Preoperatif Bilişsel İşlevler ile Bariatrik Cerrahi Sonuçları Arasındaki İlişki: Kapsam Derlemesi

Öz

Bariatrik cerrahi, obezite tedavisinde en etkili müdahalelerden biri olarak kabul edilmektedir. Cerrahinin başarısı sadece kilo kaybı ve ilişkili biyolojik faktörlere değil, aynı zamanda psikolojik ve bilişsel etmenlere de bağlıdır. Bu kapsam derlemesi, bariatrik cerrahi sonuçlarında preoperatif bilişsel işlevlerin ve süreçlerin rolünü inceleyen ampirik literatürü sistematik biçimde derleyerek literature katkı sunmayı amaçlamaktadır. Web of Science, Scopus ve PubMed veri tabanlarında yürütülen sistematik tarama sonucunda, belirlenen dahil etme ve dışlama ölçütlerine göre 11 çalışma bu derlemenin kapsamına dahil edilmiştir. Taramalar PRISMA-ScR yönergeleri temel alınarak gerçekleştirilmiş ve analizler popülasyon, kavramsal odak ve bağlama göre yapılandırılmıştır. Bulgular üç ana tema altında sunulmuştur: (1) Dikkat, bellek ve yürütücü işlevlerde düşük performans gösteren bireylerde kilo kaybı düzeylerinin daha düşük olduğu ancak bu ilişkinin tüm çalışmalarda tutarlı olmadığı görülmüştür. (2) Tedaviye uyum davranışlarındaki (randevuya katılım, diyet takibi, fiziksel aktivite) azalma ile bilişsel işlevlerdeki zayıflıkların ilişkili olduğu anlaşılmaktadır. (3) Dikkat eksikliği ve hiperaktivite bozukluğu veya yüksek dürtüsellik gibi bilişsel risk profillerine sahip bireylerde cerrahi sonrası dönemde madde kullanımı, yeme bozukluğu davranışları ve komplikasyon riskinde artış rapor edilmiştir. Bu bulgular, preoperatif bilişsel işlevlerin bariatrik cerrahi sonrası yalnızca fiziksel değil, davranışsal ve psikososyal uyum açısından da etkili olabileceğini göstermektedir.

Anahtar Kelimeler

• Bariatrik cerrahi
• bilişsel işlevler
• obezite cerrahisi
• yürütücü işlevler

Relationship Between Preoperative Cognitive Functions and Bariatric Surgery Outcomes: A Scoping Review

Abstract

Bariatric surgery is recognized as one of the most effective interventions in the treatment of obesity. Its success depends not only on weight loss and related biological factors, but also on psychological and cognitive aspects. This scoping review aims to systematically review empirical studies that examine the role of cognitive functions and processes assessed before surgery in predicting bariatric surgery outcomes. A comprehensive literature search was carried out using the Web of Science, Scopus, and PubMed databases. In total, 11 studies that satisfied the established inclusion and exclusion criteria were selected for analysis. The review was performed following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Analyses were structured using the population, concept, and context framework. Findings were organized under three main themes. First, individuals with lower performance in attention, memory, and executive functions tended to lose less weight after surgery, though this relationship was not consistently observed across all studies. Second, reduced cognitive functioning before surgery was associated with lower adherence to treatment-related behaviors such as attending medical appointments, maintaining dietary routines, and engaging in physical activity. Third, individuals with cognitive risk profiles, including symptoms of attention deficit hyperactivity disorder or high impulsivity, were more likely to experience complications such as substance use, disordered eating, and psychosocial difficulties postoperatively. These findings suggest that preoperative cognitive functioning may influence not only physical outcomes but also behavioral and psychosocial adaptation following surgery.

Keywords

• Bariatric surgery
• cognitive functions
• obesity surgery
• executive functions

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