Bariatric surgery is an increasingly popular intervention for obesity, and psychologists have seen a growing role in the evaluation of surgery candidates. Studies of pre-surgery psychosocial and physical health variables that are predictive of post-surgical outcome have been inconclusive. In the present study, pre-operative health status, psychological testing results, and support group attendance were measured to determine their relationship with weight-loss outcome at 6 months post-surgery. The Health Perception scale of the Health Status Questionnaire was a significant predictor of weight loss outcome. This suggests that individuals who endorse more negative perceptions of their physical health are more likely to have a better outcome post-surgery. The results of this study emphasize the importance of evaluating an individual's psychological perceptions of their physical health when they present for bariatric surgery.

According to the World Health Organization and National Institutes of Health, obesity is a global health problem. Worldwide, obesity is the fifth-leading cause of death. Weight loss surgeries such as gastric banding, sleeve gastrectomy, and gastric bypass surgery have become increasingly popular methods to manage intractable obesity in the United States. Such surgeries have inherent risks, both medical and psychosocial, and as a result, candidates for weight loss surgery routinely undergo pre-surgical evaluations to determine their suitability for weight loss procedures. The current study was done in partnership with Kettering Bariatrics in Kettering, Ohio, and is an analysis of the ability of their pre-surgical psychological evaluation to predict post-surgical success. In this study, success was defined as percentage of weight lost. Regression analyses examined the predictive ability of six psychological constructs and four demographic variables on weight loss at three post-surgical time points. Different predictor variables were demonstrated to predict weight loss at different post-surgical intervals. The results of this study were interpreted using Prochaska & DiClemente’s Stages of Change as a theoretical framework. The clinical implications for mental health providers working with the weight loss surgery population are discussed, and suggestions for future research are made.

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.

Bariatric surgery plays an important role in the treatment of obesity; in this comprehensive resource the worldwide leaders of the field provide the most up-to-date information on the psychosocial issues that affect their patients. Included is an overview and history of surgical procedures, complete with illustrations, practical advice on topics such as physical activity and nutritional care after surgery, and essential information that allows clinicians to assist their clients as much as possible; for example, how pre-weight loss surgery psychosocial evaluations can serve as clinical interventions in their own right, and how structured interviews and questionnaires can be used in multiple contexts such as screening, treatment planning, and prognostic assessment. A distinctive chapter includes an overview of the special issues present in treating adolescents, who increasingly are the target of bariatric surgery procedures. This book is an essential reference for clinicians from the evaluation through the follow-up and aftercare of bariatric surgery patients.

This critical summary of current literature on eating disorders aims to keep researchers and health practitioners informed on the clinical implications of new studies. It is the first volume in what's projected as an annual review that will highlight topics related to the major aspects of eating disorders.

This book is designed to present a comprehensive, state-of the-art approach to assessing and managing bariatric surgery and psychosocial care. Unlike any other text, this book focuses on developing a biopsychosocial understanding of patients’ obesity journey and psychosocial factors contributing to their obesity and its management from an integrated perspective. Psychiatric Care in Severe Obesity takes a 360 approach by covering the disease’s prevalence and relationship to psychiatric illness and social factors, including genetics, neurohormonal pathways and development factors for obesity. This book presents evidence and strategies for assessing psychiatric issues in severe obesity and uses common psychiatric presentations to feature the impact on bariatric surgery and key assessment features for weight loss. Concluding chapters focus on evidence-based psychosocial treatments for supporting patients with weight loss and bariatric surgery and includes educational tools and checklists for assessment, treatment, and care. Experts on non-pharmacological interventions such as mindfulness, cognitive-behavioral therapy and nutrition education describe treatment approaches in each modality, concluding with pharmacological approaches for psychiatric conditions and eating pathology. Additional tools in the appendices support clinicians, making this the ultimate guide for managing psychiatric illness in patients suffering from severe obesity. As obesity continues to grow in prevalence as a medically recognized epidemic, Psychiatric Care in Severe Obesity serves a vital resource to medical students, psychiatrists, psychologists, bariatric surgeons, primary care physicians, dietitians, mental health nurses, social workers, and all medical professionals working with severely obese patients.

This book offers a step-by-step guide to mental health assessment for bariatric surgery patients. A general introduction explains the concepts of bariatric psychology and psychiatry, their relevance in contemporary bariatric surgery, and reasons to include psychologists and psychiatrists in multidisciplinary teams taking care of bariatric patients. The following four chapters address the aspects of mental health that are investigated by bariatric psychology. The psychological processes analyzed here play a major role in influencing patients’ perception of the outcomes of bariatric surgery and in determining their commitment to lifestyle changes and follow-up programs. The second part of the book includes nine chapters addressing the clinical conditions relevant to bariatric psychiatry. For each condition, the major focus is on the impact of psychopathology on bariatric surgery outcomes (weight loss, weight regain, quality of life) and the impact of surgery on its course (remission, worsening, de novo onset). Each chapter in this part includes a discussion of the diagnostic instruments (i.e., structured interviews, clinician-rated tests, and patient-rated tests) that should be used to obtain a valid assessment of the patient’s mental status. Separate chapters focus on psychiatric complications (e.g., suicide and addiction transfer) and psychological problems related to quality of life (e.g., body image dissatisfaction) that may emerge postoperatively. Data on these postsurgery conditions has been reported only recently and, therefore, no published book deals with them. The final chapter offers an overview of unsolved issues in bariatric psychology and psychiatry and reviews emerging research findings that are likely to change assessment and care of bariatric patients’ mental health in the near future. Given its scope—and its wealth of tables, diagrams, mnemonics, and key fact boxes—the book will be an invaluable reference tool for clinicians.

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

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