Psychological Outcomes and Predictors of Initial Weight Loss Outcomes Among Severely Obese Adolescents Receiving Laparoscopic Adjustable Gastric Banding

Objective: Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery. The role of mental health providers in this population is not well defined, and the selection of candidates is often the result of clinical judgment alone. The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric banding (LAGB) by (1) examining changes in depressive symptoms and quality of life in the year following surgery; (2) evaluating the interaction between patterns of change in depression, quality of life, and weight postsurgery; and (3) identifying presurgical psychological predictors of initial weight change.

Method: Participants were 101 severely obese adolescents aged 14 to 18 years receiving LAGB at the Center for Adolescent Bariatric Surgery at the Morgan Stanley Children’s Hospital of New York Presbyterian/Columbia University Medical Center between August 2006 and December 2009. Measures of height, weight, depressive symptoms, and quality of life were obtained in the first year following surgery. Changes in the Beck Depression Inventory (BDI), Pediatric Quality of Life Inventory (PedsQL), and body mass index were analyzed using latent growth curve modeling.

Results: Short-term changes in psychiatric symptoms and weight were analyzed using latent growth curve modeling. Significant changes in total BDI (βslope=−0.885, SE=0.279, P<.01; βquadratic=0.054, SE=0.021, P<.001) and PedsQL (βslope=−0.885, SE=0.279, P<.001) scores were observed following LAGB, and comparable postoperative changes between psychosocial variables and body mass index were also noted (BDI: covariance [COV]=0.21, SE=0.06, P<.001; PedsQL: COV=−0.41, SE=0.10, P<.01). Two variables (family conflict/loss of control eating) were found to be significant predictors of weight change over the year following surgery (P<.05).

Conclusions: Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB, and measures of preoperative binge eating and family conflict affected postsurgery body mass index among youth.

Trial Registration: ClinicalTrials.gov identifier: NCT01045499

J Clin Psychiatry 2012;73(10):1351-1357

© Copyright 2012 Physicians Postgraduate Press, Inc.

Submitted: February 1, 2012; accepted May 7, 2012(doi:10.4088/JCP.12m07690).

Corresponding author: Robyn Sysko, PhD, New York State Psychiatric Institute, 1051 Riverside Drive, Unit 98, New York, NY 10032 ([email protected]).