The effect of mental health on weight loss after bariatric surgery (original) (raw)
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Psychosocial Factors and 2-Year Outcome Following Bariatric Surgery for Weight Loss
Obesity Surgery, 2003
Background: How psychosocial factors may impact on weight loss after bariatric surgery is not well understood. This lack of knowledge is problematic, because there is a high prevalence of psychosocial distress in patients seeking treatment for obesity in hospital-based programs. The purpose of this study was to examine the relationship between preoperative psychosocial factors and eventual weight loss.
Surgery for Obesity and Related Diseases, 2019
Background: Long-term, longitudinal data are limited on mental disorders after bariatric surgery. Objective: To report mental disorders through 7 years post-surgery and examine their relationship with changes in weight and health-related quality of life (HRQoL). Setting: Three U.S. academic medical centers. Method: As a sub-study of the Longitudinal Assessment of Bariatric Surgery Consortium, 199 adults completed the Structured Clinical Interview for DSM-IV prior to Roux-en-Y Gastric Bypass (RYGB) or Laparoscopic Adjustable Gastric Band (LAGB). Participants who completed ≥1 follow-up through 7-years post-surgery are included (n=173; 86.9%). Mixed models were used to examine mental disorders over time, and among the RYGB subgroup (n=104), their relationship with long-term (≥4 years) pre-to post-surgery changes in weight and HRQoL, measured with the Short Form-36 Health Survey, and with weight regain from nadir. Results: Compared with pre-surgery (34.7%), the prevalence of having any mental disorder was significantly lower 4 years (21.3%; p<.01) and 5 years (19.2%; p=.01), but not 7 years (29.1%; p=.27) following RYGB. The most common disorders were not related to long-term weight loss
Psychiatric Disorders and Weight Change in a Prospective Study of Bariatric Surgery Patients
Psychosomatic Medicine, 2016
Objective-To document changes in Axis I psychiatric disorders following bariatric surgery and examine their relationship with post-surgery weight loss. Methods-As part of a 3-site sub-study of the Longitudinal Assessment of Bariatric Surgery (LABS) Research Consortium, 199 patients completed the Structured Clinical Interview for DSM-IV prior to Roux-en-Y Gastric Bypass (RYGB) or Laparoscopic Adjustable Gastric Band (LAGB). At 2 or 3 years post-surgery, 165 (83%) patients completed a follow-up assessment [pre-surgery median body mass index (BMI) 44.8 kg/m 2 , median age 46 years, 92.7% white, 81.1% female]. Linear mixed modeling was used to test change in prevalence of psychiatric disorders over time, report remission and incidence, and examine associations between psychiatric disorders and weight loss.
Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery
JAMA, 2016
IMPORTANCE Bariatric surgery is associated with sustained weight loss and improved physical health status for severely obese individuals. Mental health conditions may be common among patients seeking bariatric surgery; however, the prevalence of these conditions and whether they are associated with postoperative outcomes remains unknown. OBJECTIVE To determine the prevalence of mental health conditions among bariatric surgery candidates and recipients, to evaluate the association between preoperative mental health conditions and health outcomes following bariatric surgery, and to evaluate the association between surgery and the clinical course of mental health conditions. DATA SOURCES We searched PubMed, MEDLINE on OVID, and PsycINFO for studies published between January 1988 and November 2015. Study quality was assessed using an adapted tool for risk of bias; quality of evidence was rated based on GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. FINDINGS We identified 68 publications meeting inclusion criteria: 59 reporting the prevalence of preoperative mental health conditions (65 363 patients) and 27 reporting associations between preoperative mental health conditions and postoperative outcomes (50 182 patients). Among patients seeking and undergoing bariatric surgery, the most common mental health conditions, based on random-effects estimates of prevalence, were depression (19% [95% CI, 14%-25%]) and binge eating disorder (17% [95% CI, 13%-21%]). There was conflicting evidence regarding the association between preoperative mental health conditions and postoperative weight loss. Neither depression nor binge eating disorder was consistently associated with differences in weight outcomes. Bariatric surgery was, however, consistently associated with postoperative decreases in the prevalence of depression (7 studies; 8%-74% decrease) and the severity of depressive symptoms (6 studies; 40%-70% decrease).
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.
International Journal of Psychology and Psychological Therapy
AbstrAct Bariatric surgery has proven to be the most effective treatment for severe obesity. Weight loss and long-term maintenance depend on patient's ability to implement permanent lifestyle changes. Presurgical psychological evaluation and intervention are proposed for a better post surgical prognosis. The aim of present study was to make a psychosocial profile with the results of psychological evaluation performed to 129 bariatric surgery candidates and to determine associations between psychological variables with obesity level. Patients were evaluated with an oral interview, the MINI International Neuropsychiatric Interview, and the following self-reported instruments: Beck Depression Inventory, Anxiety Sensitivity Inventory, Stress Control Perception, Risk Factors related to Eating Behavior Disorders Scale, Quality of Life and Health Inventory. Study population was divided in groups according to obesity level, evaluation results were compared according to these groups. Res...
