Psychiatric and Psychosocial Effects of Bariatric Surgery
Psychiatric and psychosocial effects of bariatric surgery, bariatric surgery has become an increasingly popular and frequently preferred method for the treatment of obesity both in Turkey and worldwide in recent years. The main reasons why this surgical method is preferred are that it provides rapid weight loss and helps to improve comorbidities related to obesity. However, bariatric surgery is also closely related to the psychiatric and psychosocial status of patients.
In this article, we will discuss the importance of psychiatric and psychosocial evaluation of patients who will undergo bariatric surgery.
Types and Effects of Bariatric Surgery
Bariatric surgery, also popularly known as weight loss surgery, includes various methods used to combat obesity. Different surgical procedures such as gastric sleeve, gastric bypass and gastric balloon are used to reduce obesity-related health problems and promote weight loss. Each procedure has different effects and risks. However, all of these procedures may require psychological support during the weight loss process.
Gastric Sleeve (Sleeve Gastrectomy)
Gastric sleeve, in which a large part of the stomach is surgically removed, leads to reduced stomach volume and less food consumption. It promotes weight loss in overweight or obese individuals and reduces obesity-related health problems.
Gastric Bypass (Stomach Bypass)
Gastric bypass takes place by removing part of the stomach and creating a small gastric pouch. This procedure allows some of the food to bypass the digestive system. This promotes weight loss and reduces the absorption of some nutrients.
Gastric Balloon (Stomach Balloon)
Gastric balloon, popularly known as stomach balloon, is performed by inserting an inflatable balloon into the stomach. This method limits stomach volume and increases the feeling of fullness. This procedure can be less invasive. However, it may still require psychological support.
The Relationship Between Bariatric Surgery and Mental Health
While bariatric surgery can be an effective tool in the fight against obesity, these surgical procedures are also known to have a significant impact on mental health. Although weight loss surgeries are often associated with a decrease in symptoms of depression and anxiety, the adjustment process and lifestyle changes after bariatric surgery may require psychological support.
Psychological Effects of Weight Loss
Bariatric surgery is usually associated with a significant reduction in symptoms of depression and anxiety. However, the adaptation process and lifestyle changes after surgery may require psychological support.
Body Image and Self-Esteem
Individuals struggling with obesity may experience positive changes in their body image and self-esteem after weight loss surgery.
Obesity Surgery and Mental Disorders
Psychiatric conditions commonly observed in patients undergoing bariatric surgery include specific eating disorders and mood disorders such as depression and anxiety. There are some debates as to whether these conditions are related to the surgical intervention or whether they develop independently of surgery.
However, the general opinion is that bariatric surgery should be supported by psychiatric evaluations.
Psychiatric Evaluation Before Bariatric Surgery
Psychiatric and psychosocial evaluation of patients before bariatric surgery is critical for successful outcomes of surgery. The main issues to be considered in this evaluation are as follows:
- Psychopathology: It should be evaluated whether the patient has an existing psychiatric disorder.
- Level of Knowledge: The patient’s level of knowledge about the surgical procedure and its aftermath should be examined.
- Expectations: The patient’s expectations regarding the expected physical, psychological and social changes after surgery should be evaluated.
Behavioral Changes and Compliance: Behavioral changes that may occur after surgery and the capacity to follow medical recommendations should be evaluated.
Methods of the Psychiatric Assessment Process
Psychiatric assessment methods include a detailed examination of patients’ dietary habits, lifestyle, physical activity levels and problematic eating behaviors.
These evaluations can positively affect the weight loss process and general health status of patients in the postoperative period.
- Eating Habits and Lifestyle
Having information about previous weight loss attempts and the difficulties faced by patients who are candidates for bariatric surgery helps in the management of the postoperative period.
A detailed examination of patients’ eating habits and lifestyles contributes to the adoption of a healthier lifestyle after surgery.
- Physical Activity
Physical activity and exercise have a critical importance in the treatment of obesity and postoperative period. Raising awareness of patients about physical activity in the preoperative period and identifying possible barriers facilitates the acquisition of exercise habits in the post-bariatric surgery period.
- Problematic Eating Behaviors
Determining the problematic eating behaviors of patients has an important place in the psychiatric evaluation performed before bariatric surgery. Evaluation of these behaviors helps to develop healthier eating habits in the post-surgical period.
How long is the psychiatric evaluation?
During the psychiatric evaluation process, emotional, psychological and cognitive problems that may affect the outcome of the surgery are examined. In this process, clinical interviews are conducted and various psychological tests are applied.
However, it is not correct to give a definite time for the duration of these evaluations. Because the duration may vary depending on the individual’s condition. Generally, this process involves more than one session and each session is shaped according to the needs of the individual.
Do Psychiatric Problems Occur After Surgery?
Psychiatric evaluations in bariatric surgery show that some short-term effects may occur after surgery by examining preoperative depressive symptoms and fear of obesity.
Psychological Counseling and Guidance
Psychological support should be provided for bariatric surgery candidates and postoperative patients. This support includes preoperative assessment, guidance and emotional support services during the postoperative adaptation process.
Changing Eating Habits
Since changing eating habits and relearning the diet after surgery can be psychologically challenging, counseling is important in this process.
Exercise and Lifestyle Changes
Weight loss surgeries require not only dietary habits but also exercise and lifestyle changes. Psychological support is important to adapt to these changes.
Importance of Multidisciplinary Approach in Bariatric Surgery
The success of bariatric surgery can be achieved through a multidisciplinary approach. In this approach, surgeons, psychiatrists, psychiatrists, psychologists, dietitians and other health professionals should work together to address the needs of patients in a holistic manner.
Clear protocols should be established on who, how and when psychosocial support and assessment will be provided.
Bariatric surgery is an effective method in the treatment of obesity in terms of rapid weight loss and improvement of comorbid diseases. However, for the surgery to be successful, patients should be evaluated in detail from a psychiatric and psychosocial perspective. This evaluation not only improves the quality of life of patients, but also ensures that the post-surgical weight loss process proceeds in a healthy manner.
Having mental health professionals play a fundamental role in the evaluation of bariatric surgery patients increases the effectiveness of the multidisciplinary approach and improves the long-term success rates of surgical interventions.
Psychiatric and psychosocial evaluation of bariatric surgery patients is an important factor that will positively affect the efficacy of surgical intervention and the general health of patients. Considering the increasing prevalence of obesity, such multidisciplinary approaches should become a standard practice in healthcare services.
