INFLUENCE OF CLINICAL AND DEMOGRAPHIC FACTORS AND EATING BEHAVIOR MODELS ON THE EFFECTIVENESS OF BARIATRIC SURGERY IN PATIENTS WITH MORBID OBESITY

Introduction. Predictive analysis of clinical and demographic factors, geographic factors and the psychological status of patients in particular the eating behavior model, separately and in common, is promising from the standpoint of a personified approach to the choice of bariatric procedure and the prediction of results.
The aim of this study is to assess the influence of clinical and demographic factors and eating behavior models on the effectiveness of bariatric procedures in patients with morbid obesity.
Material and methods. A retrospective cohort study included 230 patients with restrictive (68.3%) and bypass (31.7%) bariatric surgeries. From the Central region of Russia were 74.8% of patients, from the Northern region were 13% and from Southern — 12.2%. The age groups of patients were different, men were 29.1%, females — 70.9%. Class I obesity at the time of the operation had 12.2% of patients, class II had 25.2%, class III — 62.6% of patients. The universal criterion of effectiveness was %EWL after 12 months. The Dutch Eating Behavior Questionnaire (DEBQ) was used to assess eating behavior. Statistical analysis was carried out on the StatTech v. 1.2.0. Results. The Effectiveness of Bariatric Surgeries in patients living in the Southern region was significantly higher than in Patients living in the Central and Northern regions (% EWL — 73.9%, 62.3% and 46% respectively). More favorable results were achieved in "thinner" and younger patients. In the correlation analysis of the relationship between % EWL 12 months after surgery and the eating behavior model it was found that a decrease in % EWL by 1.141% should be expected with an increase in BMI of 1. The increase in the index of the restrictive eating behavior scale by one leads to decrease in % EWL by 3.943%. The increase in the index of the emotional scale by one leads to decrease in % EWL by 6.043% 12 months after surgery.
Conclusions. The best results of the operation should be expected in people with an external type of eating behavior, although this dependence was poorly expressed and did not reach statistical significance. At the same time, significantly worse results were obtained in patients with an emotional type of eating disorders, which requires the participation of a psychologist in the treatment of such patients.

1. Dedov I.I. Morbidnoe ozhirenie [Morbid obesity]. M: MIA; 2014, 608 S ISBN/ISSN: 978-5-9986-0171-2. (In Russ.)

2. Gumnitskaia T.N. Psikhopatologicheskie narusheniia i ikh psikhoterapiia u bol’nykh s alimentarno-obmennym ozhireniem (sostoianie problemy) [Psychopathological disorders and their psychotherapy in patients with alimentary-metabolic obesity (the state of the problem)]. Meditsinskie issledovaniia, 2001, No. 1 (1), рр. 92–93. (In Russ.)

3. Brethauer S.A., Kim J., el Chaar M., Papasavas P., Eisenberg D., Rogers A., Ballem N., Kligman M., Kothari S. ASMBS Clinical Issues Committee. Standardized outcomes reporting in metabolic and bariatric surgery. Surg. Obes. Relat. Dis., 2015, May-Jun.; 11(3), рр. 489–506. https://doi.org/10.1016/j.soard.2015.02.003 PMID: 26093765.

4. Hsu L., Benotti P., Dwyer J. Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom. Med., 1998, 60, рр. 338–346.

5. Sarwer D.B., Wadden T.A., Fabricatore A.N. Psychosocial and behavioral aspects of bariatric surgery. Obes. Res., 2005, Apr.; 13 (4), рр. 639–348. https://doi.org/10.1038/oby.2005.71 PMID: 15897471

6. Welbourn R., Hollyman M., Kinsman R., Dixon J., Liem R., Ottosson J., Ramos A., Våge V., Al-Sabah S., Brown W., Cohen R., Walton P., Himpens J. Bariatric Surgery Worldwide: Baseline Demographic Description and One-Year Outcomes from the Fourth IFSO Global Registry Report 2018. Obes. Surg., 2019, Mar.; 29 (3), рр. 782–795. https://doi.org/10.1007/s11695-018-3593-1 Epub 2018 Nov 12. PMID: 30421326.

7. Perrone F., Bianciardi E., Ippoliti S., Nardella J., Fabi F., Gentileschi P. Long-term effects of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for the treatment of morbid obesity: a monocentric prospective study with minimum follow-up of 5 years. Updates Surg., 2017, Mar.; 69(1), рр. 101–107. https://doi.org/10.1007/s13304-017-0426-z Epub 2017 Mar 6. PMID: 28266000.

8. Sarwer D.B., Allison K.C., Wadden T.A., Ashare R., Spitzer J.C., Mc- Cuen-Wurst C., LaGrotte C., Williams N.N., Edwards M., Tewksbury C., Wu J. Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surg. Obes. Relat. Dis., 2019, Apr.; 15 (4), рр. 650–655. https://doi.org/10.1016/j.soard.2019.01.029 Epub. 2019 Feb. 23. PMID: 30858009; PMCID: PMC6538470.

9. Peterli R., Wölnerhanssen B.K., Peters T., Vetter D., Kröll D., Borbély Y., Schultes B., Beglinger C., Drewe J., Schiesser M., Nett P., Bueter M. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. JAMA, 2018, Jan., 16, 319 (3), рр. 255–265. https://doi.org/10.1001/jama.2017.20897 PMID: 29340679; PMCID: PMC5833546.

10. Benaiges D., Climent E., Goday A., Julià H., Flores-Le Roux J.A., Pedro-Botet J. Mid-term results of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy compared-results of the SLEEVEPASS and SM-BOSS trials. Ann. Transl. Med., 2018, Nov.; 6 (Suppl. 1), р. 83. https://doi.org/10.21037/atm.2018.10.70 PMID: 30613658; PMCID: PMC6291585.

11. Cebolla A., Barrada J.R., van Strien T., Oliver E., Baños R. Validation of the Dutch Eating Behavior Questionnaire (DEBQ) in a sample of Spanish women. Appetite, 2014, Feb.; 73, рр. 58–64. https://doi.org/10.1016/j.appet.2013.10.014 Epub 2013 Oct 28. PMID: 24177441.

12. Subramaniam K., Low W.Y., Lau P.C., Chin K.F., Chinna K., Kosai N.R., Taher M.M., Rajan R. Eating Behaviour Predicts Weight Loss Six Months after Bariatric Surgery: A Longitudinal Study. Nutrients, 2018, Nov. 2; 10 (11), р. 1616. https://doi.org/10.3390/nu10111616 PMID: 30400129; PMCID: PMC6266615.

13. Zavrazhnykh L.A., Smirnova E.N., Zin’kovskaia T.M. Vliianie psikhologicheskogo profilia na effektivnost’ lecheniia bol’nykh metabolicheskim sindromom [The influence of the psychological profile on the effectiveness of treatment of patients with metabolic syndrome]. Prakticheskaia meditsina, 2010, No. 43, рр. 118–121. (In Russ.)