Psychological status before and after gastric restriction as predictors of weight loss in the morbidly obese.

Before gastric restriction, 118 morbidly obese women were psychiatrically assessed by clinical interview and self-report questionnaire. One year after surgery, 71 repeated the questionnaires. Weight was assessed at yearly intervals until the four year follow-up (n = 91). The maximum mean weight loss of 35 kg occurred at one year follow-up, when questionnaire respondents reported a slight overall improvement in personal and marital adjustment, and 72% rated themselves as very pleased with the results of surgery. Subsequently, 70% of patients regained weight, although the mean annual increase was only 1.9 kg. Marital dissatisfaction was a significant positive predictor of weight at one year, and generalized anxiety was a significant negative predictor of weight at four years. An increase in phobia scores at one year predicted subsequent maintenance of weight loss, whereas an increase in extrapunitiveness (mainly irritability and criticism of others) predicted subsequent weight gain.