Does obesity surgery improve psychosocial functioning? A systematic review

Abstract

OBJECTIVE:The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL). PURPOSE: A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y. RESEARCH METHODS AND PROCEDURES:The relevant literature was identified by a search of computerized databases. All articles published in English and German since 1980 were reviewed. Based on the requirements of the evidenced-based guidelines of the Agency for Health Care Policy and Research and the Scottish Intercollegiate Guidelines Network, each study was rated by a level of evidence. RESULTS: In all, 171 publications were reviewed. Using the above inclusion/exclusion criteria, 63 articles including two systematic reviews were identified. A total of 40 studies focused on psychosocial outcome after obesity surgery. CONCLUSION: Mental health and psychosocial status including social relations and employment opportunities improve for the majority of people after bariatric surgery thus leading to an improved QoL. Psychiatric comorbidity, predominantly affective disorders, and psychopathologic symptoms decrease postsurgically. A substantial percentage of bariatric surgery patients suffer from binge eating disorder or binge eating symptoms. The effect of bariatric surgery on the outcome of binge eating symptoms largely depends on the type of operation. With the exception of patients with a severe psychiatric comorbidity, the concern that obesity surgery will reinforce psychic symptoms and lead to a reduction in the QoL seems to be unfounded.

Weight loss and quality of life after bariatric surgery: a study of 200 patients after vertical gastroplasty or adjustable gastric banding

“…Both psychosocial and behavioral factors contribute to the successful post-operative outcomes (Sarwer et al, 2005). Another positive impact of surgery may be the improvement in socio-economic level of obese people after weight loss (Hawke et al, 1990, Naslund andAgren, 1991;Herpetz et al, 2003), but this parameter, as well as depression scores were not recorded in our study. A prospective survey of socio-economical status is currently ongoing in our institution.…”

Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits

“…In studies examining personality traits, selfesteem and self-confidence have been reported to increase, whereas depression, rigidity and anxiety decreased. 22,24,25,[29][30][31][32] Presumably related to the operation, somatization increased as well. 24,33,34 Compared to norm values we showed more inadequacy and less social inadequacy in females, a higher dominance in males and females and a lower self-esteem, a lower rigidity and a higher grievance in all.…”

Aspectos do acompanhamento psiquiátrico de pacientes obesos sob tratamento bariátrico: revisão

“…Revisões mais recentes têm apresentado resultados bastante animadores em termos de melhora psicossocial dos pacientes após cirurgia bariátrica. Uma revisão da literatura inglesa e alemã das duas últimas décadas concluiu que a saúde mental e os fatores psicossociais (funcionamento socioocupacional) melhoraram para a maioria dos pacientes bariátricos 94 . Houve uma genérica redução na gravidade e frequência de transtornos mentais, documentada também por estudos anteriores 95 .…”