Background

Psychological assessments are an integral part of patient optimization prior to metabolic surgery(MBS). Broadband personality assessments such as the Millon Behavior Medicine Diagnostic(MBMD), are essential tools in the psychological evaluation process. We examined the association between preoperative MBMD psychosocial indicators and the reduction in BMI(ΔBMI) at 6 and 12 months postoperatively.

Methods

We retrospectively reviewed 97 MBS patient records who underwent MBS(60.8% Sleeve Gastrectomy(SG) and 39.2% Gastric Bypass(GB)) and preoperative MBMD at our institution between 2020-2022. Pearson correlations were utilized to assess the relationship between the psychosocial indicators and the ΔBMI(p=0.05) at each time point. Models with interactions were used to assess if correlations needed to be run separately for each procedure type.

Results

We found a positive correlation at both 6 and 12 months between ΔBMI and the scales of Anxiety-tension(6mos p=0.04; 12mos p=0.02) and Psych Referral(6mos p=0.046; 12mos p=0.01) and a negative correlation in ΔBMI with the Confident scale at both time points(6mos p=0.001; 12mos p=0.003). However, the association between ΔBMI and MBMD scales for Illness Apprehension in the Stress Moderator Domain was different between procedure types at 12 months. In patients who received SG, higher scores for this scale were associated with increased, ΔBMI at 12 months, but this was not observed in the patients receiving GB. This scale refers to the patients' focus on and awareness of changes in their bodies.

Conclusions

Psychological assessments help in preoperative optimization and may be predictive of weight loss outcomes.