Mental health status after gastric bypass

Mental health status after gastric bypass

Morbid obesity is a serious disease that affects as many as 5 million Americans. During the past 30 years, various surgical procedures have been developed for the treatment of obesity. The Greenville gastric bypass procedure has emerged as the current standard in the surgical treatment of obesity. Several studies have demonstrated successful weight loss and improved physical and mental health function with this surgery, but follow-up has been limited by both time and poor patient compliance. To study the effects of the Greenville gastric bypass surgery on mental health, Waters and colleagues followed 157 patients who underwent the procedure between 1984 and 1989.

All of the patients were at least 100 lb above their ideal body weight. Mean body weight was 294 lb, with a range of 198 to 565 lb. Mean age of the patients was 36.3 years, with a range of 19 to 67 years. The patients were carefully screened before the procedure to exclude those with surgical and medical risks. This screening also included a psychiatric evaluation.

As shown in the table, the proportion of patients complying with follow-up declined steadily, with only 60 patients (38 percent) seen 36 months after surgery. The mean weight loss was 103.1 lb over the 36-month period. Measures of mental health showed statistically significant improvement at six and 12 months after surgery. However, at 24 months after surgery, these scores had reverted to levels that were not statistically different from preoperative scores. No significant physical findings were found to explain this phenomenon.

While the reasons for the changes in mental health status following gastric bypass surgery are unknown, the study findings emphasize the importance of psychologic support and follow-up in such cases. The authors stress the necessity of a thorough psychologic assessment before surgery, including sources of support and expectations of emotional change from the surgery. The patient’s expectations for the success of this procedure may far exceed the actual results. (American Journal of Surgery, January 1991, vol. 161, p. 154.) TABULAR DATA OMITTED

COPYRIGHT 1991 American Academy of Family Physicians

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