Psychiatric Issues During the Postoperative Period of Bariatric Surgery

  • Adriano Segal
  • Debora Kinoshita Kussunoki


The most effective treatment for severe obesity in terms of weight loss and weight loss maintenance, in terms of positive impacts on many quality of life and health markers – including mental health markers – and in terms of overall mortality decrease is the surgical approach.

Despite that, there are many clinical and psychological concerns associated to the follow-up of bariatric surgeries. Although not always declared, there is a generalized fear that there are some psychological and/or psychiatric complications resulting from the procedure, regardless of the care offered.

For a significant part of the patients, the postoperative period will represent at least half of their lives, usually more. Therefore, it is reasonable to expect a higher chance of a psychiatric disorder onset during that period than on the preoperative period.

Some candidate causes of psychiatric disorders onset during the postoperative period such as age group, gender, eating disorders, pharmacokinetic changes of alcohol, and insufficient psychiatric anamnesis, among others along with strategies to approach the problem will be discussed.

Psychiatrist’s presence on the multidisciplinary team is strictly required. Psychologists with proper training may be able to diagnose some psychiatric diagnosis (by means of clinical open, semistructured, or structured interviews) but have no technical capacitation for comprehensively treating the majority of PDs as biological treatments are a core tool for achieving better results.


Obesity Obesity surgery Postoperative psychiatric disorders Postoperative multidisciplinary care Bariatric surgery Prejudice Psychiatric evaluation Psychiatric disorders Comorbidity Prognosis Psychiatric treatment Malnutrition Nutritional deficiencies 



The authors would like to thank Rodrigo Rezende for his English revision.


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Adriano Segal
    • 1
    • 2
    • 3
    • 4
    • 5
  • Debora Kinoshita Kussunoki
    • 1
    • 2
    • 3
    • 4
    • 5
  1. 1.Obesity and Diabetes CenterGerman Hospital Oswaldo CruzSão PauloBrazil
  2. 2.Obesity and Metabolic Syndrome Outpatient Clinic, Service of Endocrinology and Metabolism-HCFMUSP/SPSão PauloBrazil
  3. 3.Brazilian Society of Bariatric and Metabolic SurgerySão PauloBrazil
  4. 4.Brazilian Association for the Study of Obesity and Metabolic SyndromeSão PauloBrazil
  5. 5.Segal ClinicSão PauloBrazil

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