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Morbid obesity: Significance of psychological treatment after bariatric surgery

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Abstract

Conservative interventions for weight reduction are not very effective in many cases of morbid obesity. For this reason, bariatric surgery plays an increasing role in the treatment of these patients. Bariatric surgery, however, is not the solution but an important precondition for successful management of morbid obesity. Psychological evaluation of the weight loss surgery patients is recommended because of the prevalence of psychiatric comorbidities and of eating disorders in individuals with morbid obesity. Morbid obese eatingdisordered patients with co-morbid psychiatric disorders, especially with personality disorders, show greater difficulties in adapting to the new demands, including the need to cope with stress and other problems in a new way, to relearn how to eat, distress over weight loss plateaus, failure to achieve a normal-looking body etc. Therefore, psychological and/or psychiatric treatment seem to be needed in some obese patients to gain an early postoperative understanding of possible psychological or eating problems. Various kinds of psychological support are available at Innsbruck Medical University Hospital before and after bariatric surgery, such as pharmacotherapy, individual psychotherapy, small-group psychotherapy, and the “Obesity Club”. The reasons for the relatively low degree of willingness to take part in psychological treatment programs are demonstrated.

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References

  1. Bray GA. Obesity: a time bomb to be defused. Lancet 1998; 352: 160–1.

    Article  CAS  PubMed  Google Scholar 

  2. Bray GA. The missing link — lose weight, live longer. N Engl J Med 2007; 357: 818–20.

    Article  CAS  PubMed  Google Scholar 

  3. Sjostrom L, Narbro K, Sjostrom CD. Swedish Obese Subjects Study: Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007; 357: 741–52.

    Article  PubMed  Google Scholar 

  4. Adams TD, Gress RE, Smith SC, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007; 357: 753–61.

    Article  CAS  PubMed  Google Scholar 

  5. Van Hout GC, Leibbrandt AJ, Jakimowicz JJ, et al. Bariatric surgery and bariatric psychology general overview and the Dutch approach. Obes Surg 2003; 13: 926–31.

    Article  PubMed  Google Scholar 

  6. Van Hout GC, Boekestein P, Fortuin FA, et al. Psychosocial functioning following bariatric surgery. Obes Surg 2006; 16: 787–94.

    Article  PubMed  Google Scholar 

  7. Saunders R. Post-surgery group therapy for gastric bypass patients. Obes Surg 2004; 14: 1128–31.

    Article  PubMed  Google Scholar 

  8. Rusch MD, Andris D. Maladaptive eating patterns after weight-loss surgery. Nutr Clin Pract 2007; 22: 41–9.

    Article  PubMed  Google Scholar 

  9. Fox KM, Taylor SL, Jones JU. Understanding the bariatric surgical patient: A demographic, lifestyle and psychological profile. Obes Surg 2000; 10: 477–81.

    Article  CAS  PubMed  Google Scholar 

  10. Grothe KB, Dubbert PM, O’Jile JR. Psychological assessment and management of the weight loss surgery patient. Am J Med Sci 2006; 331: 201–6.

    Article  PubMed  Google Scholar 

  11. Vallis TM, Ross MA. The role of psychological factors in bariatric surgery for morbid obesity: identification of psychological predictors of success. Obes Surg 1993; 3: 346–59.

    Article  CAS  PubMed  Google Scholar 

  12. Powers PS, Rosemurgy A, Boyd F, et al. Outcome of gastric restriction procedures: weight, psychiatric diagnoses, and satisfaction. Obes Surg 1997; 7: 471–7.

    Article  CAS  PubMed  Google Scholar 

  13. Maddi SR, Khoshaba DM, Persico M, et al. Psychosocial correlates of psychopathology in a national sample of the morbidly obese. Obes Surg 1997; 7: 397–404.

    Article  CAS  PubMed  Google Scholar 

  14. Sarwer DB, Cohn MI, Gibbons LM, et al. Psychiatric diagnoses and psychiatric treatment among bariatric surgery candidates. Obes Surg 2004; 14: 1148–56.

    Article  PubMed  Google Scholar 

  15. Guisado JA, Vaz FJ, Lopez-Ibor JJ, et al. Eating behavior in morbidly obese patients undergoing gastric surgery: differences between obese people with and without psychiatric disorder. Obes Surg 2001; 11: 576–80.

    Article  CAS  PubMed  Google Scholar 

  16. Pawlow LA, O’Neil PM, White MA, et al. Findings and outcomes of psychological evaluations of gastric bypass applicants. Surg Obes Relat Dis 2005; 1: 523–7.

    Article  PubMed  Google Scholar 

  17. Glinski J, Wetzler S, Goodman E. The psychology of gastric bypass surgery. Obes Surg 2001; 11: 581–8.

    Article  CAS  PubMed  Google Scholar 

  18. Kinzl JF, Schrattenecker M, Traweger C, et al. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg 2006; 16: 1609–14.

    Article  PubMed  Google Scholar 

  19. Kinzl JF. Bedeutung der psychologischen Betreuung morbid Adipöser nach bariatrischer Operation. Aktuel Ernaehr Med 2007; 32: 1–4.

    Article  Google Scholar 

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

    Article  Google Scholar 

  21. Terra JL. The psychiatrist’s point of view on the treatment of morbid obesity by gastroplasty. Ann Chir 1997; 51: 177–82.

