{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T18:28:55Z","timestamp":1775759335186,"version":"3.50.1"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T00:00:00Z","timestamp":1775692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nearly all third-party healthcare plans adhere to the 1991 National Institutes of Health guidelines, which require preoperative psychological assessments before bariatric surgery. Despite these guidelines, the impact of these assessments on the long-term weight loss outcomes in laparoscopic sleeve gastrectomy patients without pre-existing psychological disorders remains ambiguous and insufficiently explored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study is to identify any relationship between preoperative psychological assessments and the long-term weight loss outcomes of patients having undergone a laparoscopic sleeve gastrectomy procedure without a diagnosed psychological disorder at the time of surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program registry for 120 patients who underwent laparoscopic sleeve gastrectomies (2008\u20132022) were retrospectively reviewed. The average percent weight loss was compared between those with (n\u2009=\u200961) and without (n\u2009=\u200959) preoperative psychological evaluations. All patients had given their consent for data collection for research purposes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Statistical comparisons using a two-tailed t-test revealed no statistically significant difference in the average percent weight loss between patients who underwent and did not undergo psychological evaluations (27.76% vs. 29.42%, p\u2009=\u20090.37) before a laparoscopic sleeve gastrectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort, no statistically significant association was observed between preoperative psychological evaluation and long-term weight loss outcomes.<\/jats:p>\n                    <jats:p>This raises questions about the necessity of these assessments, suggesting they may act as unnecessary barriers to care. Further research is required to determine whether preoperative psychological evaluations should be specifically aimed at patients with pre-existing mental health conditions instead of being applied universally to all candidates for bariatric surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0344917","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T17:33:53Z","timestamp":1775756033000},"page":"e0344917","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The association of preoperative psychological assessments with long-term sleeve gastrectomy surgery outcomes"],"prefix":"10.1371","volume":"21","author":[{"given":"Sofia","family":"Yeremian","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7403-3575","authenticated-orcid":true,"given":"Ara","family":"Keshishian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Mardirosian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"issue":"11","key":"pone.0344917.ref001","doi-asserted-by":"crossref","DOI":"10.1001\/jamasurg.2018.3326","article-title":"Comparative effectiveness and safety of bariatric procedures in medicare-eligible patients: a systematic review","volume":"153","author":"OA Panagiotou","year":"2018","journal-title":"JAMA Surg"},{"key":"pone.0344917.ref002","doi-asserted-by":"crossref","DOI":"10.5888\/pcd18.210094","article-title":"Geographic Variation in Obesity at the State Level in the All of Us Research Program","volume":"18","author":"CR Clark","year":"2021","journal-title":"Prev Chronic Dis"},{"key":"pone.0344917.ref003","article-title":"Has the prevalence of overweight, obesity and central obesity levelled off in the United States? Trends, patterns, disparities, and future projections for the obesity epidemic","author":"Y Wang","year":"2020","journal-title":"Inter J Epidemiol"},{"issue":"7","key":"pone.0344917.ref004","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1002\/oby.22200","article-title":"Self-reported weight-loss methods and weight change: ten-year analysis in the swedish obese subjects study control group","volume":"26","author":"E Zent\u00e9nius","year":"2018","journal-title":"Obesity (Silver Spring)"},{"key":"pone.0344917.ref005","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2147\/DMSO.S141235","article-title":"Reasons for discontinuation of GLP1 receptor agonists: data from a real-world cross-sectional survey of physicians and their patients with type 2 diabetes","volume":"10","author":"MV Sikirica","year":"2017","journal-title":"Diabetes Metab Syndr Obes"},{"issue":"13","key":"pone.0344917.ref006","doi-asserted-by":"crossref","first-page":"10449","DOI":"10.3390\/ijms241310449","article-title":"Emerging role of GLP-1 agonists in obesity: a comprehensive review of randomised controlled trials","volume":"24","author":"M-S