Psychopathology in bariatric surgery candidates: A review of studies using structured diagnostic interviews

Abstract

Psychiatric disorders are not uncommon among severely obese patients who present for bariatric surgery. This paper (1) reviews the results of the published studies using the structured interviews to assess psychopathology in bariatric surgery candidates; (2) compares the prevalence rates of psychiatric disorders across these studies with the data from other population samples; and (3) assesses whether sociodemographic variables appear to affect these prevalence rates. We searched online resources, PubMed, PsychINFO and reference lists of all the relevant articles to provide an overview of evidence so far and highlight some details in the assessment and comparisons of different samples in different countries. The prevalence estimates in the non- treatment obese group did not appear to differ substantially from the general population group in the US or the Italian population samples, although they were relatively higher for the German population. However, the rates of psychopathology in the bariatric surgery candidates were considerably higher than the other two population groups in all the samples. Overall, the most common category of lifetime Axis I disorders in all the studies was affective disorders, with anxiety disorders being the most common category of current Axis I disorders. Certain demographic characteristics are also associated with higher rates of psychopathology, such as, female gender, low socioeconomic status, higher BMI. Overall, methodological and sociodemographic differences make these studies difficult to compare and these differences should be taken into account when interpreting the results.

Stigma In Persons with Obesity

“…However, research suggests that patients with severe obesity tend to exhibit more psychopathology than healthy-weight individuals or those with milder obesity [ 7 , 38 -43 ]. These fi ndings are particularly true among those seeking medical weight loss treatment (i.e., pharmacological or surgical interventions), compared to those seeking behavioral weight loss treatment [ 37 ]. Few studies have examined the relationship between obesity and personality disorders, and fi ndings from these studies are mixed and inconclusive [ 7 , 9 , 11 ].…”

“…Empirically, there is a lack of consistent evidence that obesity, in and of itself, is associated with higher rates of psychopathology [ 36 ], particularly among individuals with mild obesity [ 37 ]. However, research suggests that patients with severe obesity tend to exhibit more psychopathology than healthy-weight individuals or those with milder obesity [ 7 , 38 -43 ].…”

Clinical Practice Recommendations for the Management of Obesity in the United Arab Emirates

“…Patients with a history of such disorders experience poor weight loss due to the nature of their psychiatric illness [39]. They are also susceptible to internalized weight bias and body shame [40,41].…”

Abnormal Bodily Experiences Mediate the Relationship between Impulsivity and Binge Eating in Overweight Subjects Seeking Bariatric Surgery

“…Briefly, the severity of abnormal bodily experiences and identity disorders, measured by IDEA total score, was found to be positively associated with the overvaluation of body shape and body weight of patients with anorexia nervosa, bulimia nervosa and binge ED [5]. Obese patients seeking bariatric surgery often show impulsive traits, high psychiatric comorbidity, and relevant ED-specific psychopathological features [6,7]. In the ED population, impulsivity has been associated with binge eating and purging [8].…”