Morbid obesity is associated with an increased risk of morbidity and mortality as well as psychosocial problems and poor quality of life. The ultimate goal of bariatric surgery is not only reduced weight and reduction of co-morbidities, but also improved psychosocial functioning and quality of life. However, not all patients are successful. A systematic literature search of recent articles identified relevant variables reflecting postoperative psychosocial functioning. Most studies showed that bariatric surgery does not only lead to substantial weight reduction, but also to improvement or cure of physical as well as psychological co-morbidities. Although most studies are optimistic and report broad psychosocial improvement, a significant minority of patients do not benefit psychologically from surgery. Although there are mixed results, the overall improvements in psychosocial functioning provide additional justification for surgical treatment of morbid obesity.

Background In addition to increased risks of morbidity and mortality, extreme obesity is substantially associated with psychosocial problems. Therefore, the ultimate goal of bariatric surgery should not only be reducing weight and counteracting comorbid conditions but also improving psychosocial functioning. In addition to being an important goal of bariatric surgery, enhanced psychosocial functioning may motivate patients to adhere to adequate health behavior to maintain the surgically established weight loss. Methods We evaluated early postoperative psychosocial functioning in several domains over time. Preoperatively as well as 6, 12, and 24 months after vertical banded gastroplasty, 104 patients were psychologically assessed using a semi-structured interview and psychological questionnaires focusing on psychosocial functioning, personality, and body image. Results Over time, we found significant changes in weight: 2 years excess weight loss was 58.6%. In addition, most aspects of psychosocial functioning showed significant improvements over time. However, initial improvements in depressive symptoms, sleeping problems, and neuroticism did not last. With respect to personality features, only short-term changes in self-esteem were found. The most robust improvements were seen in the case of body image. Finally, within the patient group, there was a wide variability in changes.Conclusion Vertical banded gastroplasty not only leads to considerable weight loss but also to significant improvements in psychosocial functioning. However, some improvements waned over time, and successful postoperative functioning did not apply to all patients.

BackgroundBariatric surgery is the treatment of choice for patients with morbid obesity. In addition to surgery, postoperative dietary behavior is an important mediator of weight loss and, therefore, critical in influencing outcome. Surgical treatment of obesity is not an alternative to dieting but a method to enforce dieting.MethodsWe evaluated early weight loss and postoperative eating behavior over time. Preoperatively as well as 6 months, 1 and 2 years after vertical banded gastroplasty (VBG), 91 patients were psychologically assessed using a semi-structured interview and a psychological questionnaire focusing on eating behavior.ResultsOver time, we found significant changes in weight, mostly in the 1st postoperative year (EWL= 52.0%); at 2 years, EWL was 61.5%. Patients reported substantial changes in feelings of hunger, appetite, satiety, and eating behavior; however, most improvements waned over time. In addition, there was a wide variability in changes within our patient group, and changes in weight loss appeared to be related to changes in restrained eating.ConclusionVBG not only leads to considerable weight loss, but also to significant improvements in eating behavior, at least within 2 years. However, most improvements wane over time and not all patients profit in the same way.

BackgroundBariatric surgery is the treatment of choice for patients with morbid obesity. In addition to surgery, postoperative dietary behavior is an important mediator of weight loss and, therefore, critical in influencing outcome. Surgical treatment of obesity is not an alternative to dieting but a method to enforce dieting.MethodsWe evaluated early weight loss and postoperative eating behavior over time. Preoperatively as well as 6 months, 1 and 2 years after vertical banded gastroplasty (VBG), 91 patients were psychologically assessed using a semi-structured interview and a psychological questionnaire focusing on eating behavior.ResultsOver time, we found significant changes in weight, mostly in the 1st postoperative year (EWL= 52.0%); at 2 years, EWL was 61.5%. Patients reported substantial changes in feelings of hunger, appetite, satiety, and eating behavior; however, most improvements waned over time. In addition, there was a wide variability in changes within our patient group, and changes in weight loss appeared to be related to changes in restrained eating.ConclusionVBG not only leads to considerable weight loss, but also to significant improvements in eating behavior, at least within 2 years. However, most improvements wane over time and not all patients profit in the same way.

VBG not only leads to considerable weight loss, but also to significant improvements in HRQoL. However, some of the initially reported improvements lessened over time and not all patients appeared to profit in the same way.