The Psychological Side of Bariatric Surgery: A Surgeon’s Perspective

 Obesity is one of the prevalent conditions affecting millions of people worldwide. The management of obesity requires a multi-disciplinary, integrated treatment of medical, physical, nutritional, and psychological factors. Bariatric surgery happens to be the last resort for individuals trying to lose weight, however, in vain.

Bariatric surgery is designed to reduce the size of the stomach or intestine so that a person feels full faster and their body absorbs lesser nutrients. This approach helps in weight management in the long run. It has several types, from traditional to laparoscopic, each leading to a high success rate and substantial weight loss, all of which improve your quality of life in the long run.

Because of the life-changing effects of bariatric surgery, a pre-evaluation of the psychological conditions of the candidate is required. It helps to achieve the desired post-operative outcomes in the long run. Pre and post-operative psychological interventions are highly recommended for patients who have psychological difficulties.

Does Bariatric Surgery Impact Mental Health?

Bariatric surgery has a beneficial effect on mental health. However, in some conditions, mental health benefits are not fully guaranteed. The experts are continuously researching the mental health effects and offering some direction about how to approach this area before and after the procedure.

As per a meta-analysis, the most common health issues among people seeking bariatric surgery are depression and binge eating order. Around 20% of individuals were found to have depression, and 18% suffered a binge eating disorder.

Some people also experience severe symptoms of depression after the surgery. However, these results may vary, and there is no certainty that every individual will experience the same negative psychological effects. Other effects of bariatric surgery include the following:

  • Many people experience mental health symptoms even after bariatric surgery that doesn’t change their quality of life. For some patients, even cognitive behavioral therapy doesn’t work to alleviate these symptoms. These inconsistent results are a little alarming, especially in those who have been greatly affected by mental health conditions.

  • Weight bias internalization is another common problem among patients who undergo bariatric surgery. The bias results in low self-esteem. Some individuals experience frequent episodes of depression and anxiety. In this situation, doctors suggest therapy as a beneficial approach.

Current Practices of Pre-Surgical Psychological Evaluation of Bariatric Surgery

When preparing an individual for bariatric surgery, it becomes important for the surgeons to investigate several areas to understand their psychological condition.

Understanding of the Surgery for Patient

It is vital that a patient undergoing bariatric surgery must have adequate knowledge about the surgery procedures, including the pros and cons associated with it. Bariatric surgery leads to a great behavioural change that must occur for achieving expected results.

The surgeon should carry out a psychological evaluation of the patient’s condition with the help of a psychologist. It is important to learn the patient’s expectation with the surgery and assess their willingness to engage themselves in a healthy behavioural change.

Eating Behaviors

Many obese people have a condition called binge eating disorder, characterized by frequent episodes of binge eating in the absence of following compensatory strategies such as purging or vomiting. Some patients also suffer from other eating disorders, including Bulimia nervosa or Night eating syndrome.

The former refers to recurrent binge episodes of weight-control behaviors like vomiting, strict dieting, etc., while the latter includes morning anorexia, hyperphagia, and even insomnia. Any individual with an eating disorder must understand that bariatric surgery alone will not modify their eating behaviors. Surgeons need to push patients towards changing their lifestyle behaviors to achieve lifelong weight loss.

Psychiatric Condition

Surgeons should ensure that any previous or current psychiatric disturbance of the patient is duly addressed during their pre-surgical assessment. The evaluation of psychiatric disorders helps identify symptoms related to anxiety, depression, mania, psychosis, suicidal ideation, substance abuse, and other related conditions that may take a toll on the patient’s life even after surgery.

The presence of one or more above-listed conditions may affect their quality of life. It is vital to evaluate the degree at which the patient is experiencing these episodes. As soon as these conditions are ruled, they can be addressed which eventually prepares the patient properly for the surgery and its outcomes.

Social Support

The impact of bariatric surgery is not just limited to the patient but also on the environment where they live. During the psychological assessment, the surgeons must explore the familial and social context surrounding the patients. The candidate should be asked to give details about the people they live with and whether their family will offer them a support system after surgery.

Likewise, patients should also be informed about the possible social outcomes of the surgery. Finding social support is extremely important.

Takeaway

The psychological side of bariatric surgery is important to address for the best outcomes of the surgery and for an improved quality of life of the patient. Whether you are a patient or a doctor, these factors should not be overlooked.

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