Popoviciu","year":"2023","journal-title":"Int J Mol Sci"},{"key":"pone.0344917.ref007","article-title":"Anti-obesity drug discovery: advances and challenges","author":"TD M\u00fcller","journal-title":"Nat Rev Drug Discov"},{"key":"pone.0344917.ref008","author":"K Crossan","year":"2024"},{"issue":"1","key":"pone.0344917.ref009","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5946\/ce.2021.019","article-title":"The efficacy and safety of endoscopic sleeve gastroplasty as an alternative to laparoscopic sleeve gastrectomy","volume":"54","author":"Study Group for Endoscopic Bariatric and Metabolic Therapies of the Korean Society of Gastrointestinal Endoscopy","year":"2021","journal-title":"Clin Endosc"},{"key":"pone.0344917.ref010","article-title":"Adverse events and complications with intragastric balloons: a narrative review (with Video).","author":"I Braga Ribeiro"},{"issue":"9","key":"pone.0344917.ref011","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1381\/0960892042387066","article-title":"Duodenal switch is a safe operation for patients who have failed other bariatric operations","volume":"14","author":"A Keshishian","year":"2004","journal-title":"Obes Surg"},{"issue":"2","key":"pone.0344917.ref012","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.soard.2022.10.024","article-title":"Conversion of gastric sleeve to Roux-en-Y gastric bypass and biliopancreatic diversion\/duodenal switch: safe and viable options","volume":"19","author":"H Spivak","year":"2023","journal-title":"Surg Obes Relat Dis"},{"key":"pone.0344917.ref013","doi-asserted-by":"crossref","first-page":"4946","DOI":"10.1007\/s00464-021-08850-y","article-title":"Ten year comparative analysis of sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch in patients with BMI \u2265 50 kg\/m 2","volume":"36","author":"J Maroun","year":"2021","journal-title":"Surg Endosc"},{"issue":"3","key":"pone.0344917.ref014","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.soard.2011.05.012","article-title":"Comparative early outcomes of three laparoscopic bariatric procedures: sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch","volume":"8","author":"P Topart","year":"2012","journal-title":"Surg Obes Relat Dis"},{"issue":"1","key":"pone.0344917.ref015","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11695-022-06332-1","article-title":"2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery","volume":"33","author":"D Eisenberg","year":"2022","journal-title":"Obes Surg"},{"key":"pone.0344917.ref016","doi-asserted-by":"crossref","unstructured":"Rutledge T, Adler S, Friedman R. A prospective assessment of psychosocial factors among bariatric versus non-bariatric surgery candidates. 2010.","DOI":"10.1007\/s11695-010-0287-8"},{"issue":"3","key":"pone.0344917.ref017","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.soard.2016.11.008","article-title":"Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients","volume":"13","author":"RJ Marek","year":"2017","journal-title":"Surg Obes Relat Dis"},{"issue":"3","key":"pone.0344917.ref018","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1037\/hea0001142","article-title":"The relationship of presurgical personality assessment inventory scales to BMI following bariatric surgery","volume":"41","author":"T Hoyt","year":"2022","journal-title":"Health Psychol"},{"issue":"5","key":"pone.0344917.ref019","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.soard.2021.01.012","article-title":"Six-year bariatric surgery outcomes: the predictive and incremental validity of presurgical psychological testing","volume":"17","author":"KW Martin-Fernandez","year":"2021","journal-title":"Surg Obes Relat Dis"},{"issue":"6","key":"pone.0344917.ref020","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1038\/oby.2010.336","article-title":"Binge eating disorder and the outcome of bariatric surgery at one year: a prospective, observational study","volume":"19","author":"TA Wadden","year":"2011","journal-title":"Obesity (Silver Spring)"},{"issue":"1","key":"pone.0344917.ref021","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1007\/s11695-011-0472-4","article-title":"Preoperative predictors of weight loss following bariatric surgery: systematic review","volume":"22","author":"M Livhits","year":"2012","journal-title":"Obes Surg"},{"issue":"21","key":"pone.0344917.ref022","doi-asserted-by":"crossref","first-page":"7955","DOI":"10.3390\/ijerph17217955","article-title":"Accuracy of self-reported items for the screening of depression in the general population","volume":"17","author":"J Arias-de la Torre","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0344917.ref023","doi-asserted-by":"crossref","first-page":"284","DOI":"10.7861\/clinmed.2023-0168","article-title":"Causes of obesity: a review","volume":"23","author":"B