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Psychiatric Aspects of Obesity in Transplantation

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Transplant Psychiatry

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Abstract

With the rise in national obesity levels in the United States, Transplant physicians are evaluating the health of an increased number of obese patients. Obesity and related metabolic syndrome pose threats to all major organs of the body and adverse post-transplant outcomes have also been documented. Transplant physicians need to incorporate a comprehensive evaluation of factors leading to obesity to ensure proper risk stratification and treatment planning.

With the advent of improved screening, vaccination, and treatment of hepatitis viruses, the liver transplant patient population has been changing. Alcoholic liver disease has become the most common indication for transplantation in the United States, with non-alcoholic steato-hepatitis (NASH) following closely behind. The increase in patients with non-alcoholic fatty liver disease (NAFLD) parallels the increase in obesity. Routine psychosocial evaluations do take behavioral aspects of alcohol and other substance use into account, but little, if any, attention is paid to the patient’s nutritional history and their relationship with food. In this chapter, a brief review of NAFLD and one of the most prevalent eating disorders, binge eating disorder, will be presented to highlight common concerns amongst these patient populations.

Utilizing the liver as an example of end-organ damage secondary to obesity and with the aid of a case presentation, we will highlight the need to adjust psychosocial assessments and post-transplant care of organ recipients with obesity.

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Notes

  1. 1.

    Mallory-Denk bodies: cytoplasmic hyaline inclusions in hepatocytes which can be found in various types of liver disease. Jensen, K; Gluud, C (Oct 1994). “The Mallory body: morphological, clinical and experimental studies (Part 1 of a literature survey)”. Hepatology. 20 (4 Pt 1): 1061–77. doi:https://doi.org/10.1002/hep.1840200440. PMID 7927209

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Author information

Authors and Affiliations

  1. Department of Psychiatry, School of Medicine, Stanford University, Stanford, CA, USA

    Filza Hussain

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  1. Filza Hussain
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Correspondence to Filza Hussain .

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Editors and Affiliations

  1. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Paula C. Zimbrean

  2. Department of Psychiatry, Stanford University School of Medicine, Stanford, CA, USA

    Yelizaveta Sher

  3. Department of Behavioral Health, Inova Fairfax Hospital, George Washington University, Falls Church, VA, USA

    Catherine Crone

  4. Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA

    Andrea F. DiMartini

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Hussain, F. (2022). Psychiatric Aspects of Obesity in Transplantation. In: Zimbrean, P.C., Sher, Y., Crone, C., DiMartini, A.F. (eds) Transplant Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-031-15052-4_9

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  • DOI: https://doi.org/10.1007/978-3-031-15052-4_9

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-15051-7

  • Online ISBN: 978-3-031-15052-4

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