Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Does obesity surgery improve psychosocial functioning? A systematic review

Abstract

OBJECTIVE: The objective of this study is to present a review of the psychosocial outcome of bariatric surgery with special consideration of psychiatric comorbidity, psychopathology, psychosocial functioning, econometric data, and general quality of life (QoL).

PURPOSE: A review of all (non-) controlled trials of the last two decades both with a retrospective and prospective design and a follow-up period of at least 1 y.

RESEARCH METHODS AND PROCEDURES: The relevant literature was identified by a search of computerized databases. All articles published in English and German since 1980 were reviewed. Based on the requirements of the evidenced-based guidelines of the Agency for Health Care Policy and Research and the Scottish Intercollegiate Guidelines Network, each study was rated by a level of evidence.

RESULTS: In all, 171 publications were reviewed. Using the above inclusion/exclusion criteria, 63 articles including two systematic reviews were identified. A total of 40 studies focused on psychosocial outcome after obesity surgery.

CONCLUSION: Mental health and psychosocial status including social relations and employment opportunities improve for the majority of people after bariatric surgery thus leading to an improved QoL. Psychiatric comorbidity, predominantly affective disorders, and psychopathologic symptoms decrease postsurgically. A substantial percentage of bariatric surgery patients suffer from binge eating disorder or binge eating symptoms. The effect of bariatric surgery on the outcome of binge eating symptoms largely depends on the type of operation. With the exception of patients with a severe psychiatric comorbidity, the concern that obesity surgery will reinforce psychic symptoms and lead to a reduction in the QoL seems to be unfounded.

Your institute does not have access to this article

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

References

  1. Obesity epidemic puts millions at risk from related diseases. WHO: Genf; 1997.

  2. McDowell A, Engel A, Massey JT, Maurer K . Plan and operation of the Second National Health and Nutrition Examination Survey, 1976–1980. Vital Health Stat 1 1981; Series1 : 1–144.

    Google Scholar 

  3. Hebebrand J, Remschmidt H . [Body weight under genetic control]. Med Klin 1995; 90: 403–410.

    CAS  Google Scholar 

  4. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 1991; 115: 956–961.

  5. Sjostrom L, Larsson B, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Hallgren P, Jonsson E, Karlsson J, Lapidus L, Swedish obese subjects (SOS). Recruitment for an intervention study and a selected description of the obese state. Int J Obes Relat Metab Disord 1992; 16: 465–479.

    CAS  PubMed  Google Scholar 

  6. James WP . What are the health risks? The medical consequences of obesity and its health risks. Exp Clin Endocrinol Diabetes 1998; 106(Suppl 2): 1–6.

    CAS  PubMed  Google Scholar 

  7. Assmann G, Schulte H, Cullen P . New and classical risk factors—the Munster heart study (PROCAM). Eur J Med Res 1997; 2: 237–242.

    CAS  PubMed  Google Scholar 

  8. Benotti PN, Bistrain B, Benotti JR, Blackburn G, Forse RA . Heart disease and hypertension in severe obesity: the benefits of weight reduction. Am J Clin Nutr 1992; 55: 586S–590S.

    CAS  PubMed  Google Scholar 

  9. Chow WH, Blot WJ, Vaughan TL, Risch HA, Gammon MD, Stanford JL, Dubrow R, Schoenberg JB, Mayne ST, Farrow DC, Ahsan H, West AB, Rotterdam H, Niwa S, Fraumeni Jr JF . Body mass index and risk of adenocarcinomas of the esophagus and gastric cardia. J Natl Cancer Inst 1998; 90: 150–155.

    CAS  PubMed  Google Scholar 

  10. Chu SY, Lee NC, Wingo PA, Senie RT, Greenberg RS, Peterson HB . The relationship between body mass and breast cancer among women enrolled in the Cancer and Steroid Hormone Study. J Clin Epidemiol 1991; 44: 1197–1206.

    CAS  PubMed  Google Scholar 

  11. Sonne-Holm S, Sorensen TI . Prospective study of attainment of social class of severely obese subjects in relation to parental social class, intelligence, and education. BMJ (Clin Res Ed) 1986; 292: 586–589.

