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Psychological Outcome Two Years after Restrictive Bariatric Surgery

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Background

An essential outcome criterion of obesity surgery besides weight loss is the improvement of medical and psychological health status. Both dimensions influence quality of life. This study evaluates depressive symptoms, self-esteem and health-related quality of life 2 years after bariatric surgery.

Methods

149 patients (47 males (32%), 102 females (68%), mean age 38.8 ± 10.3 years) were assessed by standardized questionnaires before and 1 and 2 years after gastric restrictive surgery.

Results

Mean BMI pre-surgery was 51.3 ± 8.4 kg/m2. BMI decreased significantly to 38.6 ± 6.8 kg/m2 at 1 year and to 37.9 ± 7.4 kg/m2 at 2 years after surgery. Statistical analyses revealed a significant decrease in depressive symptoms and a significant improvement in selfesteem and the physical dimension of health-related quality of life. Pre-surgery, 40.5% (n = 62) of the patients suffered from depressive symptoms of clinical relevance. These depressive symptoms persisted in 17.7% (n = 27) 1 year and in 16.4% (n = 25) 2 years after surgery.

Conclusion

Parallel with a considerable weight loss after bariatric surgery, important aspects of mental health such as depressive symptoms and selfesteem improved significantly. These effects appear 1 year after surgery, but do not seem to change considerably afterwards.

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References

  1. WHO Consultation on Obesity. Obesity: preventing and managing the global epidemic: report of a WHO Consultation on Obesity, Geneva, 3–5 June 1997. Geneva, Switzerland: World Health Organization 1997.

    Google Scholar 

  2. Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med 1999; 341: 427–34.

    Article  PubMed  CAS  Google Scholar 

  3. Colditz GA, Willett WC, Stampfer MJ et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol 1990; 132: 501–13.

    PubMed  CAS  Google Scholar 

  4. Sullivan M, Karlsson J, Sjostrom L et al. Swedish obese subjects (SOS) – an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes 1993; 17: 503–12.

    CAS  Google Scholar 

  5. Herpertz S, Burgmer R, Stang A et al. Prevalence of mental disorders in normal-weight and obese individuals with and without weight loss treatment in a German urban population. J Psychosom Res 2006; 61: 95–103.

    Article  PubMed  Google Scholar 

  6. Wadden TA, Butryn ML, Sarwer DB et al. Comparison of psychosocial status in treatment-seeking women with class III vs. class I–II obesity. Surg Obes Relat Dis 2006; 2: 138–45.

    Article  PubMed  Google Scholar 

  7. Wadden TA, Sarwer DB, Womble LG et al. Psychosocial aspects of obesity and obesity surgery. Surg Clin North Am 2001; 81: 1001–24.

    Article  PubMed  CAS  Google Scholar 

  8. Moore ME, Stunkard A, Srole L. Obesity, social class, and mental illness. JAMA 1962; 181: 962–6.

    PubMed  CAS  Google Scholar 

  9. Kolotkin RL, Crosby RD, Williams GR et al. The relationship between health-related quality of life and weight loss. Obes Res 2001; 9: 564–71.

    PubMed  CAS  Google Scholar 

  10. National Task Force on the Prevention and Treatment of Obesity. Overweight, obesity, and health risk. Arch Intern Med 2000; 160: 898–904.

    Article  Google Scholar 

  11. Monteforte MJ, Turkelson CM. Bariatric surgery for morbid obesity. Obes Surg 2000; 10: 391–401.

    Article  PubMed  CAS  Google Scholar 

  12. Christou NV, Sampalis JS, Liberman M et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 2004; 240: 416–23.

    Article  PubMed  Google Scholar 

  13. Dixon JB, Dixon ME, O’Brien PE. Depression in association with severe obesity: changes with weight loss. Arch Intern Med 2003; 163: 2058–65.

    Article  PubMed  Google Scholar 

  14. Dixon JB, Dixon ME, O’Brien PE. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res 2001; 9: 713–21.

    PubMed  CAS  Google Scholar 

  15. de Zwaan M, Lancaster KL, Mitchell JE et al. Healthrelated quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg 2002; 12: 773–80.

    Article  PubMed  Google Scholar 

  16. Herpertz S, Kielmann R, Wolf AM et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes 2003; 27: 1300–14.

    Article  CAS  Google Scholar 

  17. Papageorgiou GM, Papakonstantinou A, Mamplekou E et al. Pre- and postoperative psychological characteristics in morbidly obese patients. Obes Surg 2002; 12: 534–9.

    Article  PubMed  CAS  Google Scholar 

  18. Hildebrandt SE. Effects of participation in bariatric support group after Roux-en-Y gastric bypass. Obes Surg 1998; 8: 535–42.

    Article  PubMed  CAS  Google Scholar 

  19. Busetto L, Segato G, De Luca M et al. Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding. Obes Surg 2005; 15: 195–201.

    Article  PubMed  Google Scholar 

  20. Ballantyne GH. Measuring outcomes following bariatric surgery: weight loss parameters, improvement in co-morbid conditions, change in quality of life and patient satisfaction. Obes Surg 2003; 13: 954–64.

    Article  PubMed  Google Scholar 

  21. Herrmann C, Buss U. Description and validation of a German version of the Hospital Anxiety and Depression Scale (HADS): A questionnaire for identifying emotional disorders in physically ill patients. Diagnostica 1994; 40: 143–54.

