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Rates of obesity have increased exponentially over the past few decades. As over one-third of the US population is obese, conditions related to obesity, such as heart disease, diabetes, high blood pressure, and stroke, are also on the rise. Due to varying socioeconomic factors, weight loss can be extremely difficult, and a growing number of patients each year are turning to bariatric surgery as a last resort method to help them reach their weight loss goals.

Bariatric surgery is currently the most effective method of long-term weight loss for the morbidly obese. Bariatric surgery typically involves either decreasing the stomach size so that the patient physically cannot eat large quantities in one sitting or altering the connection between the stomach and small intestine so that there is less surface area for food to be absorbed by the digestive tract. In order to become a candidate for this type of surgery, the patient must be morbidly obese and have exhausted all conservative methods, such as diet, exercise, and nutrition counseling.

A gastric band is used in one type of bariatric surgery to decrease the stomach pouch to help promote weight loss.

Image Source: Tina Stallard / Contributor

While the results of these tests are not completely predictive of a patient’s response after surgery, it is important for surgeons to understand the mental health issues associated with bariatric surgery and morbid obesity. Patients who are obese are significantly more likely to suffer from mood disorders such as depression and anxiety and are also more likely to be hospitalized both pre- and post-operatively for conditions such as attempted suicide or substance abuse. Additionally, patients with pre-existing schizophrenia or bipolar disorder may experience worsening psychiatric symptoms post-operatively. Better post-surgical outcomes have been associated with patients who are younger, have less severe depression or anxiety, and are compliant with diet and exercise regimens.

Therefore, since patients who are undergoing bariatric surgery are at high risk for suffering from various psychiatric issues that may impact post-operative weight loss success, it is important to recognize the high risk patients and connect them to appropriate resources prior to surgery. Improving the emotional health of these patients will certainly accelerate readiness for physical activity after surgery, change eating habits, and improve the quality of life of morbidly obese patients.

Feature Image Source: Sandra Cohen-Rose and Colin Rose

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