A review of psychosocial outcomes of surgery for morbid obesity

Bocchieri, Lindsey E; Meana, Marta; Fisher, Barry

doi:10.1016/s0022-3999(01)00241-0

Cited by 182 publications

(238 citation statements)

References 61 publications

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“…3 Morbid obesity is associated with a substantially increased risk of morbidity and mortality from chronic health conditions, such as diabetes, hypertension, cardiovascular disease, and cancer, [4][5][6][7][8][9] and it has been linked to multidimensional impairments in health-related quality of life and psychosocial well-being. 10,11 Several articles have examined the impact of obesity, broadly defined as BMI Z30 kg/m 2 , on medical expenditures in the United States. [12][13][14] Another recent article also examined the impact of 'severe' obesity, defined as a BMI Z35 kg/m 2 , on medical expenditures for adults aged 50-69 y in 1992 and found that total expenditures among severely obese adults were 60% greater than for normal-weight adults.…”

Section: Introductionmentioning

confidence: 99%

Impact of morbid obesity on medical expenditures in adults

2005

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CONTEXT: Morbid obesity (body mass index (BMI) Z40 kg/m 2 ) is associated with substantially increased morbidity and mortality from chronic health conditions and with poorer health-related quality of life; however, less is known about the impact of morbid obesity on healthcare expenditures. OBJECTIVE: To examine the impact of morbid obesity on healthcare expenditures using a nationally representative sample of US adults. DESIGN, SETTING, AND PARTICIPANTS: We performed a cross-sectional analysis of 16 262 adults from the 2000 Medical Expenditure Panel Survey, a nationally representative survey of the noninstitutionalized civilian population of the United States. Per capita healthcare expenditures were calculated for National Institutes of Health BMI categories, based on self-reported height and weight, using a two-part, multivariable model adjusted for age, gender, race, income, education level, type of health insurance, marital status, and smoking status. MAIN OUTCOME MEASURES: Odds of incurring any healthcare expenditure and per capita healthcare expenditures associated with morbid obesity in 2000. RESULTS: When compared with normal-weight adults, the odds of incurring any healthcare expenditure in 2000 were two-fold greater among adults with morbid obesity. Per capita healthcare expenditures for morbidly obese adults were 81% (95% confidence interval (CI): 48-121%) greater than normal-weight adults, 65% (95% CI: 37-110%) greater than overweight adults, and 47% (95% CI: 11-96%) greater than adults with class I obesity. Excess costs among morbidly obese adults resulted from greater expenditures for office-based visits, outpatient hospital care, in-patient care, and prescription drugs. Aggregate US healthcare expenditures associated with excess body weight among morbidly obese US adults exceeded $11 billion in 2000. CONCLUSIONS: The economic burden of morbid obesity among US adults is substantial. Further research is needed to identify interventions to reduce the incidence and prevalence of morbid obesity and improve the health and economic outcomes of morbidly obese adults.

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Section: Introductionmentioning

confidence: 99%

Impact of morbid obesity on medical expenditures in adults

2005

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“…The majority of studies have reported a decrease in depression and depressive symptoms after bariatric surgery 24,27,[48][49][50][51][52][53][54][55][56] . Women seem to show a more marked decline than men 57 .…”

Section: Mood Disordersmentioning

confidence: 99%

“…Nevertheless, residual body image dissatisfaction due to increasing and/or sagging skin has been reported following weight loss surgery 16,19,52,75,76 . Recently, it has been established a correlation between the amount of excess skin and the degree of body image discomfort of bariatric patients 76 .…”

Section: Body Imagementioning

confidence: 99%

A psychiatric perspective view of bariatric surgery patients

Brandão¹,

Fernandes²,

Osório³

et al. 2015

Arch. Clin. Psychiatry (São Paulo)

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Background: Bariatric surgery is the only procedure that has significant results in weight loss and improvements in medical comorbidities in morbid obese patients. Severely obese patients are also associated with a higher prevalence of psychiatric disorders and poor quality of life. Objective: To evaluate specific areas of psychopathology in individuals undergoing bariatric surgery. Methods: A review of the literature was conducted from January 2002 to March 2014 by researching PubMed database using the following query: "morbid AND obesity AND bariatric AND surgery AND (psychiatry OR psychology)". Results: Overall improvements in eating behaviors, mood disorders and body image are reported after bariatric surgery, and the mechanism is not enlightened. Risk of suicide and consumption of substances of abuse, especially alcohol, after gastric bypass surgery are problems that clinicians must be aware. Discussion: Bariatric patients should be monitored after surgery to identify who did not show the expected benefits postoperatively and the ones who develop psychiatric symptoms after an initial positive response.

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“…Tal fato tem uma importância prática relevante, pois aponta para a necessidade de os membros da equipe de saúde serem orientados e, mais do que isso, de receberem suporte psicoterapêutico que os capacite a identificar e elaborar internamente essa forte carga de afetos que o paciente impõe. Caso esse cuidado não seja tomado, podemos incorrer em erros muito facilmente, pois o tipo de sentimentos e reações que o paciente obeso desperta são, muito frequentemente, de rejeição e discriminação 25,26 .…”

Section: As Vivências Psicológicas No Pós-operatóriounclassified

Características psicológicas de pacientes submetidos a cirurgia bariátrica

Magdaleno

Chaim

Turato

2009

Rev. psiquiatr. Rio Gd. Sul

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INTRODUÇÃO: O grande número de pacientes submetidos a cirurgia bariátrica e que, no pós-operatório, apresentam complicações psicológicas e psiquiátricas justifica uma investigação pré-operatória acurada, bem como categorização daqueles que se submeterão ao procedimento cirúrgico, visando predizer eventuais complicações e individualizar condutas psicológicas que possam favorecer a adesão do paciente. A avaliação psicodinâmica pode fornecer elementos para tal categorização e, assim, propor estratégias de abordagem pré e pós-operatória eficazes. Procuramos identificar estruturas de personalidade que possam orientar o acompanhamento pós-operatório, bem como critérios auxiliares de inclusão/exclusão do procedimento cirúrgico. MÉTODO: Relato de pesquisa empírica conduzida em atendimentos a pacientes submetidos a cirurgia bariátrica, em grupo terapêutico aberto. DISCUSSÃO: Pacientes, depois de operados, podem passar por determinadas fases de reestruturação emocional, como uma primeira fase de triunfo, seguida de fase de risco para surgimento de quadros melancólicos e de novas adições. Identificamos três categorias estruturais psicológicas: estrutura melancólica, cujos pacientes parecem ter maior possibilidade de desenvolver outras condutas aditivas no pós-operatório, sobretudo alimentares, por não suportarem a frustração pela perda; estrutura desmentalizada, na qual, por faltar uma capacidade elaborativa, o paciente não consegue reorganizar-se frente ao desafio de permanecer com peso controlado; e, finalmente, a estrutura perversa, cujos sujeitos mantêm a programada perda de peso, porém a custas de comportamentos que levam desconfortos à equipe de saúde. Estabelecer categorias psicológicas classificatórias pode ser crucial para que se proponham condutas no pós-operatório, inclusive indicação de psicoterapia com especialista, visando a individualizar o atendimento incrementando sucesso terapêutico específico.

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A review of psychosocial outcomes of surgery for morbid obesity

Cited by 182 publications

References 61 publications

Impact of morbid obesity on medical expenditures in adults

Impact of morbid obesity on medical expenditures in adults

A psychiatric perspective view of bariatric surgery patients

Características psicológicas de pacientes submetidos a cirurgia bariátrica

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