Understanding the role of psychopathology in bariatric surgery outcomes

• Published in: Obesity reviews 2016-02, Vol.17 (2), p.126-141
• Main Authors: Marek, R. J, Ben‐Porath, Y. S, Heinberg, L. J
• Format: Article
• Language: English
• Subjects: anxiety; Anxiety - diagnosis; Assessment; bariatric surgery; Bariatric Surgery - methods; Bariatric Surgery - psychology; Comorbidity; Contraindications; Depression - diagnosis; Feeding Behavior - psychology; Humans; obesity; Obesity, Morbid - psychology; Obesity, Morbid - surgery; outcome; patients; Predictive Value of Tests; Preoperative Care - methods; Psychopathology; Treatment Outcome; Weight Loss
• ISSN: 1467-7881; 1467-789X
• DOI: 10.1111/obr.12356

Bariatric surgery is the most effective treatment for morbid obesity; however, a subset of patients who undergo this procedure regain weight or achieve suboptimal weight loss results. A large number of studies have examined whether psychological variables play a role in weight loss surgery outcome. Although presurgical psychopathology has been found to be associated with suboptimal results in some studies, this literature is equivocal. These inconsistent findings are reviewed and considered in the context of contemporary models of psychopathology. More specifically, the review focuses on the limitations of atheoretical, descriptive diagnostic systems and examines whether comorbidity within the mood/anxiety disorders, impulse control/substance use disorders and thought disorders can account for the inconsistent findings reported to date. Contemporary models of psychopathology are highlighted and linked to the Research Domain Criteria, which have been advanced by the National Institute of Health. Means for assessing psychological constructs congruent with these models are reviewed. Recommendations are made for standardizing approaches to investigating how psychopathology contributes to suboptimal bariatric surgery outcomes.