Preoperative Psychological Conditions and Their Effect on Weight Loss During the First 18 Months Post-Surgery in Obese Patients Undergoing Gastric Bypass
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Abstract
Objective: To determine whether the preoperative presence of adverse psychological conditions affects weight loss in patients undergoing gastric bypass.
Methods: Historical cohort study. Weight loss was expressed as a percentage of excess BMI lost (%EBMIL). Using models of Generalized Estimating Equations (GEE) and Cox proportional hazards, we compared the post-surgical evolution of %EBMIL and the time in which successful weight loss was achieved (%EBMIL ≥50%) among subjects who had psychiatric disorders and/or traumatic life events and those who did not have these conditions before surgery.
Results: Of the 155 patients studied, 35.5% had psychiatric disorders and 26.5% had traumatic life events before surgery. Both in the subjects that had psychiatric disorders or traumatic life events and in those who did not have these conditions, the probability of achieving successful weight loss between 12 and 18 months post-surgery was approximately 80%. The absence of psychiatric disorder before surgery decreased the %EBMIL by 3% with respect to preoperative presence of psychopathology, although this decrease was not statistically significant (p =0.08). The absence of previous traumatic life event increased the %EBMIL by 2.9% compared to the preoperative existence of this condition, although this increase was not statistically significant (p =0.06).
Conclusions: Psychiatric illness and traumatic life events prior to gastric bypass do not adversely affect weight loss post-surgery. Thus, surgery is not contraindicated.
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Rubio MA, Martínez C, Vidal O, Larrad A, Salas-Salvadó J, Pujol J, et al. Documento de consenso sobre cirugía bariátrica. Rev Esp Obes. 2004; 4:223-249.
Institute for Clinical Systems Improvement [sede Web]. Estados Unidos: ICSI; 2009 [acceso 20 de noviembre de 2010]. Health Care Guideline: Prevention and management of obesity (mature adolescents and adults). Disponible en: https://www.icsi.org/_asset/s935hy/ObesityInteractive0411.pdf.
López-Villalta MJ, Soto A. Actualización en obesidad. Cad Aten Primaria. 2010; 17:101-107.
González JR, Girón J, Limón JL, Márquez G. Bypass gástrico. Tratamiento quirúrgico de la obesidad mórbida. Rev Hosp Jua Mex. 2005; 72:153-160.
Tessier DJ, Eagon JC. Surgical management of morbid obesity. Two epidemics: obesity and obesity Surgery. Curr Probl Surg. 2008; 45:68-137.
Kim JJ, Tarnoff ME, Shikora SA. Surgical treatment for extreme obesity: Evolution of a rapidly growing field. Nutr Clin Pract. 2003; 18:109-123.
Sarwer D, Wadden T, Fabricatore A. Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 2005; 13:639-648.
Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007; 164:328-334.
Legenbauer T, Petrak F, De Zwaan M, Herpertz S. Influence of depressive and eating disorders on short- and long-term course of weight after surgical and nonsurgical weight loss treatment. Compr Psychiat. 2010; 53:301-311.
Montt D, Koppmann A, Rodríguez M. Aspectos psiquiátricos y psicológicos del paciente obeso mórbido. Revista Hcuch. 2005; 16:282-288.
Elizagárate E, Ezcurra J, Sánchez PM. Aspectos psiquiátricos del tratamiento quirúrgico de la obesidad mórbida. Salud Global. 2001; 1:1-8.
Bustamante F, Williams C, Vega E, Prieto B. Aspectos psiquiátricos relacionados con la cirugía bariátrica. Rev Chil Cir. 2006; 58:481-485.
Oppong BA, Nickels MW, Sax HC. The Impact of a History of sexual abuse on weight loss in gastric bypass patients. Psychosomatics. 2006; 47:108-111.
Rohde P, Ichikawa L, Simon GE, Ludman EJ, Linde JA, Jeffery RW, et al. Associations of child sexual and physical abuse with obesity and depression in middle-aged women. Child Abuse Negl. 2008; 32:878-887.
Sarwer D, Wadden T, Moore R, Baker A, Gibbons L, Raper S, et al. Preoperative eating behavior, postoperative dietary adherence and weight loss following gastric bypass surgery. Surg Obes Relat Dis. 2008; 4:640-646.
Clark MM, Hanna BK, Mai JL, Graszer KM, Krochta JG, McAlpine DE, et al. Sexual abuse survivors and psychiatric hospitalization after bariatric surgery. Obes Surg. 2007; 17:465-469.
Steinmann WC, Suttmoeller K, Chitima-Matsiga R, Nagam N, Suttmoeller NR, Halstenson NA. Bariatric surgery: 1-Year weight loss outcomes in patients with bipolar and other psychiatric disorders. Obes Surg. 2011; 21:1323-1329.
Franks SF, Kaiser KA. Predictive factors in bariatric surgery outcomes: What is the role of the preoperative psychological evaluation? Primary Psychiatry. 2008; 15:74-83.
Wadden TA, Sarwer DB, Fabricatore AN, Jones L, Stack R, Williams NS. Psychosocial and behavioral status of patients undergoing bariatric surgery: What to expect before and after surgery. Med Clin North Am. 2007; 91:451-469.
Crespo ML, Ruiz S. Trastornos de la conducta alimentaria en pacientes obesos sometidos a cirugía bariátrica y su papel en el pronóstico posoperatorio. Universitas Médica. 2006; 47:157-176.
Latner JD, Wetzler S, Goodman ER, Glinski J. Gastric bypass in a low-income, inner-city population: Eating disturbances and weight loss. Obes Res. 2004; 12:956-961.
Ray EC, Nickels MW, Sayeed S, Sax HC. Predicting success after gastric bypass: The role of psychosocial and behavioral factors. Surgery. 2003; 134:555-564.
Rutledge T, Groesz LM, Savu M. Psychiatric factors and weight loss patterns following gastric bypass surgery in a veteran population. Obes Surg. 2011; 21:29-35.
Simon GE, Arterburn DE. Does comorbid psychiatric disorder argue for or against surgical treatment of obesity? Gen Hosp Psychiat. 2009; 31:401-402.