    CAS  PubMed Central  Google Scholar 

  12. Gortmaker SL, Must A, Perrin JM, Sobol AM, Dietz WH . Social and economic consequences of overweight in adolescence and young adulthood. N Engl J Med 1993; 329: 1008–1012.

    CAS  PubMed  Google Scholar 

  13. Maddox GL, Back KW, Liederman WR . Overweight as social deviance and disability. J Health Soc Behav 1968; 9: 287–298.

    CAS  PubMed  Google Scholar 

  14. Stunkard AJ, Stinnett JL, Smoller JW . Psychological and social aspects of the surgical treatment of obesity. Am J Psychiatry 1986; 143: 417–429.

    CAS  PubMed  Google Scholar 

  15. Wadden TA . The treatment of obesity—an overview. In: Stunkard AJ, Wadden TA (eds). Obesity: theory and therapy, 2nd edn. Raven Press: New York; 1993. pp 197–217.

    Google Scholar 

  16. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr 1992; 55: 615S–619S.

  17. German Society for Obesity Research: (Guidelines for treatment of obesity). Adipositas 1995; 5: 6–10.

  18. Mason EE, Tang S, Renquist KE, Barnes DT, Cullen JJ, Doherty C, Maher JW . A decade of change in obesity surgery. National Bariatric Surgery Registry (NBSR) Contributors. Obes Surg 1997; 7: 189–197.

    CAS  PubMed  Google Scholar 

  19. Hell E . (Historical Development of surgery for morbid obesity). Acta Chir Austriaca 1998; 30: 131–132.

    Google Scholar 

  20. Bray GA, Benfield JR . Intestinal bypass for obesity: a summary and perspective. Am J Clin Nutr 1977; 30: 121–127.

    CAS  PubMed  Google Scholar 

  21. Halverson JD, Scheff RJ, Gentry K, Alpers DH . Long-term follow-up of jejunoileal bypass patients. Am J Clin Nutr 1980; 33: 472–475.

    CAS  PubMed  Google Scholar 

  22. Brolin RE . Gastrointestinal surgery for obesity. Semin Gastrointest Dis 1998; 9: 163–175.

    CAS  PubMed  Google Scholar 

  23. Monteforte MJ, Turkelson CM . Bariatric surgery for morbid obesity. Obes Surg 2000; 10: 391–401.

    CAS  PubMed  Google Scholar 

  24. Brolin RE, Robertson LB, Kenler HA . Weight loss and dietary intake after vertical banded gastroplasty and Roux-en-Y gastric bypass. Ann Surg 1994; 161: 782–790.

    Google Scholar 

  25. Hall JC, Watts JM, O'Brien PE, Dunstan RE, Walsh JF, Slavotinek AH, Elmslie RG . Gastric surgery for morbid obesity. The Adelaide Study. Ann Surg 1990; 211: 419–427.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. MacLean LD, Rhode BM, Sampalis J, Forse RA . Results of the surgical treatment of obesity. Am J Surg 1993; 165: 155–160.

    CAS  PubMed  Google Scholar 

  27. Sugerman HJ, Kellum JM, Engle KM, Wolfe L, Starkey JV, Birkenhauer R, Fletcher P, Sawyer MJ . Gastric bypass for treating severe obesity. Am J Clin Nutr 1992; 55: 560S–566S.

    CAS  PubMed  Google Scholar 

  28. Sugerman HJ, Londrey GL, Kellum JM, Wolf L, Liszka T, Engle KM, Birkenhauer R, Starkey JV . Weight loss with vertical banded gastroplasty and Roux-Y gastric bypass for morbid obesity with selective versus random assignment. Am J Surg 1989; 157: 93–102.

    CAS  PubMed  Google Scholar 

  29. Brolin RE, Clemow LP, Kasnetz KA, Fynan TM, Silva EM, Greenfield DP . Outcome predictors after gastroplasty for morbid obesity. Nutr Int 1986; 2: 322–326.

