The Interplay Between Social Factors and Metabolic Bariatric Surgery Outcomes-A 5-Year Prospective Study.

INTRODUCTION

Social relationships and support are vital for well-being and health. In the context of metabolic bariatric surgery (MBS), these relationships might influence emotion regulation and health behaviors that affect surgical outcomes. Conversely, the outcomes of MBS can impact an individual's social dynamics due to enhanced social engagement or potential shifts in social structures resulting from changes in self-perception.

OBJECTIVE

This study investigated the bidirectional relationship between social factors and metabolic bariatric surgery (MBS) outcomes, testing if social factors are associated with improved MBS outcomes, and if MBS outcomes are associated with changes in social relationships.

METHODS

Patients reported about structural and functional aspects of their social relations before surgery and at 1-, 3- and 5-year post-surgery. Physiological and mental health parameters were also collected. The relationship between pre-surgery social factors and MBS outcomes 5 years post-surgery was tested with a path model based on regression analysis. The relationship between MBS outcomes 1-year post-surgery and social relationships 3 years post-surgery was tested with multiple and logistic regressions.

RESULTS

Non-family support predicted higher satisfaction with surgery. Increased family coherence in partnered patients was linked to a greater reduction in blood pressure 5 years post-surgery. However, relationship stability, social competence, relationship satisfaction, and weight-loss specific support were not related to biopsychosocial outcomes.On the other hand, changes in social relationships post-surgery were not related to weight loss or other outcomes. Depression and anxiety symptoms 1 year after surgery were associated with decreased relationship satisfaction 3 years post-surgery.

CONCLUSION

Overall, social factors had limited and selective predictive value to outcomes, potentially due to the dominant influence of physical changes or generally satisfactory relationships. These findings offer insights for patients and healthcare providers on the nuanced implications of MBS beyond physical health.