison with primary surgery patients

Abstract

Background: Patients experiencing insufficient weight loss or weight regain in their first bariatric surgery may represent a high-risk group with greater problematic eating and general psychopathology levels, which may compromise the success of a reoperative procedure.

Objectives: This study seeks to describe and compare disordered eating-related psychological and behavioral features of primary and reoperative surgery candidates after gastric band.

Setting: Hospital center and university in Portugal.

Methods: The baseline (preoperative) data from a longitudinal observational study are presented. Patients were interviewed by trained psychologists to identify binge-eating episodes and grazing and responded to a set of self-report measures: disordered eating, grazing, negative urgency, depression, anxiety, and stress.

Results: Two hundred twenty-five patients were undergoing primary surgery, and 166 were undergoing reoperative (REOP group) surgery. The groups did not differ in body mass index preoperatively, but the REOP group had greater weight suppression (t₃₈₇ = -5.35, P = .001), higher highest (t₃₈₇ = -3.40, P = .001) and lower lowest body mass index (t₃₈₁ = 2.22, P = .03). The main reasons for reoperative surgery were weight regain/poor weight loss (42.8%) or medical complications (32.5%). REOP patients with objective binge eating reported a higher frequency of these episodes (t₄₇ = 2.15, P = .04). No significant difference was found for the self-report measures assessed (only shape concern was higher for REOP group, F_1,216 = 8.30, P<.001).

Conclusions: Despite the preoperative similarities between patients undergoing reoperative or primary surgeries, the differences in binge eating and weight-related variables may associate with postoperative difficulties. The link between binge eating, weight suppression, and weight gain found in other samples suggests that patients undergoing reoperative surgery may be at increased risk for poor weight outcomes.

Keywords: Binge eating; Grazing; Psychological aspects; Reasons for reoperation; Reoperative bariatric surgery.