Psychopathological and quality of life gender differences in obese patients who were candidates for bariatric surgery

Abstract

Introduction: Gender differences in obesity go from prevalence, access to treatment, baseline characteristics, outcomes, and complications. Our aim was to access baseline differences in a bariatric surgery cohort, with an emphasis on psychopathology and quality of life (QoL). Methodology: Cross-sectional study at a bariatric surgery clinic performed by application of psychological (Y-BOCS, HAD scale, FCQ-S/T, BIS-11), and QoL (EQ-5D-3L and BQL index) questionnaires. Demographic, anthropometric, and comorbidities data was collected, as well as eating patterns, and motivation for surgery. A comparison between female and male patients was performed. Results: 244 patients were included, with similar age distribution between males (n=55) and females (n=189). Males had higher visceral fat (12.6±2.8% vs. 22.6±4.4%; p<0.001) and waist circumference (129±13cm vs. 135±14cm; p=0.02), lower total fat mass (52±4% vs. 38±4%; p<0.001), but with similar BMIs (44±5.8kg/m2 vs. 45±7.6kg/m2 ; p=ns). Hypertension, sleep apnea, and liver steatosis were more frequent in men, depression/anxiety, and venous insufficiency in women; diabetes, dyslipidemia, and osteoarticular disease were similar. Men engaged more in volume eating and females in emotional eating. Among women, issues with body image were the most usual motivation for surgery. The psychopathological profile showed a higher prevalence of anxiety in women (41% vs. 19%, p=0.02). Obsessive-compulsive traits, depression, food cravings, and impulsivity were similar. No gender differences were observed for QoL in the EQ5D-3L index and VAS and BQL index. However, there were differences in the following EQ-5D-3L health profiles of usual activities (p=0.03), pain/discomfort (p=0.001), and anxiety/depression (p<0.001). Conclusions: Although some comorbidities are more common in male obese patients, they are a minority in the bariatric surgery setting. A difference is present between male and female patients in eating patterns and motivation for surgery, inducing a psychological profile characterized by higher anxiety prevalence. This greater prevalence impacts in QoL, contributing to a higher burden of obesity among obese women.