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Chapter 24 - Preoperative psychiatric evaluation for bariatric surgery

Published online by Cambridge University Press:  04 August 2010

James J. Amos
Affiliation:
University of Iowa
Robert G. Robinson
Affiliation:
University of Iowa
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Summary

Inclusion of mental health professionals in bariatric evaluations was due to the high prevalence of psychiatric and behavioral complications in the morbidly obese. Anxiety disorders, such as social phobia (18%) and obsessive-compulsive disorder (OCD) (13.6%), are common in bariatric candidates and may require treatment. Outcomes in bariatric patients with history of sexual abuse are satisfactory. Patients may need re-assurance that the purposes of the evaluation are to help them understand the options for weight loss and to identify areas that may need to be addressed to maximize the chances for success in losing weight. One study showed that only 56% of patients given behavioral treatment recommendations before surgery were adherent, and 44% were not. Roughly one-third to two-thirds of bariatric patients are non-adherent to nutritional regimens after surgery. This non-compliance is attributed to pre-existing psychological comorbidity of bariatric patients, including one-third who have a history of substance abuse disorders.
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Psychosomatic Medicine
An Introduction to Consultation-Liaison Psychiatry
, pp. 216 - 225
Publisher: Cambridge University Press
Print publication year: 2010

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