    Google Scholar 

  30. Kral JG . Surgical treatment of obesity. Med Clin N Am 1998; 73: 251–264.

    Google Scholar 

  31. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th edition, DSM-IV, 4th edn. American Psychiatric Association: Washington, Weinheim, Basel; 1994.

  32. Black DW, Yates WR, Reich RH, Bell S, Goldstein RBME . DSM-III personality disorder in bariatric clinic patients. Ann Clin Psychiatry 1989; 1: 33–37.

    Google Scholar 

  33. Black DW, Goldstein RB, Mason EE . Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients. Am J Psychiatry 1992; 149: 227–234.

    CAS  PubMed  Google Scholar 

  34. de Zwaan M, Nutzinger DO, Schoenbeck G . Binge eating in overweight women. Compr Psychiatry 1992; 33: 256–261.

    CAS  PubMed  Google Scholar 

  35. Pekkarinen T, Koskela K, Huikuri K, Mustajoki P . Long-term results of gastroplasty for morbid obesity: binge-eating as a predictor of poor outcome. Obes Surg 1994; 4: 248–255.

    CAS  PubMed  Google Scholar 

  36. Herpertz S, Saller B . [Psychosomatic aspects of obesity]. Psychother Psychosom Med Psychol 2001; 51: 336–349.

    CAS  PubMed  Google Scholar 

  37. Kral JG, Sjostrom LV, Sullivan MB . Assessment of quality of life before and after surgery for severe obesity. Am J Clin Nutr 1992; 55: 611S–614S.

    CAS  PubMed  Google Scholar 

  38. Sarlio-Lahteenkorva S, Stunkard A, Rissanen A . Psychosocial factors and quality of life in obesity. Int J Obes Relat Metab Disord 1995; 19(Suppl 6): S1–S5.

    PubMed  Google Scholar 

  39. Brolin RE . Critical analysis of results: weight loss and quality of data. Am J Clin Nutr 1992; 55: 577S–581S.

    CAS  PubMed  Google Scholar 

  40. Yale CE . Reporting our results. Obes Surg 1991; 1: 241–242.

    CAS  PubMed  Google Scholar 

  41. La Manna A, Ricci GB, Giorgi I, Gossemburg M, La Manna L, Catona A . Psychological effects of vertical banded gastroplasty on pathologically obese patients. Obes Surg 1992; 2: 239–243.

    CAS  PubMed  Google Scholar 

  42. Bull RH, Engels WD, Engelsmann F, Bloom L . Behavioral changes following gastric surgery for morbid obesity: a prospective, controlled study. J Psychosom Res 1983; 27: 457–467.

    CAS  PubMed  Google Scholar 

  43. Carr ND, Harrison RA, Tomkins A, Baughen R, Demmer S, Godfrey J, Clark CG . Vertical banded gastroplasty in the treatment of morbid obesity: results of three year follow up. Gut 1989; 30: 1048–1053.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. Hsu LK, Betancourt S, Sullivan SP . Eating disturbances before and after vertical banded gastroplasty: a pilot study. Int J Eat Disord 1996; 19: 23–34.

    CAS  PubMed  Google Scholar 

  45. Hsu LK, Sullivan SP, Benotti PN . Eating disturbances and outcome of gastric bypass surgery: a pilot study. Int J Eat Disord 1997; 21: 385–390.

    CAS  PubMed  Google Scholar 

  46. Roschal H, Lang B, Hell E . [Effects of surgical therapy of extreme obesity on physical and psychological outcome]. Wien Klin Wochenschr 1992; 104: 467–473.

    CAS  PubMed  Google Scholar 

  47. Weiner R, Datz M, Wagner D, Bockhorn H . Quality-of-life outcome after laparoscopic adjustable gastric banding for morbid obesity. Obes Surg 1999; 9: 539–545.

    CAS  PubMed  Google Scholar 

  48. Ryden O, Olsson SA, Danielsson A, Nilsson-Ehle P . Weight loss after gastroplasty: psychological sequelae in relation to clinical and metabolic observations. J Am Coll Nutr 1989; 8: 15–23.

