The association of preoperative psychological assessments with long-term sleeve gastrectomy surgery outcomes

Abstract

Background Nearly all third-party healthcare plans adhere to the 1991 National Institutes of Health guidelines, which require preoperative psychological assessments before bariatric surgery. Despite these guidelines, the impact of these assessments on the long-term weight loss outcomes in laparoscopic sleeve gastrectomy patients without pre-existing psychological disorders remains ambiguous and insufficiently explored. Objective The objective of this study is to identify any relationship between preoperative psychological assessments and the long-term weight loss outcomes of patients having undergone a laparoscopic sleeve gastrectomy procedure without a diagnosed psychological disorder at the time of surgery. Methods Data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry for 120 patients who underwent laparoscopic sleeve gastrectomies (2008–2022) were retrospectively reviewed. The average percent weight loss was compared between those with (n = 61) and without (n = 59) preoperative psychological evaluations. All patients had given their consent for data collection for research purposes. Results Statistical comparisons using a two-tailed t-test revealed no statistically significant difference in the average percent weight loss between patients who underwent and did not undergo psychological evaluations (27.76% vs. 29.42%, p = 0.37) before a laparoscopic sleeve gastrectomy. Conclusions In this retrospective cohort, no statistically significant association was observed between preoperative psychological evaluation and long-term weight loss outcomes. This raises questions about the necessity of these assessments, suggesting they may act as unnecessary barriers to care. Further research is required to determine whether preoperative psychological evaluations should be specifically aimed at patients with pre-existing mental health conditions instead of being applied universally to all candidates for bariatric surgery.