Page 30 - When surgery alone won’t cut it - Valerie Maureen Monpellier

Chapter 2
INTRODUCTION
ABSTRACT
Insufficient weight loss after Roux-en-Y gastric bypass (RYGB), might be influenced by behavioral and psychopathology related factors. This review studies the moderating influence of several behavioral and psychopathology related factors on weight loss.
METHOD
The search was carried out using four electronic databases. Preoperative Body Mass Index and percentage Excess Weight Loss (%EWL) were calculated for all moderator and non-moderator groups of variables.
RESULTS
A total of 61 articles were included; 35 studies had sufficient data for meta-analysis. Eight studies were included to study the relationship between compliance and weight loss, compliant patients had a significantly higher EWL than non-compliant patients; difference 7.6% (p<0.001). Ten studies were included for physical activity, active patients had a significantly higher EWL, 71.3% versus 63.7% (p<0.001). Weight loss was not significantly influenced by depression (p=0.246) or binge eating (p=0.256).
CONCLUSION
This meta-analysis shows that good compliance and higher physical activity have a positive effect on weight loss after RYGB. However, symptoms of depression and binge eating do seem to not influence weight loss. Psychological evaluation varies greatly and efforts should be made to form consensus on how to conduct this evaluation. For now, decisions regarding bariatric surgery should be made based on a multidisciplinary screening of each single patient.
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