    CAS  PubMed  Google Scholar 

  49. Wennberg JA . AHCPR and the strategy for health care reform. Health Affairs (Millwood) 1992; 11: 67–71.

    CAS  Google Scholar 

  50. Keaney M, Lorimer AR . Auditing the implementation of SIGN (Scottish Intercollegiate Guidelines Network) clinical guidelines. Int J Health Care Qual Assur Inc Leadership Health Serv 1999; 12: 314–317.

    CAS  Google Scholar 

  51. Adami GF, Gandolfo P, Dapueto R, Jurich D, Scopinaro N . Eating behavior following biliopancreatic diversion for obesity: study with a three-factor eating questionnaire. Int J Eat Disord 1993; 14: 81–86.

    CAS  PubMed  Google Scholar 

  52. Adami GF, Gandolfo P, Campostano A, Meneghelli A, Ravera G, Scopinaro N . Body image and body weight in obese patients. Int J Eat Disord 1998; 24: 299–306.

    CAS  PubMed  Google Scholar 

  53. Adami GF, Gandolfo P, Campostano A, Bauer B, Cocchi F, Scopinaro N . Eating disorder inventory in the assessment of psychosocial status in the obese patients prior to and at long-term following biliopancreatic diversion for obesity. Int J Eat Disord 1994; 15: 265–274.

    CAS  PubMed  Google Scholar 

  54. Horchner R, Tuinebreijer W . Improvement of physical functioning of morbidly obese patients who have undergone a Lap-Band operation: one-year study. Obes Surg 1999; 9: 399–402.

    CAS  PubMed  Google Scholar 

  55. Karlsson J, Sjostrom L, Sullivan M . Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 1998; 22: 113–126.

    CAS  PubMed  Google Scholar 

  56. Adami G, Gandolfo P, Meneghelli A, Scopinaro N . Food- and weight-related attitudes in obese persons: a longitudinal study over two years following biliopancreatic diversion. J Psychosom Res 1996; 41: 31–38.

    CAS  PubMed  Google Scholar 

  57. Adami GF, Bauer B, Gandolfo P, Scopinaro N . Body image in early-onset obese patients. Eat Weight Disord 1997; 41: 87–93.

    Google Scholar 

  58. Hell E, Miller KA, Moorehead MK, Norman S . Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obes Surg 2000; 10: 214–219.

    CAS  PubMed  Google Scholar 

  59. Isacsson A, Frederiksen SG, Nilsson P, Hedenbro JL . Quality of life after gastroplasty is normal: a controlled study. Eur J Surg 1997; 163: 181–186.

    CAS  PubMed  Google Scholar 

  60. Gentry K, Halverson JD, Heisler S . Psychologic assessment of morbidly obese patients undergoing gastric bypass: a comparison of preoperative and postoperative adjustment. Surgery 1984; 95: 215–220.

    CAS  PubMed  Google Scholar 

  61. Gertler R, Ramsey-Stewart G . Pre-operative psychiatric assessment of patients presenting for gastric bariatric surgery (surgical control of morbid obesity). Aust N Z J Surg 1986; 56: 157–161.

    CAS  PubMed  Google Scholar 

  62. Kopec-Schrader EM, Gertler R, Ramsey-Stewart G, Beumont PJ . Psychosocial outcome and long-term weight loss after gastric restrictive surgery for morbid obesity. Obes Surg 1994; 4: 336–339.

    CAS  PubMed  Google Scholar 

  63. Larsen F, Torgersen S . Personality changes after gastric banding surgery for morbid obesity. A prospective study. J Psychosom Res 1989; 33: 323–334.

    CAS  PubMed  Google Scholar 

  64. Larsen F . Psychosocial function before and after gastric banding surgery for morbid obesity. A prospective psychiatric study. Acta Psychiatr Scand Suppl 1990; 359: 1–57.

    CAS  PubMed  Google Scholar 

  65. Powers PS, Boyd F, Blair CR, Stevens B, Rosemurgy A . Psychiatric issues in bariatric surgery. Obes Surg 1992; 2: 315–325.