    CAS  PubMed  Google Scholar 

  22. Kinzl JF, Schrattenecker M, Traweger C, et al. Quality of life in morbidly obese patients after surgical weight loss. Obes Surg 2007; 17: 229–37.

    Article  PubMed  Google Scholar 

  23. Vallis MT, Butler GS, Perey B, et al. The role of psychological functioning in morbid obesity and its treatment with gastroplasty. Obes Surg 2001; 11: 716–25.

    Article  CAS  PubMed  Google Scholar 

  24. Kinzl JF, Traweger C, Guenther V, et al. Family background and sexual abuse associated with eating disorders. Am J Psychiatry 1992; 151: 1127–31.

    Google Scholar 

  25. Guisado JA, Vaz FJ. Personality profiles of the morbidly obese patients after vertical banded gastroplasty. Obes Surg 2003; 13: 394–8.

    Article  PubMed  Google Scholar 

  26. Stunkard A, Grace WJ, Wolff HG. The night-eating syndrome. A pattern of food intake among certain obese patients. Am J Med 1955; 19: 78–86.

    Article  CAS  PubMed  Google Scholar 

  27. Saunders R. “Grazing”: a high-risk behavior. Obes Surg 2004; 14: 98–102.

    Article  PubMed  Google Scholar 

  28. Fairburn CG, Walsh BT. Atypical eating disorders. In: Brownell KD, Fairburn CG (Eds) Eating Disorders and Obesity. A comprehensive handbook. New York-London, The Guilford Press, 1995, pp 135–40.

    Google Scholar 

  29. Spitzer RR, Devlin M, Walsh BT. Binge eating disorders: a multiple field trial of the diagnostic criteria. Int J Eat Disord 1992; 11: 191–203.

    Article  Google Scholar 

  30. Hsu LKG, Bentacourt S, Sullivan SP. Eating disturbances before and after vertical banded gastroplasty: a pilot study. Int J Eat Disord 1996; 19: 23–34.

    Article  CAS  PubMed  Google Scholar 

  31. Saunders R. Binge eating in gastric bypass patients before surgery. Obes Surg 1999; 9: 72–6.

    Article  CAS  PubMed  Google Scholar 

  32. Kielmann R, Herpertz S. Möglichkeiten und Grenzen der Adipositas-Chirurgie aus psychotherapeutischer Sicht. Verhaltenstherapie 2002; 12: 319–26.

    Article  Google Scholar 

  33. Dubovsky SL, Haddenhuorst A, Murphy J, et al. A preliminary study of the relationship between preoperative depression and weight loss following surgery for morbid obesity. Int J Psychiatr Med 1985; 15: 185–96.

    Article  Google Scholar 

  34. Elkins G, Whitfield P, Macus J, et al. Noncompliance with behavioral recommendations following bariatric surgery. Obes Surg 15, 546–551, 2005.

    Article  PubMed  Google Scholar 

  35. Burgmer R, Grigutsch K, Zipfel S, et al. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg 2005; 15: 684–91.

    Article  PubMed  Google Scholar 

  36. DeZwaan M, Muhlhans B. Essverhalten vor und nach adipositaschirurgischer Behandlung. Aktuel Ernaehr Med 2009; 34: 83–7.

    Article  Google Scholar 

  37. Castelnuovo-Tedesco P, Weinberg J, Buchanan DC, et al. Long-term outcome of jejuno-ileal bypass surgery for super obesity: a psychiatric assessment. Am J Psychiatry 1982; 139: 1248–52.

    Article  CAS  PubMed  Google Scholar 

  38. American Society of Plastic Surgeons: Psychological considerations of the massive weight loss patient. Plast Reconstr Surg 2006; 117 (Suppl. 1): 17S–21S.

    Google Scholar 

  39. White MA, Masheb RM, Rothschild BS, et al. Do patients’ unrealistic weight goals have prognostic significance for bariatric surgery. Obes Surg 2007; 17: 74–81.

    Article  PubMed  Google Scholar 

  40. Smiertika JK, MacPherson BH. Beyond bariatric surgery: Complications we fail to address. Obes Surg 1995; 6: 277–381.

    Google Scholar 

  41. Delin CR, Watts JM, Bassett DL. An exploration of the outcomes of gastric bypass surgery for morbid obesity: Patient characteristics and indices of success. Obes Surg 1995; 5: 159–60.

    Article  CAS  PubMed  Google Scholar 

  42. Hawke A, O’Brien P, Watts J, et al. Psychosocial and physical activity changes after gastric restrictive procedures for morbid obesity. Aust NZ J Surg 1990; 60: 755–80.

    Article  CAS  Google Scholar 

  43. Kinzl JF, Traweger C, Trefalt E, et al. Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obes Surg 2003; 13: 105–10.

    Article  CAS  PubMed  Google Scholar 

  44. Kinzl JF, Trefalt E, Fiala M, et al. Psychotherapeutic treatment of morbidly obese patients after gastric banding. Obes Surg 2002; 12: 292–4.

    Article  PubMed  Google Scholar 

  45. Elekkary E, Elhorr A, Aziz F, et al. Do support groups play a role in weight loss after laparoscopic adjustable gastric banding. Obes Surg 2006; 16: 331–4.

    Article  Google Scholar 

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Correspondence to J. F. Kinzl MD.

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Kinzl, J.F. Morbid obesity: Significance of psychological treatment after bariatric surgery. Eat Weight Disord 15, e275–e280 (2010). https://doi.org/10.3275/7080

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