In a recent study published in the journal Obesity Surgery, a team of researchers from Taiwan determined that adherence to postoperative psychiatric follow-up is associated with increased postoperative weight loss in obesity patients with comorbid psychiatric disorders one year following gastric bypass surgery.
Bariatric surgery has been consistently shown as effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. However, empirical data suggests a high prevalence of psychiatric disorders among bariatric surgery candidates.
Studies from several countries show that around 40% of all bariatric surgery patients have at least one psychiatric diagnosis. Depressive disorders (dysthymic disorder and major depressive disorder), anxiety disorders (e.g., generalized anxiety disorder), and eating disorders (i.e., binge eating disorder) are the three most common psychiatric diagnoses. Identification and intervention in these disorders improves the quality of perioperative management and helps predict the weight loss outcome after bariatric surgery.
In order to investigate the impact of adherence to postoperative recommended psychiatric follow-up on weight loss in morbid obesity patients with psychiatric disorders one year following gastric bypass. the study titled “Adherence to Psychiatric Follow-up Predicts 1-Year BMI Loss in Gastric Bypass Surgery Patients,” Shen Carol from the Department of Psychiatry, Bariatric and Metabolic International (BMI) Surgery Center, E-Da Hospital, Kaohsiung in Taiwan and colleagues evaluated a total of 318 patients with morbid obesity. Patients were divided into four groups according to preoperative psychiatric evaluations and adherence to psychiatric follow-up one year after their bypass surgery.
In the first group, the researchers grouped patients that did not meet the referral criteria (NMRC). The second group included patients not meeting psychiatric diagnostic criteria (NMDC). The third group was comprised of patients meeting criteria for a psychiatric disorder and were non-adherent (NA) to psychiatric follow-up. The fourth group included patients meeting criteria for a psychiatric disorder and who engaged in psychiatric follow-up after their surgery
Results revealed one year after bypass surgery that patients in group A had a higher BMI change in comparison with the NA and NMRC groups of patients.
Results from the regression analyses performed to assess the effects of the grouping variable on % change in BMI (age, gender, educational level, and preoperative BMI controlled) showed that the regression coefficient for the grouping variable was 0.175 at the 6-month and 0.133 at the 1-year % change in BMI.
Based on these results, the researchers indicate that adherence to postoperative psychiatric follow-up is associated with greater weight loss following surgery. As a result, clinicians should consider postoperative psychiatric follow-up as a key part of effective medically supervised weight loss in patients undergoing Bariatric Surgery.
