The impact of adult attention deficiency and hyperactivity disorder,impulsivity and emotion regulation on outcomes following bariatricsurgery

Objective: The determination of the level of success and the factors affecting success before the operation of bariatric surgery is important in determining the appropriate support and treatment approach for these patients. In the light of this information, in our study, we aimed to examine the effects of ADHD, impulsivity and emotion regulation difficulties from moderators on the success of bariatric surgery treatment and weight loss in patients who have passed at least 1 to 5 years after obesity surgery. Method: This study was evaluated by a psychiatrist according to DSM-5 criteria, who had undergone obesity surgery who applied to Turgut Özal Medical Center General Surgery and Consultancy-Liaison Psychiatry outpatient clinic between March 2019 and September 2019. Sociodemographic Data Form, Adult Attention Deficit Hyperactivity Disorder Self-Reporting Scale (ASRS), Wender-Utah Rating Scale (WURS), Difficulties of Emotion Regulation Scale (DERS) and Eating Attitude Scale were filled in by self-report. In the planned cross-sectional study, 120 post-bariatric participants (42 women, 78 men) were included in the evaluation. Results: 65% (78 people) of our study sample were male and 35% (42 people) were female. The average age of the participants is 37.22 ± 14.22. The lowest age is 20 and the highest age is 66. Psychiatric illness was present in 16.7% (20 people) of the participants and was excluded from the sample. The rate of being positive for ADHD in our sample was 22%, and it was comparable to the frequency of other studies in which ADHD diagnosis was evaluated by direct interview. When the preoperative BMIs of the participants were examined, 8 people were in grade 1 obese, 24 people were in grade 2 obese and 64 people were in grade 3 obese. When it is evaluated as the elapsed time after the operation period; 7% were less than 24 months, 73% were between 24-48 months and 20% were more than 48 months. There was no difference in terms of age, gender, marital status, education, employment status, type of operation, and preoperative BMI between those who succeeded and did not lose weight. In those who spent more than 36 months after the operation period, the rate of weight gain was higher than those who passed 36 months or less (p = 0.001). There was no difference in our sample in terms of abnormal eating behaviors, adult and / or childhood ADHD, impulsivity, and inability to regulate emotion among successful and unsuccessful groups according to weight loss and regain weight. Discussion: The fact that ADHD diagnosis has no effect on the results of bariatric surgery is consistent with the literature, while the absence of another study examining the direct effect of emotional dysregulation on the results of bariatric surgery makes our data first. Further studies should investigate the diagnosis of ADHD, its impulsivity, emotion regulation ability, and eating behaviors based on interviews before surgery, and the course of these factors with long-term follow-up programs after surgery. Recent studies and our study point to the necessity of long-term psychiatric follow-up programs in order to be able to recognize and manage psychopathologies that may affect post-surgical outcomes. Keywords: ADHD, obesity surgery, emotion regulation, eating attitude, obesity