Post-surgery adherence to scheduled visits and compliance, more than personality disorders, predict outcome of bariatric restrictive surgery in morbidly obese patients

Antonio E. Pontiroli, Andrea Fossati, Paola Vedani, Monica Fiorilli, Franco Folli, Michele Paganelli, Monica Marchi, Cesare Maffei

Research output: Contribution to journalArticlepeer-review

Abstract

Background: With bariatric restrictive procedures a major issue is predictors of clinical outcome; non-surgical (compliance) and psychological factors might play a role in long term-results of bariatric surgery. We evaluated a set of predictors of short-term and long-term clinical outcome including psychiatric and psychological variables, as well as measures of post-surgery compliance. Methods: 172 consecutive patients undergoing laparoscopic adjustable gastric banding (LAGB) with a minimum of 12 months follow-up, were studied; before surgery they were administered the NIMH Diagnostic Interview Schedule (Version III-R, DIS III-R) and the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (Version 2.0, SCID-II). After surgery, patients were scheduled for visits at 2-week intervals for the first 2 months, at monthly intervals up to 1 year and 3-monthly intervals for 2 years; compliance with diet, rules, physical exercise, plus integrated compliance (sum of scores), and percentage of attendance at scheduled visits were recorded. Patients were contacted again at 36 and at 48 months. Results: BMI, compliance, percentage of attendance at scheduled visits (positively), and narcissistic personality (negatively) were all associated with weight loss at 12, 24 (and 36 months). Percentage of attendance was also associated at 48 months. At stepwise regression analysis, BMI and integrated compliance predicted weight loss at 12, 24, and 36 months, while percentage of attendance at scheduled visits predicted weight loss at 48 months. Narcissistic personality predicted weight loss only at 12 months. Conclusion: Adherence to scheduled visits and compliance to recommended rules, more than personality disorders, predict success of LAGB, at least during the first 4 years.

Original languageEnglish
Pages (from-to)1492-1497
Number of pages6
JournalObesity Surgery
Volume17
Issue number11
DOIs
Publication statusPublished - Nov 2007

Keywords

  • Bariatric surgery
  • Compliance
  • Laparoscopic adjustable gastric banding
  • Morbid obesity
  • Psychosocial aspects

ASJC Scopus subject areas

  • Surgery

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