    Google Scholar 

  22. Bullinger M. German translation and psychometric testing of the SF–36 Health Survey: Preliminary results from the IQOLA project. Social Science & Medicine 1995; 41: 1359–66.

    Article  CAS  Google Scholar 

  23. de Zwaan M, Mitchell JE, Howell LM et al. Two measures of health-related quality of life in morbid obesity. Obes Res 2002; 10: 1143–51.

    PubMed  Google Scholar 

  24. Rosenberg M. Society and the adolescent self-image. Princeton, NJ: Princeton University Press 1965.

    Google Scholar 

  25. Blascovich J, Tomaka J. Measures of self-esteem. In: Robinson JP, Shaver PR, Wrightsman LE, eds. Measures of Personality and Social Psychological Attitudes. San Diego, CA: Academic Press 1991; 115–60.

    Google Scholar 

  26. Bowman RL, DeLucia JL. Accuracy of self-reported weight: A meta-analysis. Behav Ther 1992; 23: 637–55.

    Article  Google Scholar 

  27. Bjelland I, Dahl AA, Haug TT et al. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002; 52: 69–77.

    Article  PubMed  Google Scholar 

  28. Stunkard AJ, Stinnett JL, Smoller JW. Psychological and social aspects of the surgical treatment of obesity. Am J Psychiatry 1986; 143: 417–29.

    PubMed  CAS  Google Scholar 

  29. Yale CE. Reporting our results. Obes Surg 1991; 1: 241–2.

    Article  PubMed  Google Scholar 

  30. Yale CE, Weiler SJ. Weight control after vertical banded gastroplasty for morbid obesity. Am J Surg 1991; 162: 13–8.

    Article  PubMed  CAS  Google Scholar 

  31. Sjostrom L, Lindroos AK, Peltonen M et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351: 2683–93.

    Article  PubMed  Google Scholar 

  32. Ryden A, Torgerson JS. The Swedish Obese Subjects Study – what has been accomplished to date? Surg Obes Relat Dis 2006; 2: 549–60.

    Article  PubMed  Google Scholar 

  33. Larsen F, Torgersen S. Personality changes after gastric banding surgery for morbid obesity. A prospective study. J Psychosom Res 1989; 33: 323–34.

    Article  PubMed  CAS  Google Scholar 

  34. Hafner RJ, Rogers J, Watts JM. Psychological status before and after gastric restriction as predictors of weight loss in the morbidly obese. J Psychosom Res 1990; 34: 295–302.

    Article  PubMed  CAS  Google Scholar 

  35. Horchner R, Tuinebreijer W. Improvement of physical functioning of morbidly obese patients who have undergone a Lap-Band operation: one-year study. Obes Surg 1999; 9: 399–402.

    Article  PubMed  CAS  Google Scholar 

  36. O’Brien PE, Dixon JB, Brown W et al. The laparoscopic adjustable gastric band (Lap-Band): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg 2002; 12: 652–60.

    Article  PubMed  Google Scholar 

  37. Schok M, Geenen R, van AT et al. Quality of life after laparoscopic adjustable gastric banding for severe obesity: postoperative and retrospective preoperative evaluations. Obes Surg 2000; 10: 502–8.

    Article  PubMed  CAS  Google Scholar 

  38. Dymek MP, Le GD, Neven K et al. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res 2002; 10: 1135–42.

    Article  PubMed  Google Scholar 

  39. Dymek MP, Le GD, Neven K et al. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg 2001; 11: 32–9.

    Article  PubMed  CAS  Google Scholar 

  40. Chandarana PC, Conlon P, Holliday RL et al. A prospective study of psychosocial aspects of gastric stapling surgery. Psychiatr J Univ Ott 1990; 15: 32–5.

    PubMed  CAS  Google Scholar 

  41. Peace K, Dyne J, Russell G et al. Psychobiological effects of gastric restriction surgery for morbid obesity. N Z Med J 1989; 102: 76–8.

    PubMed  CAS  Google Scholar 

  42. Kinzl JF, Trefalt E, Fiala M et al. Partnership, sexuality, and sexual disorders in morbidly obese women: consequences of weight loss after gastric banding. Obes Surg 2001; 11: 455–8.

    Article  PubMed  CAS  Google Scholar 

  43. van Gemert WG, Severeijns RM, Greve JW et al. Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes 1998; 22: 393–8.

    Article  Google Scholar 

  44. Hall JC, Horne K, O’Brien PE et al. Patient wellbeing after gastric bypass surgery for morbid obesity. Aust N Z J Surg 1983; 53: 321–4.

    Article  PubMed  CAS  Google Scholar 

  45. Rand CS, Macgregor AM. Morbidly obese patients’ perceptions of social discrimination before and after surgery for obesity. South Med J 1990; 83: 1390–5.

    PubMed  CAS  Google Scholar 

  46. Hawke A, O’Brien P, Watts JM et al. Psychosocial and physical activity changes after gastric restrictive procedures for morbid obesity. Aust N Z J Surg 1990; 60: 755–8.

    Article  PubMed  CAS  Google Scholar 

Download references

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Correspondence to Ramona Burgmer PhD.

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Burgmer, R., Petersen, I., Burgmer, M. et al. Psychological Outcome Two Years after Restrictive Bariatric Surgery. OBES SURG 17, 785–791 (2007). https://doi.org/10.1007/s11695-007-9144-9

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  • DOI: https://doi.org/10.1007/s11695-007-9144-9

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