The impact of temperament and executive attention on the 2-year outcome of bariatric surgery for morbid obesity

The impact of temperament and executive attention on the 2-year outcome of bariatric surgery for morbid obesity

Aims: This longitudinal study aimed to clarify whether temperamental traits denoting the ability to resist immediate temptations in favour of long-term goals (Persistence, P) and the related capacity for executive attention (EA) predict greater weight loss and greater adherence to medical recommenda...

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Bibliographic Details
Published in:Journal of psychosomatic research Vol. 109; p. 104
Main Authors: Generali, I., Fabietti, C., Passamonti, N., Dall’Aglio, E., Marchesi, F., Marchesi, C., De Panfilis, C.
Format: Journal Article
Language:English
Published: London Elsevier Inc 01-06-2018
Elsevier Science Ltd
Subjects:
Adherence
Attention
Body mass index
Body weight loss
Comorbidity
Computerization
Emotions
Gastric bypass
Gastric restriction surgery
Gastrointestinal surgery
Impact analysis
Mental disorders
Morbidity
Obesity
Prescription drugs
Surgery
Temperament
Timing
Weight loss
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Summary:Aims: This longitudinal study aimed to clarify whether temperamental traits denoting the ability to resist immediate temptations in favour of long-term goals (Persistence, P) and the related capacity for executive attention (EA) predict greater weight loss and greater adherence to medical recommendations after gastric by-pass for severe obesity at a 2-year follow-up. Methods: Ninety-four patients seeking bariatric surgery for severe obesity (94 females, 88.3%; mean BMI=46.40±6.5; mean age 41.96±11.0) self-reported P before receiving gastric by-pass. A subsample (n=29) also completed the Attention Network Test revised, a computerized flanker task evaluating the efficiency of the attention networks, including EA. Post-surgical BMI was recorded 1,6, 12 and 24 months after the operation, and adherence to medical recommendations (i.e., adherence to dietary, physical and laboratory prescriptions) was evaluated after 6,12 and 24 months from gastric bypass. The influence of P and EA on post-surgical weight-loss and treatment adherence was evaluated with mixed model analyses, controlling for the presence of psychiatric disorders. Results: BMI significantly decreased during follow-up (Timing: F^sub 5, 93.5^=235.94, p<.001; 2-year BMI=31.62±5.3). Presenting with a psychiatric disorder at baseline (24.5% of the sample) was associated with greater baseline BMI but not with post-surgical weight loss (Timing X Comorbidity: F^sub 5, 85.1^=2.79, p=.02). Conversely, greater P scores predicted lower BMI at any time of follow-up (F^sub 1, 91.3^=6.07, p=.02). Finally, greater EA predicted better adherence to medical recommendations (and specifically exercise prescription) in the first post-operatory year (Timing X EA: F^sub 2, 9^=6.11, p=.02). Conclusion: The ability to successfully solve conflicts between immediate stimuli and long-term goals predict better outcome of bariatric surgery for severe obesity. These findings suggest the utility to implement bariatric surgery programs with interventions aimed at improving such capacity, in order to maximize surgical success.
ISSN:0022-3999
1879-1360
DOI:10.1016/j.jpsychores.2018.03.060