Current psychological assessment practices in obesity surgery programs: what to assess and why.

PURPOSE OF REVIEW: The present editorial review examines current psychological assessment practices in obesity surgery programs, reasons for making such assessments and data obtained prior to surgery and during follow-up. It summarizes findings from previous review articles and reports on new research findings that have been published between August 2006 and August 2009. RECENT FINDINGS: Patients with morbid obesity applying for weight loss are commonly administered extensive psychiatric and psychological assessment prior to surgery. Although the value of psychopathological factors for predicting weight loss and mental health after surgery remains controversial, the presence of psychopathology should be taken into account in the presurgery as well as in the postsurgery management of patients undergoing weight-loss surgery. SUMMARY: Morbid obesity is associated with high rates of psychopathology, including depression, anxiety, eating disorders, abnormal personality traits and personality disorders. There is a decrease in psychopathology after obesity surgery in many, though not all, individuals. There is some evidence for poorer postsurgery outcome in individuals with significant presurgery psychopathology, but there is a clear need for more substantial information with regard to reliable psychological predictors of weight loss and mental health after surgery. Whatever the predictive value of psychopathology prior to surgery, it is essential to detect patients in need of psychiatric and/or psychological support after surgery.