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November 12, 2002
Most patients seeking radical gastric bypass surgery suffer from some form of mental health problem and should first be evaluated by a mental health worker, according to a study completed by psychologists and surgeons at the Center for Weight Reduction at Montefiore Medical Center.
"There is a high degree of psychopathology in this population, which could influence their ability to make informed consent and/or their reaction to the surgery and subsequent weight loss," said the authors in an article published in the professional journal Obesity Surgery.
The psychological aspect of obesity surgery is a little talked about topic, but is of increasing relevance today as the number of radical surgeries for obesity increases. In the article, the authors cite a significant amount of depression and anxiety disorders among those patients enrolled in the study.
In a study of 115 surgical candidates, the Montefiore researchers discovered that 70 percent have a current or past mental disorder. More specifically, the candidates had "a lifetime prevalence rate of 56 percent" for "depressive disorders" (versus a lifetime prevalence of 17 percent for the general population). Anxiety disorders were prevalent at the time of the interview among 17 percent of patients.
"These are significant findings," said Elliot Goodman, MD, chief of Bariatric Surgery at Montefiore. "We tend to measure success in terms of weight loss alone. We have neglected to measure outcome in terms of other medical and psychological complications, satisfaction with surgery, nutritional intake, exercise level, measure of self-esteem, interpersonal functioning and work functioning. More studies are needed to further clarify which psychological factors play a role in these outcome variables."
Montefiore Medical Center, the University Hospital and Academic Medical Center for the Albert Einstein College of Medicine, is internationally recognized as a leader in patient care, research, teaching and community service. Montefiore serves as a primary health resource for one-and one-quarter-million Bronx residents, and as a tertiary care referral center offering the most advanced care to patients from the entire metropolitan area and across the nation.
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