When surgery alone won’t cut it: Physical and psychological influences on weight loss after bariatric surgery

This thesis demonstrates that preoperative factors such as self-reported binge eating, depressive symptoms, eating style, and physical activity are not reliable predictors of weight loss following metabolic-bariatric surgery. As a result, these factors should not be used as grounds for denying surgery.
In contrast, postoperative physical and psychological factors are closely linked to both weight loss outcomes and health-related quality of life after surgery. This underscores the importance of addressing these factors in the postoperative care plan to enhance patient outcomes. Notably, aspects like body image, weight loss, and depressive symptoms are interrelated, suggesting that counseling for patients undergoing metabolic bariatric surgery should incorporate these elements to improve results.
Additionally, the presence of overhanging skin significantly affects patient well-being following surgery. Patients with excess skin who seek body contouring surgery often report more negative body image, higher levels of depressive symptoms, and a lower quality of life. Currently, these concerns are not included in the reimbursement criteria for body contouring surgery (BCS). Therefore, it is recommended that efforts be made to revise Dutch guidelines to incorporate these factors, ensuring that reimbursement policies better align with the psychological and physical needs of post-bariatric surgery patients.