Biopsychosocial profiles and postoperative weight-loss trajectories among bariatric surgery patients

Abstract

Obesity affects over one billion people worldwide and is recognized as a significant global health challenge. Metabolic and bariatric surgery (MBS) is one of the most effective treatments for individuals with severe obesity. Because patients may present with additional biopsychosocial factors related to obesity, understanding their overall health profile is important for anticipating how these factors may shape surgical outcomes. This study utilized a latent class analysis approach to identify three preoperative biopsychosocial profiles (varying in physical comorbidities, mental health diagnoses, and psychosocial supports). Next, an unconditional growth curve was used to examine the percent total weight loss (%TWL) following the first year after surgery. The growth curve showed a linear pattern of total weight loss from 1 to 12 months with meaningful individual variability, but patients’ initial weight at surgery did not predict later weight trajectories. When the LCA profile classes were added as a predictor, the profiles did not significantly predict %TWL across the first year. Interpreted through the biopsychosocial model, early outcomes appear driven by shared biological effects of surgery and standardized aftercare, which may temporarily minimize the impact of preexisting psychological and social differences. The absence of differences in early postoperative weight-loss trajectories across biopsychosocial profiles suggests that a combination of shared factors may minimize the influence of preoperative psychological and social differences during the first postoperative year. Whether biopsychosocial factors exert greater influence after one-year post-surgery remains an important area for future research.