title: Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients.
abstract: BACKGROUND
  Weight loss surgery (WLS) is an effective weight loss treatment for individuals with severe obesity. Psychosocial factors can affect short-term WLS outcomes. This study sought to identify psychosocial predictors of medium-term outcomes.
  
  
  METHODS
  In this prospective study, 250 consecutive WLS candidates were evaluated between January 1, 2010 and December 31, 2010. Each completed baseline medical, surgical, and psychological evaluations as part of standard of care. Two hundred and four patients had surgery (81.6%). Successful surgical outcome was defined as ≥50% excess weight loss two years post-surgery.
  
  
  RESULTS
  Comparison of study sample (n=80) and those lost to follow-up (n=124) revealed negligible differences across baseline characteristics. At follow-up, 60% (n=48) of the sample was classified as a success with an average of 72.58% (std dev=13.01%) excess weight lost. The remaining 40% (n=32) was classified as a failure with an average of 33.98% (std dev=13.19%) excess weight lost. Logistic regression revealed that pre-surgical marital status, emotional eating, and history of physical abuse were independently associated with outcome variables, p<0.05.
  
  
  CONCLUSIONS
  Being married, perhaps as a proxy for social support, is associated with 6.9 times increased odds of medium-term WLS success and emotionally driven disordered eating patterns are associated with 7.4 times increased odds of medium-term WLS success. A history of physical abuse is associated with an 84% decreased odds of successful medium-term outcomes. Further research that studies both the quality and impact of spousal support on weight loss as well as longer-term effects of emotional eating on outcomes is needed. Addressing longer-standing consequence of abuse may improve WLS outcomes.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States. Electronic address: wedin@musc.edu.
authors.forename: Sharlene
authors.initials: S
authors.lastname: Wedin
authors.affiliation: The Menninger Clinic, 12301 South Main St., Houston, TX 77035, United States; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States.
authors.forename: Alok
authors.initials: A
authors.lastname: Madan
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Correll
authors.affiliation: Bariatric Surgery Program, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States.
authors.forename: Nina
authors.initials: N
authors.lastname: Crowley
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States.
authors.forename: Robert
authors.initials: R
authors.lastname: Malcolm
authors.affiliation: Bariatric Surgery Program, Medical University of South Carolina, 25 Courtenay Dr, Charleston, SC 29425, United States.
authors.forename: T
authors.initials: T
authors.lastname: Karl Byrne
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, United States.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Borckardt
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D004435:Eating / Q000523:psychology*; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017533:Marital Status / Q000706:statistics & numerical data*; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014754:Violence / Q000706:statistics & numerical data*; D015431:Weight Loss
keywords: Bariatric surgery; Outcomes assessment; Predictor; Psychosocial factors; Weight loss