Deterioration of mental health in bariatric surgery after 10 years despite successful weight loss
European Journal of Clinical Nutrition, 2015
BACKGROUND/OBJECTIVE: The present study evaluated the mental health and psychological functioning of bariatric patients before surgery, and after 1 year and 10 year follow-ups, and compared them with participants in a dietary program. Such long follow-up is rare, but strongly recommended by the American Association of Bariatric Surgeons. SUBJECTS/METHODS: Thirty-six bariatric surgery patients and 34 participants of a weight loss program were weighed and assessed at all 3 points in time. Participants were administered the mental health inventory, neuroticism, sense of control and fear of intimacy scales. Along with these mental and psychological measurements, the medical outcome short form (SF-36) was used. RESULTS: The surgery group achieved successful weight loss outcomes (27% reduction of pre-operative weight) after 10 years and better than baseline health-related quality-of-life scores. However, their general mental health, neuroticism, sense of control and fear of intimacy scores showed significant deterioration in comparison to pre-operative levels after 10 years. The dietary group participants remained psychologically stable among all three points in time. CONCLUSIONS: This study highlights the importance of identifying a risk group among bariatric patients for which the dietary and psychological follow-up may be of special significance.
REVIEW STUDY: THE RELATION BETWEEN BARIATRIC SURGERY WITH DEPRESSION AND ANXIETY
Obesity has been linked to a variety of psychological problems and has been demonstrated to have a detrimental effect on one's overall well-being in several research investigations. Research has found that the link between obesity and mental health varies by culture. Predictors of reduced family income are associated with poorer self-assessed beauty; gender; health policy; life satisfaction; and socioeconomic situations. More weight reduction and better comorbidity remission have been seen in trials comparing bariatric surgery with non-surgical therapy for obesity. Some studies have shown that bariatric surgery improves mental health and quality of life, as well as the financial condition of patients. A few experts, like Borgeraas et al., have studied the impact of bariatric surgery on health, including psychological elements. Variability in weight loss results after bariatric surgery might be rather high. The kind of bariatric surgery done, weight reduction, medical comorbidity, and social support are all important predictors of improved mental health in bariatric surgery patients. Mental health benefits from bariatric surgery may be influenced by variables other than weight reduction alone, such as pre-existing health conditions and the aftermath of surgery. Sleeve-gastrectomy and gastric bypass surgery resulted in higher improvements in mental health than laparoscopic adjustable gastric banding and vertical banding gastroplasty, research by Picot et al. found (2 years). Possibly due to the fact that these operations result in increased weight loss throughout this timeframe.
Advances in Psychiatry, 2014
Objective. Obesity has been linked to psychiatric disorders in several studies. Prevalence and severity of psychiatric disorders are high in patients undergoing bariatric surgery. Thus, psychiatric assessment of bariatric surgery candidates has become a standard procedure. However, socially desirable responding leads to biased results in self-reported questionnaires. Here, bariatric surgery candidates were screened with the Patient Health Questionnaire (PHQ-D) additionally to the psychiatric examination. Method. 355 bariatric surgery candidates filled in the PHQ-D before the psychiatric examination as a part of the surgery assessment procedure. PHQ-D results were compared to psychiatric diagnoses and body mass index (BMI). Results. Gender ratio, mean BMI, and age were comparable to earlier studies. Depressive and somatization symptoms did not correlate to BMI. However, females showed higher prevalence of psychiatric disorders with elevated syndrome severity in depressive and somatization disorders, as well as more frequent antidepressant intake. Eating disorders and addiction disorders were rarely reported. Conclusion. The findings suggest a socially desirable responding when filling in the PHQ-D before bariatric surgery. The use of the PHQ-D in this patient sample could be augmented by psychometric tests with internal correction and validation scales. Furthermore, psychiatric examination should be separated from the surgery evaluation process.
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 2015
Purpose This study aims to examine associations between metabolic profile and psychological variables in post-bariatric patients and to investigate if metabolic and psychological variables, namely high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glycated hemoglobin (HbA 1c), impulsivity, psychological distress, depressive and eating disorder symptoms are independently associated with percentage of excess weight loss (%EWL) after bariatric surgery. Methods One hundred and fifty bariatric patients (BMI = 33.04 ± 5.8 kg/m 2) who underwent to bariatric surgery for more than 28.63 ± 4.9 months were assessed through a clinical interview, a set of self-report measures and venous blood samples. Pearson's correlations were used to assess correlations between %EWL, metabolic and psychological variables. Multiple linear regression was conducted to investigate which metabolic and psychological variables were independently associated with %EWL, while controlling for type of surgery. Results Higher TG blood levels were associated with higher disordered eating, psychological distress and depression scores. HDL-C was associated with higher depression scores. Both metabolic and psychological variables were associated with %EWL. Regression analyses showed that, controlling for type of surgery, higher % EWL is significantly and independently associated with less disordered eating symptoms and lower TG and HbA_1c blood concentrations (R 2 aj = 0.383, F (4, 82) = 14.34, p \ 0.000). Conclusion An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.