Psychological Support and Well-being in Post-Bariatric Surgery Patients (original) (raw)
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Background The purpose of the present study is to evaluate the impact of a health psychology-led bariatric rehabilitation service (BRS) on patient weight loss following bariatric surgery at 1 year. Methods A single-site open-randomised parallel group control trial based at St. Richard's Hospital in Chichester in the UK. Patients (n=162) were recruited immediately prior to Roux-en-Y gastric bypass and randomly allocated to receive either treatment as usual (n=80) or the BRS (n=82). The BRS involved three 50-min one-to-one sessions with a health psychologist and provided information, support and mentoring pre and post surgery addressing psychological issues such as dietary control, self esteem, coping and emotional eating. Weight loss was assessed at 1 year. The key outcome variable was BMI and change in BMI. Results Follow-up weight was available for 145 patients. Intention-to-treat analysis (n = 162) using last measured weights showed that mean change in BMI by 1 year post surgery was −16.49. There was no significant difference between the two groups ; η p 2 =0.001). Similarly, explanatory analysis (n=145) showed a mean change in BMI of −17.17. The difference between the two groups was not significant (control group=−16.9, 95 % CI =15. ; η p 2 =0.001). Conclusions Psychological support pre and post bariatric surgery had no impact on weight loss as measured by BMI and change in BMI by 1 year. It is argued that psychological support should be targeted to patients who start to demonstrate weight regain at a later stage. Trial registration: ClinicalTrials.gov NCT01264120.
Background The purpose of the present study is to evaluate the impact of a health psychology-led bariatric rehabilitation service (BRS) on patient weight loss following bariatric surgery at 1 year. Methods A single-site open-randomised parallel group control trial based at St. Richard's Hospital in Chichester in the UK. Patients (n=162) were recruited immediately prior to Roux-en-Y gastric bypass and randomly allocated to receive either treatment as usual (n=80) or the BRS (n=82). The BRS involved three 50-min one-to-one sessions with a health psychologist and provided information, support and mentoring pre and post surgery addressing psychological issues such as dietary control, self esteem, coping and emotional eating. Weight loss was assessed at 1 year. The key outcome variable was BMI and change in BMI. Results Follow-up weight was available for 145 patients. Intention-to-treat analysis (n = 162) using last measured weights showed that mean change in BMI by 1 year post surgery was −16.49. There was no significant difference between the two groups ; η p 2 =0.001). Similarly, explanatory analysis (n=145) showed a mean change in BMI of −17.17. The difference between the two groups was not significant (control group=−16.9, 95 % CI =15. ; η p 2 =0.001). Conclusions Psychological support pre and post bariatric surgery had no impact on weight loss as measured by BMI and change in BMI by 1 year. It is argued that psychological support should be targeted to patients who start to demonstrate weight regain at a later stage. Trial registration: ClinicalTrials.gov NCT01264120.
The effect of mental health on weight loss after bariatric surgery
Danish medical journal, 2019
INTRODUCTION Psychosocial assessment of pre-bariatric patients is an internationally recommended practice. However, the applicability of the assessments remains unaccounted for. This study investigated if the allocation of bariatric surgery candidates to a high-risk category on the basis of a psychosocial assessment correlates with attenuated weight loss and reduced mental health improvements. METHODS The assessment procedure consisted of standardised psychometric questionnaires, structured diagnostic interviews and semi-structured interviews. Outcome measures were BMI and psychiatric symptom load measured by the Symptom Checklist 90 at baseline and 18 months after surgery. All patients received either the gastric bypass or sleeve gastrectomy procedure. RESULTS Forty pre-bariatric patients participated in the study. The findings point towards an enhanced weight loss but reduced mental health improvement in the high-risk category. CONCLUSIONS Eating disorder symptomology might explai...
Background: Improvement of mental health and health-related quality of life (HRQOL) is an important success criterion for bariatric surgery. In general, mental health and HRQOL improve after surgery, but some patients experience negative psychological reactions postoperatively and the influence of pre-surgical psychological factors on mental wellbeing after surgery is unclear. The aim of the current article therefore is to review recent research investigating psychological predictors of mental health and HRQOL outcome. Methods: We searched PubMed, PsycInfo and Web of Science for studies investigating psychological predictors of either mental health or HRQOL after bariatric surgery. Original prospective studies published between 2003 and 2012 with a sample size >30 and a minimum of 1 year follow-up were included. Results: Only 10 eligible studies were identified. The findings suggest that pre-operative psychological factors including psychiatric symptoms, body image and self-esteem may be important for mental health postoperatively. Predictors of post-operative HRQOL seem to include personality, severe psychiatric disorder at baseline and improvement of depressive symptoms. In addition, psychiatric symptoms that persist after surgery and inappropriate eating behaviour postoperatively are likely to contribute to poor health-related quality of life outcome.
Obesity Surgery, 2011
Background Psychological and behavioural factors seem to influence the results of bariatric surgery and the ability to achieve sustained weight loss and subjective wellbeing after the operation. Adequate pre-and postoperative psychological counselling are suggested to improve the results of surgery. However, some patients are reluctant to participate in pre-and postoperative counselling. The aim of the present study was to investigate the possible influence of psychiatric disorders on willingness to participate in group counselling in patients accepted for bariatric surgery. Methods One hundred and forty-one patients referred to bariatric surgery (F/M: 103/38) with mean body mass index (BMI) of 45.2 kg/m 2 (SD=5.3) and mean age of 42.0 years (SD = 10.4) were interviewed with Mini International Neuropsychiatric Interview (M.I.N.I.) and Structured Clinical Interview (SCID-II) preoperatively.