Masood","year":"2023","journal-title":"Clin Med (Lond)"},{"issue":"7","key":"pone.0344917.ref024","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3928\/02793695-20080701-06","article-title":"Pharmacotherapy for psychotropic drug-related weight gain","volume":"46","author":"RH Howland","year":"2008","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"key":"pone.0344917.ref025","first-page":"37","article-title":"Weight gain and antidepressants","author":"M Fava","year":"2000","journal-title":"J Clin Psychiatry"},{"key":"pone.0344917.ref026","first-page":"507","article-title":"Psychotropic drugs induced weight gain: a review of the literature concerning epidemiological data, mechanisms and management","volume":"31","author":"O Ruetsch","year":"2005","journal-title":"Encephale"},{"issue":"7","key":"pone.0344917.ref027","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1097\/JXX.0000000000000447","article-title":"Obesity and genetics","volume":"32","author":"A Golden","year":"2020","journal-title":"J Am Assoc Nurse Pract"},{"key":"pone.0344917.ref028","doi-asserted-by":"crossref","unstructured":"Frank J, Gupta A, Osadchiy V, Mayer EA, Oppenheimer G. Brain-Gut-microbiome interactions and intermittent fasting in obesity. 2021.","DOI":"10.3390\/nu13020584"},{"key":"pone.0344917.ref029","doi-asserted-by":"crossref","first-page":"289645","DOI":"10.1155\/2010\/289645","article-title":"Chronic inflammation in obesity and the metabolic syndrome","volume":"2010","author":"R Monteiro","year":"2010","journal-title":"Mediators Inflamm"},{"issue":"6","key":"pone.0344917.ref030","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1089\/lap.2020.0154","article-title":"Why we think laparoscopic sleeve gastrectomy is a good operation: step-by-step technique","volume":"30","author":"M Palermo","year":"2020","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"2","key":"pone.0344917.ref031","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2020.e03496","article-title":"The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review","volume":"6","author":"M Kheirvari","year":"2020","journal-title":"Heliyon"},{"issue":"5","key":"pone.0344917.ref032","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/j.soard.2013.05.007","article-title":"Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials","volume":"9","author":"S Trastulli","year":"2013","journal-title":"Surg Obes Relat Dis"},{"key":"pone.0344917.ref033","doi-asserted-by":"crossref","DOI":"10.1093\/milmed\/usab078","article-title":"Preoperative psychological assessment and weight loss outcomes in bariatric surgery patients at a military treatment facility: a retrospective profile analysis","volume":"187","author":"FA Walter","year":"2022","journal-title":"Mil Med"},{"issue":"10","key":"pone.0344917.ref034","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s11695-008-9469-z","article-title":"Preoperative psychological testing--another form of prejudice","volume":"18","author":"D Ashton","year":"2008","journal-title":"Obes Surg"},{"issue":"10","key":"pone.0344917.ref035","doi-asserted-by":"crossref","first-page":"3090","DOI":"10.1007\/s11695-023-06722-z","article-title":"Procedure matters in gender-associated outcomes following metabolic-bariatric surgery: five year north american matched cohort analysis","volume":"33","author":"T Bharani","year":"2023","journal-title":"Obes Surg"},{"key":"pone.0344917.ref036","article-title":"Sociodemographic Trends in Bariatric Surgery Utilization in the USA","author":"OE Pickett-Blakely","journal-title":"N\/A"},{"key":"pone.0344917.ref037","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/2046-4053-3-15","article-title":"Health inequity in access to bariatric surgery: a protocol for a systematic review","volume":"3","author":"TD Jackson","year":"2014","journal-title":"Syst Rev"},{"issue":"10","key":"pone.0344917.ref038","doi-asserted-by":"crossref","first-page":"1330","DOI":"10.1007\/s11695-008-9469-z","article-title":"Preoperative psychological testing--another form of prejudice","volume":"18","author":"D Ashton","year":"2008","journal-title":"Obes Surg"},{"issue":"12","key":"pone.0344917.ref039","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.soard.2022.08.013","article-title":"2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery","volume":"18","author":"D Eisenberg","year":"2022","journal-title":"Surg Obes Relat Dis"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344917","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T17:33:59Z","timestamp":1775756039000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0344917"}},"subtitle":[],"editor":[{"given":"Kwang-Sig","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,4,9]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0344917","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,9]]}}}