Psychologic assessment of morbidly obese patients undergoing gastric bypass: a comparison of preoperative and postoperative adjustment.

ABSTRACT

Thirty-three morbidly obese patients underwent gastric bypass operation after intensive medical and psychiatric evaluation. Five psychometric tests were administered before and after operation. The study patients were found to have less self-esteem and more depressive traits than a normal population. This did not change after operation despite weight loss. High levels of optimism were not associated with better weight loss. However, patients who understood before operation that the success of the operation depended upon changing their eating behavior lost more weight. After operation patients expressed satisfaction with life and a new freedom from constant hunger. There was a reported decrease in organic symptoms, an increase in social activities, an improvement in interpersonal relationships, and a social usefulness not experienced previously. In selected patients with no active psychiatric disease or psychologic instability, gastric bypass, coupled with consistent postoperative reinforcement, produces behavioral changes that can lead to permanent weight loss without concomitant psychologic deterioration.