A400 Bariatric Surgery Weight Loss Success and Mental Health Symptomatic Improvement

SummaryObesity is common in patients with mental illness. Weight-loss surgery, known as bariatric surgery, is becoming a familiar intervention for treating people who are morbidly obese and for whom other weight-reduction methods have failed. This article offers guidance for mental health professionals on the assessment and management of patients with mental illness undergoing such treatment. Assessment is of the patient's suitability for surgery, taking into account their mental health diagnosis, expectations, knowledge and insight into the psychological impact of surgery, and ability to address and cope with lifestyle changes before and after surgery. The patient's capacity and ability to cooperate and engage with services are also assessed. Potential risks and complications of bariatric surgery and how the weight-loss procedures may affect patients' mental health and management of their medication are addressed.

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Psychological Diagnoses and Weight Loss among Appalachian Bariatric Surgery Patients

Journal of Obesity ◽

10.1155/2020/1743687 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Makenzie L. Barr ◽

Cassie Brode ◽

Lawrence E. Tabone ◽

Stephanie J. Cox ◽

Melissa D. Olfert

Keyword(s):

Mental Health ◽

Bariatric Surgery ◽

Weight Loss ◽

Data Extraction ◽

Gastric Bypass Surgery ◽

Retrospective Chart Review ◽

Excess Body Weight ◽

Percent Excess Weight Loss ◽

The Relationship

Background. The relationship between presurgical psychopathology and weight loss following bariatric surgery is complex; previous research has yielded mixed results. The current study investigates the relationship among presurgical mental health diagnoses, symptom severity, and weight loss outcomes in an Appalachian population, where obesity-related comorbidities are prominent. Methods. A retrospective chart review was performed on bariatric surgery patients in an accredited Appalachian centered academic hospital in northern West Virginia between 2013 and 2015 (n = 347). Data extraction included basic demographics, anthropometrics (percent excess weight loss (%EWL)) at six-month, one-year, and two-year postoperative visits, and two validated psychological questionnaires (Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI)) from patient’s presurgical psychological evaluation. Results. Average patient population was 92.5% Caucasian, 81.5% female, 45 ± 11.5 years old, and 84.1% who underwent laparoscopic Roux-en-Y gastric bypass surgery with the remaining having laparoscopic sleeve gastrectomy. At baseline, no differences were detected in weight, excess body weight, or body mass index between surgery types. Average baseline BDI-II score was 10.1 ± 8.68 (range 0–41) and BAI score was 6.1 ± 6.7 (range 0–36), and this was not significantly different by surgery at baseline. Both baseline psychological scores were in the “minimal” severity range. BDI-II was positively related to BMI of patients at baseline (p=0.01). Both BDI-II and BAI were not significantly related to %EWL across follow-up. Conclusion. Other than baseline weight, BDI-II and BAI scores were not related to %EWL outcomes in patients receiving bariatric surgery in the Appalachian region. Future work should examine mixed methods approaches to capture prospective and longitudinal data to more thoroughly delve into mental health aspects of our Appalachian patients and improve efforts to recapture postoperative patients who may have been lost to follow-up.

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Receptivity to Bariatric Surgery in Qualified Patients

Journal of Obesity ◽

10.1155/2016/5372190 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 8

Author(s):

Michael Fung ◽

Sean Wharton ◽

Alison Macpherson ◽

Jennifer L. Kuk

Keyword(s):

