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"Bariatric Surgery psychology."
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Living with bariatric surgery : managing your mind and your weight
Living with Bariatric Surgery: Managing Your Mind and Your Weight aims to help those who are considering bariatric surgery develop a psychological understanding of their eating behaviour and the changes needed in order to make surgery successful. It is also a resource for those who have undergone surgery to help them adapt to the physical, psychological and relationship adjustments that occur. Whilst the benefits of bariatric surgery are significant, the psychological challenges it presents for patients have been overlooked. This book will help patients develop a realistic view of bariatric surgery and the changes required. It incorporates the real-life experiences of people who have had bariatric surgery, showing how they have responded to the psychological and behavioural changes after surgery, and also features helpful psychoeducation, exercises and strategies to facilitate reflection and learning. Living with Bariatric Surgery will be an essential guide for anyone considering, preparing for or recovering from bariatric surgery, as well as mental health professionals working with these clients.\"-- Provided by publisher.
Book
Qualitative study on postbariatric surgery follow-up in France: a new patient–physician relationship
BackgroundMost studies on bariatric patients to date have only examined mortality and morbidities in terms of surgery or no surgery. Few have investigated loss to follow-up in post-surgery patients.PurposeThis study aimed to describe the dynamics behind non-adherence to follow-up in bariatric patients postsurgery.DesignUsing semi-structured interviews, we performed a qualitative study. Using a thematic analysis, we described themes involved in patient adherence to postsurgery follow-up.SettingParticipants were recruited from a university hospital near Paris and via social networks.Participants17 patients who had undergone surgery, some of whom were lost to follow-up, 15 women and 2 men, were interviewed, during a mean time of 90 min. 10 were adherent, and 7 were lost to follow-up.ResultsFollow-up was seen as a support in which the care provider–patient relationship can act on the four following themes: (1) regaining control, (2) knowledge acquisition, (3) management of fears and (4) overall restructuring of one’s life postsurgery.ConclusionsPatients’ experiences and representations of postsurgery follow-up should be documented in detail in order to define the specific roles of the various care providers offering support to this population, and to strengthen the coordination of care pathways between these actors. In addition, improving the quality of communication could improve adherence to follow-up after bariatric surgery.
Journal Article
Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study
Purpose
The main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients.
Methods
Two studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years.
Results
In Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape.
Conclusions
The present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body.
Level of evidence
III, well-designed cohort
Journal Article
Psychosocial Assessment and Treatment of Bariatric Surgery Patients
Bariatric surgery plays an important role in the treatment of obesity; in this comprehensive resource the worldwide leaders of the field provide the most up-to-date information on the psychosocial issues that affect their patients. Included is an overview and history of surgical procedures, complete with illustrations, practical advice on topics such as physical activity and nutritional care after surgery, and essential information that allows clinicians to assist their clients as much as possible; for example, how pre-weight loss surgery psychosocial evaluations can serve as clinical interventions in their own right, and how structured interviews and questionnaires can be used in multiple contexts such as screening, treatment planning, and prognostic assessment. A distinctive chapter includes an overview of the special issues present in treating adolescents, who increasingly are the target of bariatric surgery procedures. This book is an essential reference for clinicians from the evaluation through the follow-up and aftercare of bariatric surgery patients.
eBook
Psychosocial Evaluation for Bariatric Surgery: The Boston Interview and Opportunities for Intervention
The process of psychosocial evaluation for weight loss surgery (WLS) is one that goes beyond serving the function of information-gathering (Bauchowitz et al. in Surg Obes Relat Dis 3:554–558,
2007
; Friedman et al. in Surg Obes Relat Dis 3:376–382,
2007
; Lanyon and Maxwell in Obes Surg 17:321–328,
2007
; Sogg and Mori in Obes Surg 14:370–380,
2004
; Sogg and Mori in Surg Obes Relat Dis 4:455–463,
2008
). This process offers myriad opportunities for delivering significant and powerful interventions that can enhance the patient’s success in the WLS process. A discussion of the unique opportunities for psychosocial intervention afforded by the pre-surgical evaluation process is presented, using The Boston Interview for Bariatric Surgery (Sogg and Mori in Surg Obes Relat Dis 4:455–463,
2008
) as the organizing framework.
Journal Article
Interdisciplinary European Guidelines on Metabolic and Bariatric Surgery
In 2012, an expert panel composed of presidents of each of the societies, the European Chapter of the International Federation for the Surgery of Obesity (IFSO-EC), and of the European Association for the Study of Obesity (EASO), as well as of the chair of EASO Obesity Management Task Force (EASO OMTF) and other key representatives from IFSO-EC and EASO, devoted the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery in advance of the 2013 European Congress on Obesity held in Liverpool. This meeting was prompted by the extraordinary advancement made in the field of metabolic and bariatric surgery during the past decade. It was agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced by focusing in particular on the evidence gathered in relation to the effects on diabetes and the changes in the recommendations of patient eligibility criteria. The expert panel allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.
