Does obesity surgery improve psychosocial functioning? A systematic review

• Published in: International Journal of Obesity 2003-11, Vol.27 (11), p.1300-1314
• Main Authors: Herpertz, S, Kielmann, R, Wolf, A M, Langkafel, M, Senf, W, Hebebrand, J
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Eating behavior; Eating disorders; Epidemiology; Health policy; Health Promotion and Disease Prevention; Internal Medicine; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Obesity; Public Health; Quality of life; Research methods; Systematic review
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/sj.ijo.0802410

OBJECTIVE: The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL). PURPOSE: A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y. RESEARCH METHODS AND PROCEDURES: The relevant literature was identified by a search of computerized databases. All articles published in English and German since 1980 were reviewed. Based on the requirements of the evidenced-based guidelines of the Agency for Health Care Policy and Research and the Scottish Intercollegiate Guidelines Network, each study was rated by a level of evidence. RESULTS: In all, 171 publications were reviewed. Using the above inclusion/exclusion criteria, 63 articles including two systematic reviews were identified. A total of 40 studies focused on psychosocial outcome after obesity surgery. CONCLUSION: Mental health and psychosocial status including social relations and employment opportunities improve for the majority of people after bariatric surgery thus leading to an improved QoL. Psychiatric comorbidity, predominantly affective disorders, and psychopathologic symptoms decrease postsurgically. A substantial percentage of bariatric surgery patients suffer from binge eating disorder or binge eating symptoms. The effect of bariatric surgery on the outcome of binge eating symptoms largely depends on the type of operation. With the exception of patients with a severe psychiatric comorbidity, the concern that obesity surgery will reinforce psychic symptoms and lead to a reduction in the QoL seems to be unfounded.