Psychosomatic and Psychosocial Questions Regarding Bariatric Surgery: What Do We Know, or What Do We Think We Know?

Abstract

ZusammenfassungPsychosoziale Fragen zur Adipositas-Chirurgie: was SummarySubject: In view of the epidemic increase in severe obesity and the ineffectiveness of conservative weight-loss interventions, bariatric surgery delivers compelling results for patients with class II (BMI ≥ 35 kg/m²) and class III obesity (BMI ≥ 40 kg/m²), not only in reducing weight over the long term, but also in reducing obesity-related somatic comorbidity and improving psychosocial functioning and quality of life. Investigations into the psychosocial aspects of obesity surgery have proliferated over the last 15 years, providing a huge amount of essential research data. Yet the results are partly contradictory and highly dependent on the duration of follow-up. Method: Based of a narrative review, this article provides an overview of the current status and recent developments of the reciprocal effects between bariatric surgery and psychosocial functioning. The review focused on eight domains representing important psychosomatic and psychosocial aspects of bariatric surgery. Results: Especially in cases of class II and III obesity, bariatric surgery is the only means to reduce bodyweight significantly and permanently, though they carry with them the associated risk factors of metabolic, cardiovascular, and oncological diseases. With regard to psychosocial and psychosomatic aspects, studies with a short-term catamnesis (approx. 3 years) speak in favor of an improvement in the quality of life including mental disorders. If we consider studies with longer follow-ups, however, the results are not as uniform. In particular, we observe an increase in harmful alcohol consumption, self-harm behavior, and suicide risk. Discussion: In light of mental well-being and thus also quality of life, bariatric surgery would appear to convey an elevated risk for a minority of patients. Yet identifying these patients before surgery has so far been insufficient.

Effects of a Combined High-Intensity Interval Training and Resistance Training Program in Patients Awaiting Bariatric Surgery: A Pilot Study

“…Therefore, FFM% increased after the ETP. Conservative weight loss programs aim to lose from 5% to 10% body weight to be able to consider a reduction as clinically significant to decrease surgical risk [39]. In this pilot study, the EG showed a decrease close to 6% in EBW% (33.55 ± 3.89 vs 27.00 ± 4.06, p = 0.052).…”

Soy Products Ameliorate Obesity-Related Anthropometric Indicators in Overweight or Obese Asian and Non-Menopausal Women: A Meta-Analysis of Randomized Controlled Trials

“…There are no recognized effective ways to lose weight, and some even pose health threats, such as the long-term effects of phentermine/topiramate on the heart and blood vessels, as well as diarrhea, nausea, vomiting, depression, anxiety and cognitive function caused by other drugs [14]. In addition, weight loss surgery not only increases the risk of metabolic disorders, cardiovascular disease and oncology diseases, but also has a certain impact on psychological function [15]. The results of a 2019 systematic review and meta-analysis show that weight loss surgery patients had higher self-harm or suicide attempt risk [16].…”

BMI Course Over 10 Years After Bariatric Surgery and Biopsychosocial Complexity Assessed with the INTERMED: a Retrospective Study

“…Patients suffering from severe obesity, more stigmatized by the social environment, have more difficulties to remain mobile and socially active and more often lose their work [ 38 ]. In addition, considering the important psychosocial stress and high psychiatric morbidity associated with obesity [ 39 ], the sole buffer for coping with obesity might be social support. Social support not only beneficially influence psychiatric morbidity and eating disorders after bariatric surgery [ 40 ] but is also a decisive factor for greater weight loss after surgery, and social support plays an important role with regard to treatment adherence [ 41 ] and motivation for change [ 42 ].…”