Psychological assessment for bariatric surgery: current practices

Abstract

IntroductionThe prevalence of obesity on a global scale has alarmed health institutions, the general population and professionals involved in its treatment. Bariatric surgery has emerged as an effective and lasting alternative for weight reduction and improved general health. In this context and as part of a multidisciplinary team, psychologists are responsible for the preoperative psychological assessment of bariatric candidates.AimTo investigate how psychological assessments are occurring, including the identification of utilized resources; factors that are addressed; the duration of the process; existing protocols; and to evaluate the importance of this practice.MethodA systematic review of national and international literature, through PubMed and Scielo's databases, using "psychological assessment", "obesity" and "surgery", as keywords.ConclusionThere is an agreement about the main factors that should be investigated during the preoperative assessment, as well as the main contraindications for the surgical procedure. The importance of the psychological assessment is well established in the field of bariatric surgery. However, this area needs a standard protocol to guide the mental health professionals that deal with bariatric patients.

Mental Health in Bariatric Surgery: Selection, Access, and Outcomes

“…A growing number of authors have criticized the requirement of preoperative psychological evaluation for all patients seeking bariatric surgery . Surgeries, including amputation, mastectomy, oophorectomy, orchiectomy, neurosurgery, and others, do not require preoperative psychosocial evaluation.…”

Surgical Management of Obesity Among People with Schizophrenia and Bipolar Disorder: a Systematic Review of Outcomes and Recommendations for Future Research

“…Little is established regarding psychiatric contraindications to bariatric surgery, and individual teams have their own psychiatric exclusion criteria [32]. Psychiatric disorders are often considered contraindications for bariatric surgery, especially psychosis, affective disorders, and personality disorders.…”

Correlation Between Pre and Postoperative Levels of GLP-1/GLP-2 and Weight Loss After Roux-en-Y Gastric Bypass: A Prospective Study

“…Weight loss and maintenance appear to be linked to a wider array of different gut hormones and physiologic responses affected by the surgical procedure, along the environmental factors related to the eating behavior of each individual 1 , 8 Further research, especially in prospective controlled settings, is necessary to confirm and expand these findings.…”