A multisite view of psychosocial risks in patients presenting for bariatric surgery

Abstract

, and the TeenView Writing Group in cooperation with the Teen-LABS ConsortiumObjective: The psychosocial health of adolescents with severe obesity (BMI 120% for age and gender) has only recently been the focus of empirical work. Methods: This multisite study-an ancillary to a prospective longitudinal observational study documenting health in adolescents having weight loss surgery (WLS)-presents preoperative/baseline data from 141 WLS adolescents and 83 nonsurgical comparisons (NSComps). Self-report data from adolescent and caregiver dyads characterize adolescent psychopathology and potential correlates. Results: One in three adolescents reported internalizing symptoms, and one in five endorsed externalizing symptoms in the clinical range. Generalized linear model analysis demonstrated that increased risk of psychopathology for adolescents with severe obesity was associated with family dysfunction, eating pathology, family composition, and seeking behavioral intervention (versus WLS), whereas better quality of life (QOL) was associated with lower psychopathology. Conclusions: While psychopathology rates are comparable to national samples, there is a subgroup of youth who present for behavioral weight loss services and are at greater risk for psychopathology relative to national adolescent base rates. Adolescents who achieve candidacy for WLS may be a highly selective population of youth with severe obesity and may have lower base rates of psychopathology compared to NSComps.

Mental distress in treatment seeking young adults (18–25 years) with severe obesity compared with population controls of different body mass index levels: cohort study

“…The few studies on clinical cohorts published to date have been limited by small sample sizes, lack of control group comparisons and/or insufficient adjustments for confounding variables . Britz et al .…”

“…The few studies on clinical cohorts published to date have been limited by small sample sizes, lack of control group comparisons and/or insufficient adjustments for confounding variables (17,20). Britz et al displayed comparable prevalence rates of (present) depressive disorder (according to DSM-IV, 23%) in 15-21-year-old patients in behavioural weight reduction treatment (n = 47, mean BMI = 42.4 kg m −2 ) as the present study (lifetime incidence = 22%) (17).…”

“…For young adults, mental distress has been studied more frequently in candidates for bariatric surgery than in patients in behavioural weight loss programmes. However, Table 3 Lifetime prevalence of self-reported, physician-diagnosed depression; lifetime suicidal behaviour; quality of life (EQ-5D); and present psychosomatic symptoms in 121 young adults (18)(19)(20)(21)(22)(23)(24)(25) the surgical studies generally lacked control group comparisons and predominantly included adolescents (i.e. younger participants than what was the focus for this article) (19).…”

“…The primary aim of this study was to compare the prevalence and levels of mental distress in young adults (18)(19)(20)(21)(22)(23)(24)(25) years) seeking specialist behavioural weight reduction treatment for severe obesity with those in normal weight young adults in the general population. Our secondary aim was to explore the prevalence and levels of mental distress in young adult treatment seekers with severe obesity compared with non-treatment-seeking young adults with different levels of obesity in the general population.…”

From adolescence to young adulthood: trajectories of psychosocial health following Roux-en-Y gastric bypass

“…Consistent with national bariatric surgery trends, the sample was primarily white and female. Presurgery BMI and psychopathology rates were higher than a more contemporary multisite sample (surgery 2008 or later) using the same protocol (i.e., study eligibility, timing of enrollment) [30]. Psychosocial approval processes may have grown more stringent over time, or more likely, patients with less psychosocial impairment and lower BMI, are now seeking/being referred for and undergoing bariatric surgery.…”