The influence of preoperative psychological profiles on weight loss following sleeve gastrectomy (SG) has not been thoroughly examined, particularly with respect to sex differences. To analyze the preoperative psychological profiles of individuals with obesity and explore whether sex differences exist in the associations between preoperative psychological factors and weight loss after SG. This prospective cohort study involved participants scheduled for SG at an affiliated hospital between November 2020 and September 2022, with a follow-up period of 1-year post-surgery. Preoperative psychological profiles were assessed using validated scales, covering anxiety, depression, self-esteem, internalized weight bias, eating behaviors, sleep quality, and quality of life. Independent t-tests and Pearson correlation analyses were used to assess sex differences and associations between psychological factors and %TWL at 1-year post-surgery. Univariate and multivariate regression analyses were then performed to identify independent predictors of %TWL at 1-year post-surgery, with significance defined as p < .05. In total, 491 patients with obesity undergoing SG were enrolled, of whom 452 (314 women and 138 men) completed the study. Preoperatively, participants exhibited high levels of internalized weight bias, moderate alterations in eating behaviors, and poor sleep quality and quality of life. Compared to women, men demonstrated significantly lower levels of anxiety, depression, internalized weight bias, and emotional eating, but demonstrated significantly higher health transition scores (i.e., self-perceived improvement in general health compared to one year ago). Among women, 1-year postoperative weight loss was significantly positively associated with preoperative anxiety and internalized weight bias, but negatively associated with self-esteem and quality of life. Conversely, no statistically significant associations were found between preoperative psychological factors and weight loss outcomes in men. In multivariate regression analysis, no psychological factors independently predicted %TWL at 1-year post-surgery in women. Sex differences were observed in the associations between preoperative psychological factors and weight loss after SG. Among women, psychological factors demonstrated stronger associations with weight loss after SG; however, none of these remained significant predictors in the multivariate regression model. No such associations were observed in males. These findings suggest that the impact of preoperative psychological factors on postoperative weight loss may be complex and merit further investigation.
Pan et al. (Tue,) studied this question.