Determinants of Weight Loss following Laparoscopic Sleeve Gastrectomy: The Role of Psychological Burden, Coping Style, and Motivation to Undergo Surgery.

BACKGROUND: The amount of excess weight loss (%EWL) among obese patients after bariatric surgery varies greatly. However, reliable predictors have not been established yet. The present study evaluated the preoperative psychological burden, coping style, and motivation to lose weight as factors determining postoperative treatment success.

METHODS: The sample included 64 morbidly obese patients with a preoperative BMI of 51 ± 8 kg/m(2) who had undergone laparoscopic sleeve gastrectomy (LSG). Well-established questionnaires were applied before surgery to assess the psychological burden in terms of "perceived stress" (PSQ-20), "depression" (PHQ-9), "anxiety" (GAD-7), and "mental impairment" (ISR) as well as coping style (Brief COPE) and motivation to lose weight. %EWL as an indicator for treatment success was assessed on average 20 months after surgery.

RESULTS: Based on the %EWL distribution, patients were classified into three %EWL groups: low (14-39%), moderate (40-59%), and high (60-115%). LSG patients with high %EWL reported significantly more "active coping" behavior prior to surgery than patients with moderate and low %EWL. Patients' preoperative psychological burden and motivation to lose weight were not associated with %EWL.

CONCLUSION: An "active coping" style might be of predictive value for better weight loss outcomes in patients following LSG intervention.