    CAS  PubMed  Google Scholar 

  66. Powers PS, Rosemurgy A, Boyd F, Perez A . Outcome of gastric restriction procedures: weight, psychiatric diagnoses, and satisfaction. Obes Surg 1997; 7: 471–477.

    CAS  PubMed  Google Scholar 

  67. Chandarana PC, Conlon P, Holliday RL, Deslippe T, Field VA . A prospective study of psychosocial aspects of gastric stapling surgery. Psychiatr J Univ Ott 1990; 15: 32–35.

    CAS  PubMed  Google Scholar 

  68. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd edition, DSM-III, 3rd edn. American Psychiatric Association: Washington, Weinheim, Basel; 1980.

  69. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 3rd edition, Revision, DSM-III-R, 3rd Revision edn. American Psychiatric Association: Washington, Weinheim, Basel; 1987.

  70. Hafner RJ, Rogers J . Husbands' adjustment to wives' weight loss after gastric restriction for morbid obesity. Int J Obes Relat Metab Disord 1990; 14: 1069–1078.

    CAS  Google Scholar 

  71. Rowston W, McCluskey S, Gazet JC, Lacey JH, Franks G, Lynch D . Eating behavior, physical symptoms and psychological factors associated with weight reduction following the Scopinaro operation as modified by Gazet. Obes Surg 1992; 2: 355–360.

    CAS  PubMed  Google Scholar 

  72. Sjöström L . Surgical intervention as a strategy for treatment of obesity. Endocrine 2000;13:213–230.

    PubMed  Google Scholar 

  73. Sullivan M, Karlsson J, Sjostrom L, Backman L, Bengtsson C, Bouchard C, Dahlgren S, Jonsson E, Larsson B, Lindstedt S . Swedish obese subjects (SOS)—an intervention study of obesity. Baseline evaluation of health and psychosocial functioning in the first 1743 subjects examined. Int J Obes Relat Metab Disord 1993; 17: 503–512.

    CAS  PubMed  Google Scholar 

  74. Sullivan M, Karlsson J, Sjöström L, Taft C . Why quality of life measures should be used in the treatment of patients with obesity. In: Björntrop P (ed). International textbook of obesity. John Wiley and Sons: London; 2001.

    Google Scholar 

  75. Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, Wonderlich SA, Gosnell BA . Long-term follow-up of patients' status after gastric bypass. Obes Surg 2001; 11: 464–468.

    CAS  PubMed  Google Scholar 

  76. Kalarchian MA, Wilson GT, Brolin RE, Bradley L . Binge eating in bariatric surgery patients. Int J Eat Disord 1998; 23: 89–92.

    CAS  PubMed  Google Scholar 

  77. Adami GF, Gandolfo P, Bauer B, Scopinaro N . Binge eating in massively obese patients undergoing bariatric surgery. Int J Eat Disord 1995; 17: 45–50.

    CAS  PubMed  Google Scholar 

  78. Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG . Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg 2000; 4: 598–605.

    CAS  PubMed  Google Scholar 

  79. Baltasar A, Bou R, Arlandis F, Martinez R, Serra C, Bengochea M, Miro J . Vertical banded gastroplasty at more than 5 years. Obes Surg 1998; 8: 29–34.

    CAS  PubMed  Google Scholar 

  80. Powers PS, Perez A, Boyd F, Rosemurgy A . Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord 1999; 25: 293–300.

    CAS  PubMed  Google Scholar 

  81. Peace K, Dyne J, Russell G, Stewart R . Psychobiological effects of gastric restriction surgery for morbid obesity. N Z Med J 1989; 102: 76–78.

    CAS  PubMed  Google Scholar 

  82. Rabner JG, Greenstein RJ . Obesity surgery: expectation and reality. Int J Obes Relat Metab Disord 1991; 15: 841–845.

    CAS  Google Scholar 

  83. Crampton NA, Izvornikov V, Stubbs RS . Silastic ring gastric bypass: results in 64 patients. Obes Surg 1997; 7: 489–494.

