Background: Psychosocial factors measured after bariatric surgery for obesity may have important influences on longer term outcomes. Knowledge of early predictors of longer term weight outcomes could allow for early intervention for those at risk of poorer results. No review exists examining early post-surgical predictors of later surgical outcomes.
Aim: This systematic literature review aimed to identify early psychosocial predictors of later weight outcome following bariatric surgery.
Method: Articles were identified using Medline, CINAHL, Psych and Behavioural Sciences, PsycInfo, PsycArticles, Web of Science, EMBASE, and Scopus. Search terms were developed across three concepts of “bariatric surgery”, “post-surgery”, and “predictors”. Studies were only included if they measured the post-surgery predictor variable earlier than the weight outcome.
Results: Predictor variables included number of post-surgical appointments, support groups, weight loss trajectory, eating behaviours and cognitions, body image, and physical activity. Most research has focused on the number of appointments attended as the predictor of later weight loss outcome. Generally, increased early contact was predictive of better later weight loss. Early weight trajectory was also generally predictive of later weight loss outcomes. Mixed findings emerged for the few studies examining support group attendance, however the definition of both group attendance and successful weight loss varied. Few studies examined the early predictive value of physical activity and eating behaviour on later outcome. These studies demonstrate a wide variety of measurement standards, time frames, and mixed findings. With respect to the few studies examining early post-surgical psychological factors, loss of control over eating and cognitive function emerged as early predictors of later outcome, while body image and avoidance of weight related thoughts did not.
Conclusion: In order to develop more theoretically informed interventions for those at risk of poorer outcomes, further research examining early post-surgical prediction of later outcomes in bariatric surgery is required.