Social Support ◽

Bariatric Surgery ◽

Weight Loss ◽

Weight Management ◽

Diabetes Management ◽

Effective Intervention ◽

Publicly Funded ◽

Factors Influencing ◽

Positive Social Support ◽

Weight Loss Success

Objectives. Bariatric surgery has been shown to be an effective intervention for weight loss and diabetes management. Despite this, many patients qualified for bariatric surgery are not interested in undergoing the procedure. The objective of this study is to determine the factors influencing receptivity to bariatric surgery among those who qualify for the procedure.Methods. Patients attending a publicly funded weight management clinic who qualified for bariatric surgery were asked to complete an elective questionnaire between February 2013 and April 2014.Results. A total of 371 patients (72% female) completed the questionnaire. Only 87 of 371 (23%) participants were interested in bariatric surgery. Individuals interested in bariatric surgery had a higher BMI (48.0 versus 46.2 kg/m2,P=0.03) and believed that they would lose more weight with surgery (51 versus 44 kg,P=0.0069). Those who scored highly on past weight loss success and financial concerns were less likely to be interested in bariatric surgery, whereas those who scored highly on high receptivity to surgery and positive social support were more likely to be interested in bariatric surgery.Conclusion. Although participants overestimated the effect of bariatric surgery on weight loss, most were still not interested in bariatric surgery.

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The Role of Hormonal Factors in Weight Loss and Recidivism after Bariatric Surgery

Gastroenterology Research and Practice ◽

10.1155/2013/528450 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 21

Author(s):

S. D. Pedersen

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Explanatory Power ◽

Future Research ◽

Hormonal Factors ◽

Weight Loss Failure ◽

Postoperative Weight Loss ◽

Interdisciplinary Approaches ◽

Hormonal Milieu ◽

Weight Loss Success

Substantial heterogeneity exists in weight loss trajectories amongst patients following bariatric surgery. Hormonal factors are postulated to be amongst the contributors to the variation seen. Several hormones involved in hunger, satiety, and energy balance are affected by bariatric surgery, with the alteration in hormonal milieu varying by procedure. Limited research has been conducted to examine potential hormonal mediators of weight loss failure or recidivism following bariatric surgery. While hormonal factors that influence weight loss success following gastric banding have not been identified, data suggest that hormonal factors may be involved in modulating weight loss success following gastric bypass. There may be hormonal mediators involved in determining the weight trajectory following sleeve gastrectomy, though the extremely limited data currently available prohibits definitive conclusions from being drawn. There is great need for future research studies to explore this knowledge gap, as improving this knowledge base could be of benefit to guide clinicians toward understanding the hormonal contributors to a patient’s postoperative weight loss failure or recidivism or perhaps be of value in selecting the most appropriate bariatric procedure based on the preoperative hormone milieu. Integrative interdisciplinary approaches exploring these complex interrelationships could potentially increase the explanatory power of such investigations.

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Comment on: Cognitive function predicts 24 month weight loss success following bariatric surgery

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2013.04.010 ◽

2013 ◽

Vol 9 (5) ◽

pp. 771-772

Author(s):

Katherine L. Applegate

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Cognitive Function ◽

Weight Loss Success

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The Bariatric Interprofessional Psychosocial Assessment Of Suitability Scale (BIPASS): Predictive Validity for Outcomes 1 And 2 Years Following Bariatric Surgery

10.32920/ryerson.14643789.v1 ◽

2021 ◽

Author(s):

Molly Atwood

Keyword(s):

Quality Of Life ◽

Mental Health ◽

Bariatric Surgery ◽

Weight Loss ◽

Psychosocial Assessment ◽

Health Related Quality ◽

Related Quality ◽

Health Related

Bariatric surgery is the most effective intervention for severe obesity; however, many patients demonstrate insufficient and/or unsustained weight loss, and unsatisfactory psychosocial functioning in the longer-term. Although it is well established that attendance at postsurgical follow-up appointments is integral to sustained weight loss, nonadherence to follow-up is common. Consequently, presurgical psychosocial evaluations are conducted in order to identify patients at high risk of poor outcomes. Yet, no consensus has been established regarding a standardized protocol for the assessment of variables relevant to surgical outcomes, and bariatric programs vary widely in their interpretation of psychosocial risk. In addition, there is a paucity of research examining the predictive utility of psychosocial evaluations. The Bariatric Interprofessional Psychosocial Assessment of Suitability Scale (BIPASSTM), a novel psychosocial evaluation tool, was developed to address these issues. The purpose of the present study was to contribute to the validation of the BIPASS tool via two aims: 1) by examining the psychometric properties of the BIPASS, and; 2) by examining the ability of the BIPASS tool to predict outcomes 1 and 2 years following bariatric surgery, including weight loss and weight regain, quality of life, psychiatric symptoms, and adherence to postsurgical follow-up appointments. The BIPASS was applied retrospectively to the charts of 200 consecutively referred patients of the Toronto Western Hospital Bariatric Surgery Program (TWH-BSP). Factor analysis of BIPASS items revealed a two-factor structure, reflecting “Mental Health” and “Patient Readiness” subscales. Internal consistency for the BIPASS Total and subscale scores ranged from poor to good, and inter-rater reliability was excellent. Higher BIPASS scores significantly predicted higher binge eating symptomatology, and lower physical and mental health-related quality of life at 1 year postsurgery. The BIPASS did not predict any outcome variables at 2 years postsurgery, or adherence to postsurgical follow-up appointments. Findings suggest that the BIPASS can be used to identify patients at increased risk of problematic eating and poor health-related quality of life early in the postsurgical course, thereby facilitating appropriate interventions.

