title: Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes.
abstract: OBJECTIVE
  This study aims to examine associations between metabolic profile and psychological variables in post-bariatric patients and to investigate if metabolic and psychological variables, namely high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glycated hemoglobin (HbA 1c), impulsivity, psychological distress, depressive and eating disorder symptoms are independently associated with percentage of excess weight loss (%EWL) after bariatric surgery.
  
  
  METHODS
  One hundred and fifty bariatric patients (BMI = 33.04 ± 5.8 kg/m(2)) who underwent to bariatric surgery for more than 28.63 ± 4.9 months were assessed through a clinical interview, a set of self-report measures and venous blood samples. Pearson's correlations were used to assess correlations between %EWL, metabolic and psychological variables. Multiple linear regression was conducted to investigate which metabolic and psychological variables were independently associated with %EWL, while controlling for type of surgery.
  
  
  RESULTS
  Higher TG blood levels were associated with higher disordered eating, psychological distress and depression scores. HDL-C was associated with higher depression scores. Both metabolic and psychological variables were associated with %EWL. Regression analyses showed that, controlling for type of surgery, higher % EWL is significantly and independently associated with less disordered eating symptoms and lower TG and HbA_1c blood concentrations (R (2) aj = 0.383, F (4, 82) = 14.34, p < 0.000).
  
  
  CONCLUSIONS
  An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.
authors.affiliation: Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Brandão
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ramalho
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pinto-Bastos
authors.affiliation: Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Arrojado
authors.affiliation: CINTESIS-Center for Research in Health Technologies and Information Systems, 4200-450, Porto, Portugal.|Department of General Surgery, Oporto Hospital Center, Porto, Portugal.
authors.forename: Gil
authors.initials: G
authors.lastname: Faria
authors.affiliation: Department of General Surgery, Oporto Hospital Center, Porto, Portugal.|Department of Biochemistry, Faculty of Medicine, University of Porto, Centro de Investigação Médica, 4200-450, Porto, Portugal.
authors.forename: Conceição
authors.initials: C
authors.lastname: Calhau
authors.affiliation: Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Coelho
authors.affiliation: University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal. econceicao@psi.uminho.pt.
authors.forename: Eva
authors.initials: E
authors.lastname: Conceição
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology*; D008076:Cholesterol, HDL / Q000097:blood; D003863:Depression / Q000523:psychology; D001068:Feeding and Eating Disorders / Q000523:psychology / Q000601:surgery; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007175:Impulsive Behavior; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D013315:Stress, Psychological / Q000453:epidemiology; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
chemical_list: D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D014280:Triglycerides; C517652:hemoglobin A1c protein, human
keywords: Bariatric surgery; Depression; Eating behavior; Metabolic profile; Type 2 diabetes mellitus