EATING DISORDERS 

Minerva Psichiatrica 2007 December;48(4):403-9

Copyright © 2007 EDIZIONI MINERVA MEDICA

language: English

Psychosocial consequences of weight loss after bariatric surgery in morbidly obese patients. A review

Kinzl J. F.

Department of Psychiatry and Psychotherapy University Hospital, Medical University Innsbruck, Austria

Bariatric surgery is the treatment of choice for morbidly obese individuals. However, surgical treatment of morbid obesity does not show the same results in every patient, because of a number of nonsurgical and psychological factors that have been shown to play a significant role in its long-term results. Psychological evaluation of the weight loss surgery patient is recommended because of the common prevalence of psychiatric comorbidities in persons with severe obesity and the behavioral adaptation required for a successful outcome. Substantial psychopathology is frequently reported in morbidly obese patients requesting treatment, particularly obesity surgery. The results of follow-up investigation show a significant improvement in life satisfaction, quality of life, physical trouble, emotional feelings, self-esteem, eating behavior and personality traits in a majority of morbidly obese patients postoperatively. Weight loss, however, is connected not only with positive changes, but also with negative consequences in some cases. It may be assumed that some psychological variables are predictors of weight loss success following bariatric surgery. Patients with two or more mental disorders and/or with a severe personality disorder frequently have more difficulties adapting to the strong demands of controlled eating behavior imposed on them by the surgical operation. Although the results are mixed, the overall improvements in psychological functioning are an additional justification for surgical treatment for morbid obesity, but more personal strategies for psychosocial intervention must be developed in order to improve postoperative outcome, especially in morbidly obese patients with psychiatric and personality disorders.