ABSTRACT
Introduction ............................................................................................................................................................................. 903 Why do Patients Consider Undergoing BaS? ......................................................................................................................... 904 Psychosocial Status of the Candidate for BaS ........................................................................................................................ 905
Preoperative Psychological Evaluations for BaS Candidates ............................................................................................ 905 Effect of BaS on Psychosocial Outcomes .......................................................................................................................... 908 Can Preoperative Psychosocial Factors Predict Outcome After Surgery? ......................................................................... 908
Contraindications for BaS ....................................................................................................................................................... 910 Psychological Follow-up and Other Treatment Recommendations for BaS Patients ............................................................. 910 Special Population Considerations for BaS ............................................................................................................................ 911
Diabetic Patients ................................................................................................................................................................. 911 Pediatric Patients ................................................................................................................................................................ 911 Geriatric Patients ................................................................................................................................................................ 912
Summary ................................................................................................................................................................................. 912 References ............................................................................................................................................................................... 913
The increased prevalence of obesity in people of all ages in the United States has been well documented.1 About two-thirds of individuals living in the United States are overweight, and of those persons, almost one half are obese. Obesity is associated with a tremendous number of comorbidities that lead to numerous medical and psychological problems. Being 50% above average weight is associated with a twofold increase in mortality rates;2 in individuals with type 2 diabetes this increases to fi ve and eight times among men and women, respectively. The obesity epidemic, poor responses to more conventional weight loss treatment, improved outcomes of bariatric surgery (BaS) procedures, and the use of the less invasive laparoscopy in BaS have spurned a tremendous growth in BaS. According to the American Society for Bariatric Surgery, 103,000 BaS’s were done in 2003. A complete review of the history of BaS, the various procedures currently performed, indications for BaS, and BaS outcomes can be found in this text (see Chapter 53). This chapter will focus primarily on the importance of a comprehensive psychological evaluation of patients being considered for BaS.