Journal Article
Risk of Suicide and Self-harm Is Increased After Bariatric Surgery—a Systematic Review and Meta-analysis
BackgroundBariatric surgery is endorsed by multiple societies as the most effective treatment for obesity. Psychosocial functioning has also been noted to improve for most patients after bariatric surgery. However, some studies have shown an increase in post-operative suicide risk. The aim of this study was to review the published literature and evaluate the association of bariatric surgery with suicide events and suicide/self-harm attempts in patients who have undergone weight loss surgery.MethodsMEDLINE and Embase were searched from inception through January 2018 for retrospective or prospective studies reporting mortality outcomes and self-harm or suicide rates after bariatric procedures. The primary outcome was the pooled event rate with 95% confidence interval (95% CI) for suicide. Secondary outcomes were suicide/self-harm attempts after bariatric surgery compared to same population prior to surgery and to matched control subjects, with the respective calculated odds ratios (OR) and 95% CI.ResultsFrom 227 citations, 32 studies with 148,643 subjects were eligible for inclusion. The patients were predominantly females (76.9%). Roux-en-Y gastric bypass (RYGB) was the most commonly performed procedure (58.9%). The post-bariatric suicide event rate was 2.7/1000 patients (95% CI 0.0019–0.0038), while the suicide/self-harm attempt event rate was 17/1000 patients (95% CI 0.01–0.03). The self-harm/suicide attempt risk was higher after bariatric surgery within the same population with OR of 1.9 (95% CI 1.23–2.95), and compared to matched control subjects, OR 3.8 (95% CI, 2.19–6.59).ConclusionsPost-bariatric surgery patients had higher self-harm/suicide attempt risk compared to age-, sex-, and BMI-matched controls. Various pre- and post-surgical psychosocial, pharmacokinetic, physiologic, and medical factors may be involved.
Journal Article
Post-operative Psychosocial Predictors of Outcome in Bariatric Surgery
Although there are several recent reviews of the pre-operative factors that influence treatment outcome for bariatric surgery, commensurate efforts to identify and review the predictive validity of post-operative variables are lacking. This review describes the post-operative psychosocial predictors of weight loss in bariatric surgery. Results suggest empirical support for post-operative binge eating, uncontrolled eating/grazing, and presence of a depressive disorder as negative predictors of weight loss outcomes; whereas, adherence to dietary and physical activity guidelines emerged as positive predictors of weight loss. With the exception of depression, psychological comorbidities were not consistently associated with weight loss outcomes. Results highlight the need for post-operative assessment of disordered eating and depressive disorder, further research on the predictive value of post-operative psychosocial factors, and development of targeted interventions.
Journal Article
Preoperative Predictors of Weight Loss Following Bariatric Surgery: Systematic Review
Background
Obesity affects 32% of adults in the USA. Surgery generates substantial weight loss, but 20–30% fails to achieve successful weight loss. Our objective was to identify preoperative psychosocial factors associated with weight loss following bariatric surgery.
Methods
We performed a literature search of PubMed® and the Cochrane Database of Reviews of Effectiveness between 1988 and April 2010. Articles were screened for bariatric surgery and weight loss if they included a preoperative predictor of weight loss: body mass index (BMI), preoperative weight loss, eating disorders, or psychiatric disorder/substance abuse. One thousand seven titles were reviewed, 534 articles screened, and 115 included in the review.
Results
Factors that may be positively associated with weight loss after surgery include mandatory preoperative weight loss (7 of 14 studies with positive association). Factors that may be negatively associated with weight loss include preoperative BMI (37 out of 62 studies with negative association), super-obesity (24 out of 33 studies), and personality disorders (7 out of 14 studies). Meta-analysis revealed a decrease of 10.1% excess weight loss (EWL) for super-obese patients (95% confidence interval (CI) [3.7–16.5%]), though there was significant heterogeneity in the meta-analysis, and an increase of 5.9% EWL for patients with binge eating at 12 months after surgery (95% CI [1.9–9.8%]).
Conclusions
Further studies are necessary to investigate whether preoperative factors can predict a clinically meaningful difference in weight loss after bariatric surgery. The identification of predictive factors may improve patient selection and help develop interventions targeting specific needs of patients.
Journal Article
Patient Perspectives on Adherence with Micronutrient Supplementation After Bariatric Surgery
BackgroundAdherence to post-bariatric surgery nutritional supplements can be poor and is associated with higher micronutrient deficiency rates. There is currently no available study specifically seeking patients’ perspectives on the reasons behind poor adherence and how to address it.MethodsBariatric surgery patients living in the UK were invited to take part in an anonymous survey on SurveyMonkey®.ResultsA total of 529 patients (92.61% females, mean age 47.7 years) took part. Most of these patients had undergone either a Roux-en-Y gastric bypass (63.0%) or sleeve gastrectomy (24.0%). Most of the patients were in full-time (49.0%, n = 260/529) or part-time (15.7%, n = 83/529) employment. Approximately 54.0% (n = 287/529) of the respondents reported having trouble taking all their supplements. Males were significantly more likely to report complete compliance. The most important reported reason for poor compliance was difficulty in remembering (45.6%), followed by too many tablets (16.4%), side effects (14.3%), cost (11.5%), non-prescribing by GP (10.8%), bad taste (10.1%), and not feeling the need to take (9.4%). Patients suggested reducing the number of tablets (41.8%), patient education (25.7%), GP education (24.0%), reducing the cost (18.5%), and more information from a healthcare provider (12.5%) or a pharmacist (5.2%) to improve the compliance.ConclusionsThis study is the first attempt to understand patient perspectives on poor adherence to post-bariatric surgery nutritional recommendation. Patients offered a number of explanations and also provided with suggestions on how to improve it.
Journal Article