Longitudinal dynamics of impulsivity in individuals undergoing obesity surgery - a systematic review.

Impulsivity is a personality trait composed of (food) reward sensitivity and inhibitory control. We have systematically synthesized evidence from prospective studies on broadly conceptualized impulsivity as agent and/or object of change within obesity surgery interventions. Using the PRISMA statement, studies were identified from a PubMed and PsychInfo search. We included studies investigating individuals with obesity undergoing surgery for weight loss which reported for the influence of impulsivity on surgery outcome and/or the effect of surgery on impulsivity as assessed by self-report or laboratory tasks. Our search resulted in 783 articles of which 40 articles were selected. Most evidence stems from self-report on food-related impulsivity using the Three-Factor Eating Questionnaire (TFEQ). We found consistent evidence that self-reported food-related impulsivity is not a predictor of weight outcome after obesity surgery and that impulsivity is decreased after surgey. There is preliminary evidence that baseline brain activity patterns in reward- and inhibition-related regions might predict surgery-induced weight loss. Post-surgery impulsivity levels and pre-post-changes in impulsivity were found to be predictive of surgery-induced weight loss. Evidence suggests a potential pathway of dynamic post-surgery self-amplifying interactions between surgery-induced physiological changes, impulsivity and its behavioral components and long-term weight development. Interventions fostering post-surgery decrease in impulsivity could improve treatment success and prevent weight regain.