Obesity has become an epidemic in the United States, especially in the past 30 years, with the rate of obesity more than doubling. Bariatric surgery has become a more common method to deal with obesity and its associated sequelae. Before being approved for surgery, one must engage in a psychological evaluation to determine whether one has the psychological and emotional resources necessary to proceed with gastric bypass surgery. The objective of the current study was to determine whether specific psychological variables obtained during the psychological evaluation for gastric bypass surgery, specifically, the validity and clinical scales of the MMPI-2 and the SCL-90-R, and psychological variables obtained during the clinical interview, could be used to predict success post-surgery in terms of percent excess weight lost (%EWL). It was expected that clinical elevations on these scales would predict lower weight loss. Results indicated that the only significant predictor of outcome, in terms of a higher %EWL, was a lower score on subscale Pd2 (Psychopathic Deviate: Authority Problems) of the MMPI-2 at six months post-surgery. However, higher scores on scale 2 (Depression) and F (Infrequency), as well as a greater number of Axis I diagnoses, approached significance as predictors of %EWL at 6 months post-surgery. In addition, a greater number of self-reported coping mechanisms and a higher score on scale 1 (Hypochondriasis) of the MMPI-2 also demonstrated a trend towards significance for being considered significant predictors at 1 and 2 years post-surgery, respectively. None of the hypothesized predictor variables were found to be significant predictors of %EWL at 3 months, 1 year, or 2 years post-surgery, or for maintenance of weight loss from 1 to 2 years post-surgery. Limitations, strategies to overcome these limitations, and directions for future research are discussed.

Abstract: There are many treatment options for overweight and obesity including a variety of diet programs, pharmaceutical drugs, and weight loss surgery. For morbidly obese persons (BMI 35 kg/rn), bariatric surgery is the most effective treatment for weight loss. Eighty eight patients who underwent Roux-En-Y surgery at The Ohio State University Medical Center in 2004 were examined to determine if age, initial body weight, number of previous diet attempts, preoperative weight loss, presurgical nutrition treatment program completion, and the duration of time between program completion and surgery date are predictors of weight loss at one-year post operation. The sample population was predominantly female, Caucasian, with an average age of 41 years. Fifty-four patients had one-year follow-up assessment data available. The duration of time between presurgical program completion and surgery date was the only variable that significantly differed between patients with and without one-year follow-up data (p=0.05). Initial weight, preoperative weight change, and total number of diet attempts were significant predictors of EBW at one-year post operation. Total number of diet attempts significantly predicted EBW% loss at one-year post operation, while initial body weight marginally predicted weight loss at one-year post operation. The average EBW% loss at one-year post operation was 61%. Further evaluation indicated that surgical intervention was the only factor significantly influencing weight loss over time (p

This book provides the first comprehensive guide to enhanced cognitive behavior therapy (CBT-E), the leading empirically supported treatment for eating disorders in adults. Written with the practitioner in mind, the book demonstrates how this transdiagnostic approach can be used with the full range of eating disorders seen in clinical practice. Christopher Fairburn and colleagues describe in detail how to tailor CBT-E to the needs of individual patients, and how to adapt it for patients who require hospitalization. Also addressed are frequently encountered co-occurring disorders and how to manage them. Reproducible appendices feature the Eating Disorder Examination interview and questionnaire. CBT-E is recognized as a best practice for the treatment of adult eating disorders by the U.K. National Institute for Health and Care Excellence (NICE).

The success of many surgical procedures depends not only on the skill of the surgeon and the use of state-of-the-art technology, but also on the actions and characteristics of the patient. Patients' emotional and psychosocial concerns, health-related behaviours, outcome expectations, and compliance with treatment regimen can all strongly influence the ultimate effectiveness of surgery. Thus, mental health professionals are increasingly called upon to perform presurgical psychological screening (PPS) to ensure that patients are given the treatments most likely to be effective, while reducing the chances of worsening their conditions. This book presents PPS procedures for a wide range of surgery types, such as spinal surgery, organ transplantation, bariatric surgery, and plastic surgery. Drawing on both research and clinical experience, the authors explain how to conduct PPS, communicate results to patients and surgeons, and identify possible pre- or post-surgery interventions to mitigate risk factors and maximise the likelihood of surgical success. Case studies and a discussion of bioethics are included

Of evidence-based recommendations -- Introduction -- Overweight and obesity: background -- Examination of randomized controlled trial evidence -- Treatment guidelines -- Summary of recommendations -- Future research.

Although bariatric surgery appears to produce success in a short period of time immediately after surgery, weight regain over time in this population cannot be ignored. Understanding the relationship between potential psychosocial predicting post-surgical variables influencing bariatric surgery may prevent long-term weight regain. The purpose of this research is to examine self-efficacy, social support, and lifestyle habits and their relationship to long term weight loss and regain in women post bariatric surgery. Weight regain is observed as early as 18 months to 2 years after bariatric surgery. Patients face challenges sustaining the dramatic lifestyle changes required to ensure positive long-term weight loss. A descriptive correlational research design was used to examine relationships among the variables. The demographic data of the women were reviewed for any correlations with reported regain. There were three independent variables explored in this research: self-efficacy, health promotion lifestyle, and social support. The dependent variable in the study was weight regain. The study was advertised for four weeks in a 'bariatric women only' Facebook forum and on the Obesity Help website. A solicitation email was placed on these sites containing five inclusion criteria: adult, female, able to read and write English, Internet users, and underwent bariatric surgery with greater than 18 months or more post-operative time. The research was conducted entirely online using the web-based survey platform SurveyMonkey. In total, 123/135 participants (91.1%) reported weight regain and 12/135 (8.8%) reported no weight regain. There was a strong negative correlation between the two variables WELQ and regain p

This book provides a complete guide to laparoscopic sleeve gastrectomy and the management of obesity. The chapters discuss guidelines for healthcare providers for the management of patients with obesity, the rationale behind choosing patients, performing the procedure in line with the patient’s condition, the perioperative period, postoperative requirements, and postoperative complications. This book aims to give readers an understanding of the surgical techniques involved in laparoscopic sleeve gastrectomy and the wider treatment options available. It is relevant to bariatric, metabolic, and general surgeons, physicians, clinical nutritionists as well as students.

Bariatric and Metabolic Surgery is recognized to be an important and effective option for the treatment of severe obesity and the various associated conditions and diseases. This book presents state of the art knowledge on such surgery with the aim of facilitating the sharing and exchange of knowledge, documenting effective techniques, and enhancing safety and outcomes. All technical aspects are covered in detail, and the text is complemented by many helpful illustrations. A further key feature is the provision of accompanying surgical videos, which will be of value to both novice and experienced surgeons. This textbook will be a great asset in clinical practice for all who are involved or interested in bariatric and metabolic surgery.