Journal of Obesity and Chronic Diseases
Background: Psychosocial factors, identified in pre-bariatric surgery evaluation, may affect surgical outcomes, as well as defer surgery, making it important to identify psychosocial predictors of surgery outcomes. Methods: Baseline depressive and social anxiety symptom scores were analyzed as predictors of post-surgical weight loss (WL) and quality of life (QOL) following Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB). Eighty-nine (82F, 7M) participants underwent surgery and completed depression, anxiety and QOL questionnaires 3-weeks pre-surgery and 1-year post-surgery. Results: Depressive scores and QOL scores improved post-surgery (P < 0.001), whereas social anxiety scores did not (P = 0.20). Baseline depressive (P = 0.90) and social anxiety (P = 0.20) scores did not predict % weight loss (WL) at 1 year, but higher baseline depressive (P = 0.04) and social anxiety (P = 0.005) scores predicted lower post-surgical QOL at 1 year. RYGB showed greater improvement in %WL (P < 0.001) than AGB, but no difference between the groups in QOL (P = 0.10). Improvement in QOL correlated with %WL (P < 0.001), whereas improvement in depressive scores did not correlate with %WL (P = 0.70) but did correlate with improvement in QOL (P = 0.01). Conclusions: Baseline depressive and social anxiety scores predicted QOL but not %WL. Depressive and QOL scores improved post-surgery, but social anxiety scores did not. The findings suggest that patients who present with depressive or social anxiety symptoms pre-surgery perhaps should not be deferred; however, more studies are needed to confirm this. Patients with pre-operative social anxiety symptoms may benefit from counseling.
Psychosocial Concerns Following Bariatric Surgery: Current Status
Current obesity reports, 2019
Purpose of Review The purpose of this paper is to review the current status of research on psychosocial concerns following bariatric surgery. Recent Findings Bariatric surgery has a positive overall impact on weight and obesity-related comorbidities, as well as a positive short-term impact on mental health and psychosocial functioning. Nonetheless, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating, substance use disorders, suicide, lack of social support, and excess skin. Moreover, special populations of patients may have distinctive psychosocial concerns based on sociodemographic factors such as age or severity of obesity. Available studies suggest that psychosocial interventions have a positive impact on post-surgery outcomes, particularly maladaptive eating. However, research is limited, and long-term data are lacking. Summary Monitoring patients after bariatric surgery for negative psychosocial outcomes is warranted. Research is needed to develop and evaluate personalized approaches to optimize long-term weight loss and psychosocial adjustment.
Body Image and Emotional Eating as Predictors of Psychological Distress Following Bariatric Surgery
Obesity Surgery, 2019
Background The purpose of this study was to shed light on the ambiguity concerning the variables affecting psychological distress following bariatric surgery, specifically the roles of body image dissatisfaction (BID) and emotional eating in detecting and predicting such outcomes. Methods Of 169 consecutive bariatric surgery candidates from a university-based bariatric center, who participated in the psychosocial pre-surgery survey from 2015 to 2017 (67% females, mean age 41.8 years (SD = 11.46), mean body mass index (BMI) 42.0 kg/m 2 (SD = 11.0)), 81 patients consented to be included in the follow-up phase (56% females, mean age 44.3 years (SD = 12.3, range 21-70), and BMI 30.1 kg/m 2 (SD = 6.2, range 19.7 to 56.2)). Risk of suicide (SBQ-R), depressive symptoms (PHQ-9), anxiety symptoms (PHQ-7), emotional eating behaviors (EES), and body image dissatisfaction (BID-BSQ8) measures were assessed before and after surgery. Results Post-surgery improvements were observed in body image and emotional eating total measures, as well as in percent total weight loss (TWL%) and percent excess weight loss (EWL%), but not in psychological distress outcomes. However, improvement in BID predicted better post-surgery in all the psychological distress outcomes whereas improvement in emotional eating predicted less post-surgery depression. Post-surgery BID positively correlated with depression and anxiety, whereas post-surgery emotional eating positively correlated with anxiety. Conclusions Weight loss is insufficient to determine a change in psychological distress following surgery. Physicians and other health professionals who treat bariatric surgery patients should be encouraged to asses BID pre-and post-surgery, as it is a sensitive indicator of improvement of psychological well-being after surgery.
Obesity Surgery, 2012
Bariatric surgery is currently considered the most effective treatment of severe obesity, but considerable individual variations in weight loss results have been reported. We therefore conducted a systematic review and meta-analysis of studies investigating the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery. A literature search was conducted in the databases PubMed and PsycINFO, identifying nine eligible studies reporting results of the effect of psychotherapeutic interventions and support groups on weight loss following bariatric surgery. The results revealed a statistically significant overall effect of both psychotherapeutic interventions and support groups on weight loss (pooled effect size correlation (ESr)0 0.18; p<0.0001). When comparing the effect sizes of psychotherapeutic interventions and support groups, no difference was found (p00.51). Higher quality studies had smaller effect sizes (0.16) than studies with low quality scores (0.22), but the difference did not reach statistical significance (p00.26). Patients attending psychotherapeutic interventions or support groups in combination with bariatric surgery appeared to experience greater weight loss results than patients treated with bariatric surgery only. However, research in this area is characterized by a lack of methodological rigor, and it is recommended that future study designs include randomization and active attention control conditions.