Psychological factors and weight loss in bariatric surgery.

Objective: Morbid obesity is associated with a high prevalence of psychopathological conditions that might have an impact on postsurgery outcomes. This review summarizes recent data about psychological disorders in obese patients before and after bariatric surgery as well as the assessment and impact of these factors on postsurgery outcomes.

Results: Psychological health and quality of life were found to improve after bariatric surgery. Weight loss could not be clearly related to any specific psychological condition prior to surgery, but the presence of more than one psychiatric condition might play a role. A multi-intervention treatment, including approaches for lifestyle changes after bariatric surgery showed positive long-term results in term of weight loss and weight loss maintenance. Recent studies focused on eating behavior changes following bariatric surgery providing important information on the topic of eating disorders after bariatric surgery.

Conclusions: Psychological assessment before bariatric surgery and systematic follow-up are necessary to guarantee optimal weight loss and weight loss maintenance. The field of psychological factors in bariatric surgery is still in need of controlled randomized prospective trials to better understand relation between psychological presurgery conditions and surgical outcomes. Self-monitoring and cognitive behavioral programs could prevent weight regain.