Original articleCognitive function predicts 24-month weight loss success after bariatric surgery
Section snippets
Trial design and participants
A total of 57 bariatric surgery patients were recruited into this multisite prospective study examining the neurocognitive effects of bariatric surgery. All participants were part of the Longitudinal Assessment of Bariatric Surgery (LABS) parent project and were recruited from 3 LABS sites [17]. Individuals participating in the parent project who were eligible for the present study were approached at the time of enrollment regarding this ancillary cognitive study. More than 80% of participants
Interventions and clinical follow-up
This study is registered with clinicaltrials.gov, and all procedures were approved by the appropriate Institutional Review Boards. All participants provided written informed consent before study involvement. Participants completed self-report measures of demographic and medical characteristics and a computerized cognitive test battery at baseline (within 30 days before surgery), 12 weeks (±5 days), and 24 months (±30 days) after surgery. Weight and height were measured in the research office
Outcomes
The present study examined whether cognitive function 12 weeks after bariatric surgery predicted %WL and BMI at 24-month follow-up. The Integneuro cognitive test battery demonstrates strong psychometric properties [19] and was chosen based on previous work from our laboratory showing its sensitivity to the cognitive difficulties manifested in obese persons [7]. This cognitive test battery consists of estimated premorbid intellectual abilities as well as performance in cognitive domains most
Data analyses
To facilitate clinical interpretation and maintain directionality within scales, all raw scores of neuropsychological measures assessing cognitive function were transformed to T-scores (a distribution with a mean of 50 and a standard deviation of 10) using existing normative data correcting for age, gender, and estimated premorbid intelligence. A global cognitive function composite score for baseline and 12-week postoperative time points was then created that consisted of the mean of the
Baseline, 12-week, and 24-month BMI and %WL
The average baseline BMI within the sample was 46.49 (SD = 5.22) kg/m2. There was a significant decrease in BMI from baseline to 12 weeks after surgery (F-statistic [F] [1,56] = 573.29; P<.001; mean 12-week BMI = 38.43 [SD = 4.81] kg/m2) and from 12 weeks to 24 months after surgery (F[1,56] = 119.59; P value<.001; mean 24-month BMI = 31.17 [SD = 6.46] kg/m2). Consistent with this pattern, there was a significant increase in %WL (F[1,56 = 120.77]; P<.001) from 12 weeks (Mean [M] = 17.30 [SD =
Discussion
The present study prospectively examined cognitive function as a predictor of weight loss after bariatric surgery. Patients who had undergone bariatric surgery demonstrated baseline cognitive impairment that improved 12 weeks after bariatric surgery. In addition, cognitive function at 12 weeks postoperatively was associated with lower BMI and significantly higher postoperative %WL at 24 months.
Finding that cognitive performance shortly after surgery predicts weight loss outcomes 2 years later
Conclusions
Results of the present study indicate that better cognitive test performance shortly after surgery predicts higher %WL and lower BMI 24 months after bariatric surgery. Further work is necessary to clarify the degree to which adherence to postoperative guidelines for diet, eating behavior, and physical activity contributes to the relationship between weight loss and cognitive function, because this approach may ultimately help identify those individuals in greatest need for intervention to
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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Data collection supported by DK075119. Manuscript supported in part by HL089311. The authors acknowledge the use of LABS data as the sole contribution of the LABS consortium.