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Bariatric Surgery Performance Improvement Role of Support Group Meetings in Weight Loss Success

Advances in Obesity Weight Management & Control ◽

10.15406/aowmc.2015.03.00056 ◽

2015 ◽

Vol 3 (3) ◽

Author(s):

Sameera Khan

Keyword(s):

Bariatric Surgery ◽

Weight Loss ◽

Performance Improvement ◽

Support Group ◽

Group Meetings ◽

Weight Loss Success

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Impact of Mental Health Background and Nutrition Intake on Medium-Term Weight Loss in Japanese Patients Undergoing Laparoscopic Sleeve Gastrectomy

Obesity Facts ◽

10.1159/000509342 ◽

2020 ◽

Vol 13 (4) ◽

pp. 371-383

Author(s):

Atsuhito Saiki ◽

Rieko Kanai ◽

Shoko Nakamura ◽

Sho Tanaka ◽

Rena Oka ◽

...

Keyword(s):

Mental Health ◽

Bariatric Surgery ◽

Weight Loss ◽

Sleeve Gastrectomy ◽

Mental Disorders ◽

Mood Disorders ◽

Japanese Patients ◽

Average Group ◽

High Prevalence ◽

Nutrition Intake

Objectives: Bariatric surgery is the most effective weight loss therapy, and recently laparoscopic sleeve gastrectomy (LSG) is gaining popularity worldwide. On the other hand, patients undergoing bariatric surgery have a high prevalence of mental disorders. A Japanese nationwide survey reported high prevalence of mental disorders in patients with low percent total weight loss (%TWL) and also in those with high %TWL. The aim of this study was to investigate the relationship of 1-year %TWL with background mental health status, 3-year outcomes, and nutrition intake in Japanese patients after LSG. Methods: This study was a single-center retrospective database analysis. A total of 89 Japanese patients who underwent LSG and were followed for 3 years were enrolled (mean age 41.9 years, baseline body mass index 44.9, baseline glycosylated hemoglobin, HbA1c, 7.0%). The patients were divided into 3 groups according to 1-year %TWL as follows: ≤19.9% (insufficient group), 20.0–34.9% (average group) and ≥35.0% (excessive group). Psychosocial and nutritional status as well as physical data were collected from all patients. Results: The prevalence of mental disorders was 51.7%, and 1-year %TWL was 28.1% in all patients. No significant differences were observed in the changes in body weight and HbA1c between patients with and those without mental disorders. The prevalence of mental disorders was particularly high in the insufficient and excessive groups. In the insufficient group, mood disorders and mental retardation/developmental disorders were frequent, and snacking and eating out habits were often observed. In the excessive group, the frequencies of mood disorders and binge eating were high, and a decrease in skeletal muscle mass due to low protein intake was observed. Furthermore, weight regain was shown 12 months after LSG in both groups. In the average group, there were fewer problems in weight loss outcomes, mental health, nutrition intake and body composition. Conclusions: Psychosocial and nutritional problems were often found not only in patients with insufficient weight loss, but also in those with seemingly “excellent” weight reduction. To improve long-term weight loss outcome and future health, a multidisciplinary approach focusing on mental health and nutrition is essential for patients undergoing bariatric surgery.

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