Skip to main content
Log in

Psychosocial Status in Adolescents Undergoing Bariatric Surgery

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Little is known about the psychosocial status of adolescents who undergo bariatric surgery. Our objective was to describe the psychological and behavioral characteristics of patients in this age group who underwent bariatric surgery at our institution.

Methods

A review of clinical charts of patients aged 14–21 years who had bariatric surgery at our institution between 2000 and 2005 was conducted. Abstracted data included clinical information and the results of a psychosocial evaluation consisting of a clinical interview with a psychologist and self-reported data from the Weight and Lifestyle Inventory and the Beck Depression Inventory-II.

Results

Twenty-five patient records were reviewed. Nineteen patients (76%) were female. The mean (±SD) age was 18.7 ± 1.6 years, and mean body mass index was 50.6 ± 7.9 kg/m2. Depression was the most common psychiatric comorbidity (68%). Abnormal eating behaviors were frequent and included binge eating (48%), rapid eating (44%), having guilt associated with eating (36%), eating until uncomfortably full (36%), loss of control (24%), eating without hunger (24%), and eating alone (20%). Sixteen patients were judged to be appropriate for surgery by the bariatric surgery team; surgery was delayed for nine patients primarily because of concerns about ability to adhere to the postoperative diet. These patients were recommended for additional dietary counseling and/or psychotherapeutic treatment prior to surgery.

Conclusions

Among adolescent bariatric surgery candidates, depression and aberrant eating behaviors were very common. Early identification and management of these conditions may enable most of these patients to undergo bariatric surgery and optimize the likelihood for a successful outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. Pediatrics 1998;102:E29.

    Article  PubMed  CAS  Google Scholar 

  2. Anonymous. Obesity still a major problem. Centers for Disease Control and Prevention (http://www.cdc.gov/nchs/pressroom/06facts/obesity03_04.htm).

  3. Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA 2003;289:1813–9.

    Article  PubMed  Google Scholar 

  4. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  5. Sjostrom L, Lindroos A-K, 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 

  6. Greenstein RJ, Rabner JG. Is adolescent gastric-restrictive antiobesity surgery warranted? Obes Surg 1995;5:138–44.

    Article  PubMed  Google Scholar 

  7. Capella JF, Capella RF. Bariatric surgery in adolescence. Is this the best age to operate? Obes Surg 2003;13:826–32.

    Article  PubMed  Google Scholar 

  8. Stanford A, Glascock JM, Eid GM, et al. Laparoscopic roux-en-y gastric bypass in morbidly obese adolescents. J Pediatr Surg 2003;38:430–3.

    Article  PubMed  Google Scholar 

  9. Sugerman HJ, Sugerman EL, DeMaria EJ, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg 2003;7:102–7.

    Article  PubMed  Google Scholar 

  10. Inge TH, Garcia V, Daniels S, et al. A multidisciplinary approach to the adolescent bariatric surgical patient. J Pediatr Surg 2004;39:442–7.

    Article  PubMed  Google Scholar 

  11. Lawson ML, Kirk S, Mitchell T, et al. One-year outcomes of roux-en-y gastric bypass for morbidly obese adolescents: a multicenter study from the pediatric bariatric study group. J Pediatr Surg 2006;41:137–43.

    Article  PubMed  Google Scholar 

  12. Silberhumer GR, Miller K, Kriwanek S, et al. Laparoscopic adjustable gastric banding in adolescents: the austrian experience. Obes Surg 2006;16:1062–7.

    Article  PubMed  Google Scholar 

  13. Nadler EP, Youn HA, Ginsburg HB, et al. Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding. J Pediatr Surg 2007;42:137–41; discussion 41–2.

    Article  PubMed  Google Scholar 

  14. Inge TH, Krebs NF, Garcia VF, et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 2004;114:217–23.

    Article  PubMed  Google Scholar 

  15. Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res 2002;52:155–65.

