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.

Although a number of studies have asserted that psychosocial factors contribute to suboptimal weight loss outcomes following bariatric surgery; research has been inconsistent regarding the associations between preoperative psychiatric diagnoses and psychological testing results and suboptimal weight loss. Research implies that psychopathology and personality are best capture by a hierarchical framework. The current investigation examined the utility of using the hierarchical model of psychopathology to predict 5-year Body Mass Index (BMI) outcomes. A total of 446 consecutively, locally residing consented patients who underwent a Roux-en-Y Gastric Bypass (RYGB) at least 5-years ago were included in the study. A majority were women (74.2%) and of Caucasian descent (66.2%). Patients' mean pre-surgical BMI was 49.14 kg/m2 [Standard Deviation (SD) = 9.50 kg/m2]. Psychiatric diagnoses were obtained from a pre-surgical, semi-structured clinical interview and all participants were administered the MMPI-2-RF at their pre-surgical evaluations. BMIs were collected at 4 post-operative time points across a 5-year trajectory. Age significantly predicted the nonlinear rate of BMI-reduction across time, such that older individuals evidenced a slower rate of change over time. Pre-surgical levels of Externalizing and Low Positive Activation/Emotionality predicted higher BMIs at the 5-year outcome. Pre-operative indicators of psychopathology are important in predicting post-operative outcomes, particularly when they are dimensional in nature and aligned with the hierarchical model of psychopathology. A closer follow-up with patients who evidence pre-surgical problems, both before and after surgery, may help improve outcomes.

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

This text focuses on the complications following bariatric surgery. The focus is on the immediate and long term complications that would be important to both the general surgeon and those surgeons with specialty experience in bariatric surgery. Sections address the nutritional deficiencies following bariatric surgery with specific attention to Roux en Y gastric bypass and pancreatico-biliary diversion as well as the correction of these deficiencies with medical intervention as well as the indications for surgical revision or reversal. The text reviews the work-up of a bariatric patient with abdominal pain including the appropriate imaging and threshold for operative intervention and the techniques to achieve optimal visualization during this difficult situation. This section focuses on the operative management of anastomotic and staple line leaks and how to definitively manage these surgical emergencies as well as achieve source control and stabilization. Later chapters focus on specific complications following bariatric surgery with specific focus on RYGB, vertical sleeve gastrectomy (VSG), biliary pancreatic diversion, and gastric band. Complications include gastric fistula, gastric staple line disruption following VSG, gastro-jejunal leak following RYGB, relux following bariatric surgery, and failure of weight loss following bariatric surgery. These sections are written by experts in the field of bariatrics and include evidence based medicine as well as expert opinion on the management of bariatric complications. The sections provide a review of the literature and references at the close of each section. Complications in Bariatric Surgery will serve as a resource for both the general surgeon who handles bariatric emergencies as well as the bariatric specialist.

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.

The Roundtable on Obesity Solutions of the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, on April 6, 2017, titled The Challenge of Treating Obesity and Overweight: A Workshop. The discussions covered treatments for obesity, overweight, and severe obesity in adults and children; emerging treatment opportunities; the development of a workforce for obesity treatments; payment and policy considerations; and promising paths to move forward. This publication summarizes the presentations and discussions from the workshop.

This book presents the surgical therapy of obesity and metabolic diseases in a practice-oriented and detailed way. The specific surgical procedures with their indications, performance and risks are described precisely in words and pictures. Special emphasis is placed on the choice of the appropriate surgical procedure for the individual patient. In addition to the mechanisms of action, interdisciplinary preoperative evaluation of the patient and postoperative aftercare are explained. Furthermore, surgical, internal and psychosomatic complications and complication management are described. Information on obesity center organization and alternative bariatric therapies complete the volume. This book is a translation of the original German 1st edition Adipositas- und metabolische Chirurgie by Jürgen Ordemann & Ulf Elbelt, published by Springer-Verlag GmbH Germany, part of Springer Nature in 2017. The translation was done with the help of artificial intelligence (machine translation by the service DeepL.com). A subsequent human revision was done primarily in terms of content, so that the book will read stylistically differently from a conventional translation. Springer Nature works continuously to further the development of tools for the production of books and on the related technologies to support the authors.

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