Mechanism Of Weight Bias Internalization On Quality Of Life In Obese Patients Who Will Undergoing Sleeve Gastrectomy And Analysis Of Postoperative Weight Loss

The prevention and treatment of obesity and its comorbidity are increasingly serious,obese individuals have a poor quality of life and psychological state.Laparoscopic Sleeve Gastrectomy(LSG)is the mainstream operation for weight loss and metabolic surgery in China.There are few studies on preoperative quality of life,psychological state,and their correlation with postoperative weight loss.This study has two parts.The first part investigated the preoperative quality of life(both physical and mental),weight bias internalization(WBI),self-esteem,and depression in obesity who underwent LSG,and further investigated the role of self-esteem and depression in mediators between weight bias internalization and quality of life;In the second part,patients were followed up at 1,3,and 6 months after surgery to investigate whether psychology was associated with postoperative weight loss.This study aims to understand the current status of preoperative quality of life and psychological status of obese patients undergoing LSG in China,to provide an empirical basis for improving the quality of life of obesity,and to provide theoretical support for the development of individualized psychological intervention strategies to improve patients’ surgical outcomes.[Part 1]Methods:A convenience sample of obese patients undergoing LSG at the hospital in Jinan,Shandong,in the Department of Weight Loss and Metabolic was selected for preoperative questionnaires,and the study instruments included the general sociodemographic inventory,Weight Bias Internalization Scale(WBIS),Self-Esteem Scale(SES)Self-rating Depression Scale(SDS),and the Mos 36-Item Short Form Health Survey(SF-36).Statistical analyses and mediated model construction were performed using SPSS 25.0 software and Process 3.4.Result:(1)A total of 246 preoperative patients were enrolled,with an average age of 32.07±7.5 years,and an average BMI was 41.10±7.91 kg/m2.(2)The quality of life score was 64.53±17.68,of which the PCS was 64.91±18.61,and the MCS was 64.15±20.99.Overall,it is a weaker level of good quality of life.(3)The scores of weight bias internalization and depression were 52.02±11.66,and 50.93±4.27,respectively,which were at high levels of self-discrimination and depression.Self-esteem scores were 28.86±4.27,with a moderate level of self-esteem.(4)Pearson correlation analysis showed that all variables were correlated(P<0.01).(5)The results of hierarchical linear regression analysis showed that WBI had had a significant negative predictive effect on the PCS and MCS.(6)Establishing a mediation:taking the PCS as the dependent variable,the indirect effects of WBI on it were significant;taking the MCS as the dependent variable,the direct of WBI were significant.And the chain mediator were all established.[Part 2]Methods:A total of 246 obese patients with LSG were followed up by telephone and WeChat in the 1,3,and 6 months after surgery.The patients who had complications,pregnancy,refusal to cooperate,failure to follow up,and missing contact were excluded,and the date for follow-up was finally recovered as the 1 month(205 cases),3 months(203 cases),and 6 months(157 cases)after surgery.Statistical analysis was performed using SPSS25.0 software.Result:(1)The percentage of total weight loss(%TWL)and the percentage of excess weight loss(%EWL)increased with the increase of postoperative time,with%EWL being 73.00±29.81%at 6 months.(2)The postoperative weight loss decreases with the increasing of preoperative BMI(P<0.001).(3)Pearson correlation analysis showed a positive correlation between%EWL and preoperative depression in patients(P<0.05).Conclusion:(1)The weight bias internalization in patients receiving LSG obesity is not optimistic;the level of quality of life needs to be improved.(2)Patients with LSG obesity who receive LSG are inherently discriminatory and depressed in their quality of life,and self-esteem is a protective factor for their quality of life.(3)Depression and self-esteem can mediate the impact of WBI on PCS in obesity.Self-esteem and depression can partially mediate the weight bias internalization on MCS\PCS.and the chain mediator of WBI→self-esteem→depression→PCS and WBI self-esteem→depression→MCS is established.(4)Postoperative weight loss is good in patients,and the postoperative weight loss effect may be related to preoperative depression.