Psychosocial predictors of adherence after bariatric surgery: a 6 month follow-up study

Abstract

Background: Bariatric surgery is among the most effective treatments for obesity. However, poor adherence to post-operative instructions is common and results in suboptimal health outcomes. The present study sought to identify psychosocial factors in the early post-operative stage that predict adherence and surgical outcomes 6 months after bariatric surgery. Methods: 62 bariatric surgery patients completed surveys at baseline (2-6 weeks post-operation) and 6-month follow-up including measures of surgical outcomes (BMI and quality of life), post-operative adherence, and psychosocial factors (depression, anxiety, eating behaviours, self-stigma and experienced stigma, obesity-specific distress, attitudes towards post-operative adherence, and self-monitoring). Findings: Correlational analyses revealed that higher self-efficacy regarding adherence, more positive beliefs about the benefits of adherence, and more frequent self-monitoring of weight at baseline predicted better adherence 6 months after surgery. Lower levels of self-reported depression and maladaptive eating behaviours at follow-up were also associated with better adherence. There was a significant positive correlation between adherence and quality of life at follow-up (even when controlling for weight change); however, there was no significant relationship between adherence and BMI. Participants also experienced improvements in anxiety, eating behaviours, self-stigma and experienced stigma, and distress at 6-month follow-up. Discussion: This study identified psychosocial factors in the early post-operative stage that may be predictive of later adherence, specifically self-efficacy, beliefs about the benefits of adherence, and weight self-monitoring. Adherence was, in turn, associated with better quality of life at follow-up. These findings may inform psychological management of patients to improve adherence and health outcomes after bariatric surgery.