Risk of Suicide and Self-harm Is Increased After Bariatric Surgery—a Systematic Review and Meta-analysis

Castañeda, Daniel; Popov, Violeta; Wander, Praneet; Thompson, Christopher C.

doi:10.1007/s11695-018-3493-4

Cited by 123 publications

(71 citation statements)

References 91 publications

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“…Formal domains for preoperative psychosocial evaluation are weight history, eating‐disorder symptoms (night‐eating syndrome, binge eating, compensatory behaviors, anorexia nervosa, etc. ), psychosocial history, developmental and family history, current and past mental health treatment, cognitive functioning, personality traits and temperament, current stressors, social support, quality of life, health‐related behaviors (substance abuse, smoking history, adherence, and physical activity), motivation and knowledge base (including weight‐loss expectations) , as well as self‐harm and suicide . Formal psychometric testing is commonly employed preoperatively and should be performed by qualified behavioral HCP providing a written report and organizing appropriate postoperative monitoring .…”

Section: Executive Summarymentioning

confidence: 99%

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

324

464

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Objective The development of these updated clinical practice guidelines (CPGs) was commissioned by the American Association of Clinical Endocrinologists (AACE), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and American Society of Anesthesiologists (ASA) Boards of Directors in adherence with the AACE 2017 protocol for standardized production of CPGs, algorithms, and checklists. Methods Each recommendation was evaluated and updated based on new evidence from 2013 to the present and subjective factors provided by experts. Results New or updated topics in this CPG include: contextualization in an adiposity‐based chronic disease complications‐centric model, nuance‐based and algorithm/checklist‐assisted clinical decision‐making about procedure selection, novel bariatric procedures, enhanced recovery after bariatric surgery protocols, and logistical concerns (including cost factors) in the current health care arena. There are 85 numbered recommendations that have updated supporting evidence, of which 61 are revised and 12 are new. Noting that there can be multiple recommendation statements within a single numbered recommendation, there are 31 (13%) Grade A, 42 (17%) Grade B, 72 (29%) Grade C, and 101 (41%) Grade D recommendations. There are 858 citations, of which 81 (9.4%) are evidence level (EL) 1 (highest), 562 (65.5%) are EL 2, 72 (8.4%) are EL 3, and 143 (16.7%) are EL 4 (lowest). Conclusions Bariatric procedures remain a safe and effective intervention for higher‐risk patients with obesity. Clinical decision‐making should be evidence based within the context of a chronic disease. A team approach to perioperative care is mandatory, with special attention to nutritional and metabolic issues.

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Section: Executive Summarymentioning

confidence: 99%

Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists

Mechanick

Apovian

Brethauer

et al. 2020

Obesity

324

464

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“…Suicidality has been found across BS literature . Some investigators observed higher suicide risk up to a 24‐fold increase in BS subjects comparing with general population in a recent study.…”

Section: Discussionmentioning

confidence: 88%

“…Some investigators observed higher suicide risk up to a 24‐fold increase in BS subjects comparing with general population in a recent study. Several mechanisms are discussed to be involved in this association, including psychiatric comorbidity, psychosocial aspects, and even physiological changes after BS . Additionally, frustration related to failure of expected weight loss and WR could play a role in suicidality .…”

Section: Discussionmentioning

confidence: 99%

Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis

et al. 2019

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Summary Bariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity. The objective of the study is to conduct a systematic review and meta‐analysis of studies investigating the relationship between psychiatric comorbidity and weight regain. A systematic review through PubMed, Web of Science, Cochrane Library, Scopus, and PsycINFO was performed, following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). After a stepwise selection, 13 articles were included in the qualitative analysis and 5 were included for a meta‐analysis. Women was majority in most of the studies (87.6%), and a bypass procedure was the bariatric intervention most evaluated (66.8%), followed by gastric banding (32.1%) and sleeve (1.1%). Higher rates of postbariatric surgery eating psychopathology were reported in patients with weight regain. However, the association between general psychopathology and weight regain was not consistent across the studies. In the meta‐analysis, the odds of eating psychopathology in the weight regain group was higher compared with the nonweight regain group (OR = 2.2, 95% CI 1.54‐3.15). Postbariatric surgery eating psychopathology seems to play an important role in weight regain.

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“…The causes of obesity are complex and multifactorial [ 1 ], and this condition is associated with different health problems, such as myocardial infarction, hypertension, stroke, dyslipidemia, diabetes mellitus, or obstructive sleep apnea [ 4 , 5 , 6 ]. All these alterations affect the quality of life and can disturb important areas of functioning (e.g., physical function, vitality, social functioning and emotional role) [ 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design

Quilez-Orden

Ferreres-Galán²,

Osma

2020

IJERPH

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Obesity is currently becoming a serious global public health problem due to its high prevalence and continuous increase. This condition is associated with different physical and mental health problems. The presence of emotional disorders (anxiety, depression and related disorders) among candidates for bariatric surgery is very high and predicts worse physical and psychological results. The present study aims to explore the feasibility and clinical usefulness of the Unified Protocol, a transdiagnostic emotion regulation-based intervention, delivered in an online group format to patients with emotional disorder diagnosis or symptoms, who are waiting for bariatric surgery. We will conduct a pilot study with a repeated single-case experimental design (multiple baseline design) in a public mental health service. The sample will consist of 60 participants, who will be randomized to three baseline conditions: 8, 12 or 15 evaluation days before the intervention. Diagnostic criteria, symptomatology and body mass index are the primary outcome measures, and we will include affectivity, personality, quality of life, body image, eating behavior and surgical complications like secondary measures. An analysis of treatment satisfaction will be also performed. Assessment points will include pre-treatment, baseline, treatment, post-treatment, and follow-ups every three months until two years after post-treatment. The results obtained in this study may have important clinical, social and economic implications for public mental health.

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Risk of Suicide and Self-harm Is Increased After Bariatric Surgery—a Systematic Review and Meta-analysis

Cited by 123 publications

References 91 publications

Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis

Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design

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