The Impact of Bariatric Surgery on the Psychiatric Morbidity of Patients with Morbid Obesity

Morbidobesity�(definedasabodymassindex�(BMI)�>40)�isasevereandincreasingly� prevalentconditionindevelopedcountries.�Ontopofmedicaldysfunctionsa� largeproportionofthesepatientsalsosufferfrompsychosocialdysfunctionsand� psychiatricdisorders.�Priortobariatricsurgeryasubstantialpercentageofpatients� sufferfrombingeeatingdisorderorbingeeatingsymptoms.�Surgeryiscarriedout� notonlytoreduceshorttermmorbidityandmortalityinpatientswithmorbid� obesitybutitalsogivesachanceforalong-termweightloss.�Toachievethisgoal� manypatientsneedsomekindofpsychiatricintervention. Objective: Theprincipalaimofthisstudyistoevaluatetheimpactofbariatric� surgeryonpsychiatricdisordersandpsychologicaldysfunctionsofpatientswith� morbidobesityoverthecourseofayearfollowingsurgery.�Specialconsideration� isgiventothepresenceofpsychiatriccomorbidity,�eatingdisorders,�bodyimage� dissatisfactionandself-esteem. Design:�Longitudinal,�psychiatricinterventionpreviousandoneyearaftersurgery. Results:�Themeanageofthepatientswas�41.7�years�(SD=2.4)�Themeanweightwas� 121.8�kg�(22.5)�whichcorrespondstoameanBMIof�45.7�(7.7).�Thesexdistribution� is�20%�maleand�80%�femalepatients.� Psychiatricdisorders�(ICD-10�criteria),�were� presentin�32.5�%.�Amongthemeatingdisorderswerethemostprevalent�(38.5%).� Followingbariatricsurgerytherewasasignificantimprovementineatingdisorders� andeatingsymptoms�(accordingtotheEatingDisordersInventoryandtheBulimic� TestofEdimburgh)�andinbodyimagesatisfaction� (measuredbyBSQ)�andself� steem�(Rosemberg).�Amultipleregressionanalysisofclinicalfactorsassociated� toweightlossshowedthat�40%�ofitisdeterminedbythedecreaseofbulimic� symptomsdetectedbytheBITE-symptoms.