The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis.

OBJECTIVE: The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified. We hypothesized that compared to post-bariatric patients with low psychological distress, post-bariatric patients with high psychological distress will be more at risk of weight regain. METHODS: A total of 67 patients (71.6% female, Mage = 45.9) participated in this observational retrospective cohort study. Patients' anthropometric data were gathered from medical records while the weight at the end of the lockdown through phone interviews. Psychological distress, operationalized with anxiety symptoms, depressive symptoms, and sleep disturbances, was assessed by an online self-report questionnaire. RESULTS: Significant differences were highlighted in the high and low psychological distressed group in weight changes, F(1,58) = 5.2, p < 0.001, η2 = 0.3. Specifically, compared to post-bariatric patients in the low psychological distress group, those in the high psychological distressed group reported weight regained (95% CI = 1.0, 2.6). CONCLUSION: Results highlight the need to target post-bariatric patients with high psychological distress who are at risk for weight regain during the COVID-19 pandemic. Interventions mitigating psychological distress and obesogenic behaviors during future pandemics or in post-COVID times are needed in vulnerable post-bariatric patients reporting high psychological distress.

The impact of COVID-19 emergency on weight and nutritional habits of patients who underwent bariatric surgery

Introduction: Since the end of 2019, the COVID-19 pandemic has been one of the most important public health problems of the last decades. To date, the most effective instrument to reduce the spread of the infection is strict social distancing, despite economic, social and psychological drawbacks. Obese people are among the most affected by both COVID- 19 mortality and public health measures effects. On one hand, obesity is associated with poorer COVID-19 outcomes and, on the other hand, lockdowns promote weight gain and a worsening of overweight comorbidities. Despite bariatric surgery emerged as the most effective therapy for obesity, only preliminary data are available about the effects of the pandemic on possible weight regain and mental health worsening in bariatric patients. Our aim was to evaluate how Italian lockdown influenced weight, food choices and psychological health of a cohort of patients who underwent bariatric surgery. Methods: We included 87 patients who underwent bariatric surgery at the Surgery of the Alimentary Tract and were followed up at the Unit of Endocrinology and Prevention and Care of Diabetes of the Sant'Orsola University Hospital of Bologna between 12 and 18 months before March 2020 lockdown. Patients' personal, socio-demographic, anthropometric, nutritional and psychological data were collected using medical records, phone interview or psychometric questionnaires at the end of lockdown. Results: Mean differences between body weight at the end of lockdown and at last follow up visit was 0,1±3,8 kg. No significant differences in consumed Kcal were found, but total lipid and oligosaccharides consumption resulted higher than expected. Family composition, psychological distress, anxiety and depression had a significant effect on mean weight and BMI differences at the end of lockdown. Foreigner patients and women obtained higher scores in psychometric questionnaires regarding acute stress and anxiety, while the prevalence of anxiety and depression at the end of lockdown were higher among immigrants. Psychological distress and depression scores were positively correlated to weight and BMI increase, but no relation were found between Kcal and principal macronutrients and differences in weight and BMI. Conclusion: The present study showed that bariatric patients seem generally protected from weight gain due to lockdown induced negative changes in lifestyle. However, people living alone or perceiving a great psychological burden during the emergency had a higher risk to increase weight.