    Article  PubMed  Google Scholar 

  16. Herpertz S, Kielmann R, Wolf AM, et al. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res 2004;12:1554–69.

    Article  PubMed  CAS  Google Scholar 

  17. van Hout GC, Verschure SK, van Heck GL. Psychosocial predictors of success following bariatric surgery. Obes Surg 2005;15:552–60.

    Article  PubMed  Google Scholar 

  18. Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res 2005;13:639–48.

    PubMed  Google Scholar 

  19. Averbukh Y, Heshka S, El-Shoreya H, et al. Depression score predicts weight loss following roux-en-y gastric bypass. Obes Surg 2003;13:833–6.

    Article  PubMed  Google Scholar 

  20. Ryden O, Hedenbro JL, Frederiksen SG. Weight loss after vertical banded gastroplasty can be predicted: a prospective psychological study. Obes Surg 1996;6:237–43.

    Article  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  22. Hsu LK, Sullivan SP, Benotti PN. Eating disturbances and outcome of gastric bypass surgery: a pilot study. Int J Eat Disord 1997;21:385–90.

    Article  PubMed  CAS  Google Scholar 

  23. Guisado Macias JA, Vaz Leal FJ. Psychopathological differences between morbidly obese binge eaters and non-binge eaters after bariatric surgery. Eat Weight Disord 2003;8:315–8.

    PubMed  CAS  Google Scholar 

  24. Kalarchian MA, Marcus MD, Wilson GT, et al. Binge eating among gastric bypass patients at long-term follow-up. Obes Surg 2002;12:270–5.

    Article  PubMed  Google Scholar 

  25. Powers PS, Perez A, Boyd F, et al. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord 1999;25:293–300.

    Article  PubMed  CAS  Google Scholar 

  26. 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 

  27. Clark LR. Approaching the adolescent patient from a psychodevelopmental framework. J Pediatr Adolesc Gynecol 2003;16:327–30.

    Article  PubMed  Google Scholar 

  28. Wadden TA, Sarwer DB. Behavioral assessment of candidates for bariatric surgery: a patient-oriented approach. Obesity 2006;14:53S–62S.

    PubMed  Google Scholar 

  29. Spitzer RL, Yanovski S, Wadden T, et al. Binge eating disorder: its further validation in a multisite study. Int J Eat Disord 1993;13:137–53.

    Article  PubMed  CAS  Google Scholar 

  30. American Psychiatric Association. Diagnostic and statistical manual of mental disorders DSM-IV. Arlington VA: American Psychiatric Publishing Inc.; 1994.

    Google Scholar 

  31. Beck AT, Steer RA. Beck depression inventory manual. San Antonio TX: Harcourt Brace & Company; 1993.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  33. Zametkin AJ, Zoon CK, Klein HW, et al. Psychiatric aspects of child and adolescent obesity: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry 2004;43:134–50.

    Article  PubMed  Google Scholar 

  34. Zeller MH, Roehrig HR, Modi AC, et al. Health-related quality of life and depressive symptoms in adolescents with extreme obesity presenting for bariatric surgery. Pediatrics 2006;117:1155–61.

    Article  PubMed  Google Scholar 

  35. Roehrig H, Xanthakos SA, Sweeney J, et al. Pregnancy after gastric bypass surgery in adolescents. Obes Surg 2007;17:873–7.

    Article  PubMed  Google Scholar 

  36. Marcus MD, Kalarchian MA. Binge eating in children and adolescents. Int J Eat Disord 2003;34:S47–57.

    Article  PubMed  Google Scholar 

  37. Allison KC, Wadden TA, Sarwer DB, et al. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Surg Obes Relat Dis 2006;2:153–8.

    Article  PubMed  Google Scholar 

  38. Sorof JM, Lai D, Turner J, et al. Overweight, ethnicity, and the prevalence of hypertension in school-aged children. Pediatrics 2004;113:475–82.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Roy J. Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, R.J., Langer, J.M., Baker, A.W. et al. Psychosocial Status in Adolescents Undergoing Bariatric Surgery. OBES SURG 18, 27–33 (2008). https://doi.org/10.1007/s11695-007-9285-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9285-x

Keywords

Navigation