AB059. SOH24AB_034. The influence of clinical and psychological wellbeing on the decision to proceed with bariatric surgery

Background: With the increase in the obesity epidemic, bariatric surgery rates have escalated exponentially. Despite this, a large proportion of those referred for bariatric consultation fail to follow through with surgery. Methods: A retrospective case note and database review was carried out on a consecutive series of patients attending a single centre of excellence. All patients completed the psychological assessment tools—Beck Depression Index (BDI) and Hospital Anxiety Depression Score (HAD), prior to consultation. Demographic and clinical data were recorded. Results: Between January 2017 and January 2021, 234 patients attended for an initial bariatric consultation and completed pre-consultation questionnaires. A total of 172 questionnaires were available for subsequent assessment. Seventy four percent (n=128) were female. Fifty four percent (n=93) underwent subsequent surgery. Private insurance cover had a significant influence on whether patients proceeded with surgery 81 (80%) vs. 13 (12%), P<0.05, Chi square. The overall BDI and HAD scores for the group were 14.63±10 and 6.34±10.5, respectively, indicating moderate depression. Patients not proceeding with surgery had a significantly higher BDI (16.2±10.1 vs. 13.2±10.5, P=0.04) and HAD score (7.2±4.6 vs. 5.5±4.2, P=0.01) than those who ultimately proceeded to surgery. Conclusions: Unsurprisingly private insurance cover has a significant influence on the decision to proceed with bariatric surgical intervention, reaffirming that a much larger number of severely obese patients would likely undergo surgery if it were within their financial remit. Patients who decline subsequent bariatric surgical intervention have significantly higher initial depression and anxiety scores, suggesting a possible benefit for early psychological/psychiatric intervention in this group.