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Research Article: Impact of parental psychological intervention on long-term outcomes following bariatric surgery: a retrospective cohort study

Date Published: 2026-07-28

Abstract:
The efficacy of bariatric surgery is often compromised by psychosocial factors within the family environment. Clinical observations suggest that parents of patients with obesity frequently exhibit maladaptive psychological traits, such as anxiety and excessive control, which may hinder long-term postoperative weight loss. We conducted a retrospective cohort study involving 200 patients who underwent bariatric surgery (Laparoscopic Sleeve Gastrectomy or Roux-en-Y Gastric Bypass) at our institution between January 2018 and January 2024. Patients treated from 2018 to early 2021 ( n =?100) comprised the Control Group (standard surgical care). Patients treated from 2021 to 2024 ( n =?100) comprised the Observation Group, who received standard surgical care plus a structured, multi-session psychological intervention for their parents, based on Cognitive Behavioral Therapy (CBT) and Family Systems Therapy. The primary outcomes were the percentage of excess weight loss (%EWL) and weight regain rate at 24 months postoperatively. Baseline demographics and preoperative BMI were comparable between groups. At the 24-month follow-up, the Observation Group demonstrated significantly superior outcomes. The mean %EWL was 78.2%?±?6.1% in the Observation Group vs. 55.1%?±?7.5% in the Control Group ( P <?0.001). The weight regain rate was significantly lower in the Observation Group (4.2% vs. 18.5%, P <?0.01). Pearson correlation analysis revealed a significant positive correlation between the reduction in parental control scores and patient dietary adherence scores at 24 months (r?=?0.86, P <?0.001) within the Observation Group. Integrating targeted psychological intervention for parents into bariatric surgery protocols is associated with significantly improved long-term weight loss and reduced weight regain. Addressing maladaptive family dynamics, specifically parental anxiety and controlling behaviors, appears to be a crucial component for the durable success of metabolic surgery. Due to the quasi-experimental design, these findings warrant confirmation in prospective, randomized controlled trials.

Introduction:
The efficacy of bariatric surgery is often compromised by psychosocial factors within the family environment. Clinical observations suggest that parents of patients with obesity frequently exhibit maladaptive psychological traits, such as anxiety and excessive control, which may hinder long-term postoperative weight loss.

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