Medical and Psychological Predictors for Long-Term Bariatric Success Using Primary Vertical-Banded Gastroplasty as a Model

Introduction: Bariatric surgery requires patients to implement permanent lifestyle changes that are affected by several factors. Psychological assessment seems to be essential for optimal weight loss and maintenance. The burden remains in identifying potential psychosocial predictors that might influence the long-term outcome. Therefore, this study was designed to identify those predictors for the long-term outcome after primary vertical-banded gastroplasty (VBG). Methods and Design: Patients who underwent primary VBG between 2001 and 2004 completed a number of psychological questionnaires. Additional postal questionnaires were sent to retrieve the latest medical outcome. Patients were categorized as failed or successful based on their excess weight loss at last follow-up. Results: This study identified a number of potential predictors. Failed patients showed more esthetic expectations, a more dominant character, more work absenteeism before surgery, and depend more on the procedure than successful patients (SPs). SPs showed that positive emotions are an inhibitory factor for eating and less underwent revisional surgery. Conclusion: This study shows a number of possible predictors, mainly found in the patient's character. The best way to prevent these predictors seems to be early recognition in the preoperative phase and a structured postoperative psychological follow-up to tackle any potential problems at an early stage.