Abstract:
Morbid obesity (defined as a Body Mass Index, BMI, > 40) is a severe and increasingly prevalent condition in developed countries. A large proportion of these patients suffer from psychosocial dysfunctions and psychiatric disorders. Prior to bariatric surgery a substantial percentage of patients suffer from binge eating disorder or binge eating symptoms. Surgery is carried out not only to reduce short-term morbidity and mortality in patients with morbid obesity, but it also gives a chance for a long-term weight loss. To achieve this goal many patients need some kind of Mental Health and Psychiatric intervention.
Objective: The principal aim of this study is to evaluate the impact of bariatric surgery on psychiatric disorders and psychological dysfunctions of patients with morbid obesity over the course of a year following surgery. Special consideration is given to the presence of psychiatric comorbidity, eating disorders, body image dissatisfaction and self-esteem.
Design: Longitudinal, psychiatric intervention previous and one year after surgery.
Results: The mean age of the patients was 41.7 years (s d 2.4) The mean weight was 121.8 kg (22.5) which corresponds to a mean BMI of 45.7 (7.7) The sex distribution is 20% male and 80% female patients. Psychiatric disorders (International Classification of Diseases- ICD-10 criteria), were present in 32.5 %. Among them eating disorders were the most prevalent (38.5%).
Following bariatric surgery there was a significant improvement in eating disorders and eating symptoms (according to the Eating Disorders Inventory and the Bulimic Test of Edinburgh) and in body image satisfaction (measured by Body Shape Questionnaire- BSQ) and self-esteem (Rosemberg). A multiple regression analysis of clinical factors associated to weight loss showed that 40% of it is determined by the decrease of bulimic symptoms detected by the Bulimic Investigatory Test BITE-symptoms
Conclusions: Morbid obesity is a risk population for psychiatric disorders and psychological dysfunctions. Bariatric Surgery reduces over one year the severity of this morbidity. The impact of increased self-esteem through the increase of body image satisfaction and of the increase in control over food intake seems to be the major factor in these changes.
Keywords: Morbid obesity; bariatric surgery; psychiatric comorbidity; eating disorders, impulsivity
Audience take-away:
- The audience will be able to understand mental health disorders associated with morbid obesity
- It will help the audience in manage Mental Health in Morbid Obesity
- This research introduce the necessity to improve detection in Psychiatric Disorders in Morbid Obesity prior to surgery
- This research provide a perspective in how Eating Disorders and self-steem improve post to surgery
- It is necessary to improve the accuracy of a design and include a Gender Perspective in this area
