Psychosocial Outcome and Long-Term Weight Loss after Gastric Restrictive Surgery for Morbid Obesity

Abstract

Forty-five of 60 consecutive morbidly obese patients who had a vertical banded gastroplasty carried out by the one surgeon between 1982 and 1988 were assessed by questionnaire at long-term follow-up in 1993. Eighteen patients (40%) had maintained their BMI at close to the lowest achieved levels. Twenty-seven patients (60%) had had a significant rise in BMI, and 14 of these (31%) had gained weight to return close to or above their pre-surgery BMI levels. No reliable predictors of successful long-term weight loss were detected in the pre-operative data. Forty-eight patients (84%) were satisfied with their surgical treatment. Twenty patients (44%) reported improved social life after surgery. Twenty-one patients (46%) reported a similar social life and only four patients (9%) a worse social life. At follow up five patients (12%) reported emotional problems related to their weight loss surgery and two of this group had had psychiatric counseling for depression. Pre-operative psychiatric assessment appeared to have facilitated intervention by the psychiatrist with these patients. Gastric restrictive surgery, however, remains unpredictable in its long-term weight loss effect.

Does obesity surgery improve psychosocial functioning? A systematic review

“…117 The majority of the studies reviewed corresponded to EC IIb and had a mean follow-up rate of 2-3 y; nevertheless, some studies reassessed patients after a longer period of up to 9 y. 62,80,94 Studies that evaluated patients after surgery or with a retrospective design can evaluate the prevalence of psychiatric disorders or psychological problems; however, they cannot give any information about the changes associated with surgery. These shortcomings might be partly compensated by large samples and follow-up periods of more than 13 y.…”

“…[60][61][62][63][64][65][66][67] Psychiatric disorders were diagnosed by standardized, 61,62 structured, [62][63][64] clinical 65,66 interviews and standardized questionnaire. 67 Four studies 61,[64][65][66] used psychiatric interviews pre-and postsurgery.…”

“…Social functioning in general was assessed by 10 studies, one study corresponding to level IIa, 55 four corresponding to EC IIb, 62,64,67,88 and six to EC III, 35,59,81,85,95,96 respectively. Obesity-related psychosocial problems were assessed in every day life of morbidly obese subjects undergoing bariatric surgery or conventionally treated subjects in the SOS study.…”

“…Satisfaction with obesity surgery A total of 11 studies, five corresponding to EC IIb 62,66,70,79,88 and six to EC III, 35,75,81,83,89,95 asked patients about their satisfaction with the operation. Within the EC IIb studies, 72 70 to 86% 79 were very satisfied with the operation; within the EC III studies, the rate even went up to 90%.…”

Bariatric surgery for pediatric extreme obesity: now or later?

“…Based on adult outcomes, it is known that postsurgery adult patients report improved HRQOL, 37,163-165 less stigmatization and discrimination, 166 an improved social life, 167,168 and improved educational and occupational status. 168,169 Further, there is evidence suggesting that pre-existing psychosocial impairment influences adult surgical outcomes.…”