    CAS  PubMed  Google Scholar 

  84. Halmi KA, Mason E, Falk JR, Stunkard A . Appetitive behavior after gastric bypass for obesity. Int J Obes Relat Metab Disord 1981; 5: 457–464.

    CAS  Google Scholar 

  85. Rand CS, Macgregor A, Hankins G . Gastric bypass surgery for obesity: weight loss, psychosocial outcome, and morbidity one and three years later. South Med J 1986; 79: 1511–1514.

    CAS  PubMed  Google Scholar 

  86. Adami GF, Gandolfo P, Meneghelli A, Scopinaro N . Binge eating in obesity: a longitudinal study following biliopancreatic diversion. Int J Eat Disord 1996; 20: 405–413.

    CAS  PubMed  Google Scholar 

  87. Adami GF, Meneghelli A, Bressani A, Scopinaro N . Body image in obese patients before and after stable weight reduction following bariatric surgery. J Psychosom Res 1999; 46: 275–281.

    CAS  PubMed  Google Scholar 

  88. Hawke A, O'Brien P, Watts JM, Hall J, Dunstan RE, Walsh JF, Slavotinek AH, Elmslie RG . Psychosocial and physical activity changes after gastric restrictive procedures for morbid obesity. Aust N Z J Surg 1990; 60: 755–758.

    CAS  PubMed  Google Scholar 

  89. Rand CS, Macgregor AM . Adolescents having obesity surgery: a 6-year follow-up. South Med J 1994; 87: 1208–1213.

    CAS  PubMed  Google Scholar 

  90. Stunkard AJ, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res 1985; 29: 71–83.

    CAS  PubMed  Google Scholar 

  91. Garner DM, Olmsted MP, Polivy J . Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia nervosa. Int J Eat Disord 1983; 2: 15–34.

    Google Scholar 

  92. Hafner RJ, Watts JM, Rogers J . Quality of life after gastric bypass for morbid obesity. Int J Obes Relat Metab Disord 1991; 15: 555–560.

    CAS  Google Scholar 

  93. Kinzl JF, Trefalt E, Fiala M, Hotter A, Biebl W, Aigner F . Partnership, sexuality, and sexual disorders in morbidly obese women: consequences of weight loss after gastric banding. Obes Surg 2001; 11: 455–458.

    CAS  PubMed  Google Scholar 

  94. van Gemert WG, Severeijns RM, Greve JW, Groenman N, Soeters PB . Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes Relat Metab Disord 1998; 22: 393–398.

    CAS  PubMed  Google Scholar 

  95. Hall JC, Horne K, O'Brien PE, Watts JM . Patient well-being after gastric bypass surgery for morbid obesity. Aust N Z J Surg 1983; 53: 321–324.

    CAS  PubMed  Google Scholar 

  96. Rand CS, Macgregor AM . Morbidly obese patients' perceptions of social discrimination before and after surgery for obesity. South Med J 1990; 83: 1390–1395.

    CAS  PubMed  Google Scholar 

  97. Valley V, Grace DM . Psychosocial risk factors in gastric surgery for obesity: identifying guidelines for screening. Int J Obes Relat Metab Disord 1987; 11: 105–113.

    CAS  Google Scholar 

  98. Narbro K, Jonsson E, Larsson B, Waaler H, Wedel H, Sjostrom L . Economic consequences of sick-leave and early retirement in obese Swedish women. Int J Obes Relat Metab Disord 1996; 20: 895–903.

    CAS  PubMed  Google Scholar 

  99. Narbro K, Agren G, Jonsson E, Larsson B, Naslund I, Wedel H, Sjostrom L . Sick leave and disability pension before and after treatment for obesity: a report from the Swedish Obese Subjects (SOS) study. Int J Obes Relat Metab Disord 1999; 23: 619–624.

    CAS  PubMed  Google Scholar 

  100. Sjöström CD, Peltonen M, Sjöström L . Blood pressure and pulse pressure during long-term weight loss in the obese: the Swedish Obese Subjects (SOS) Intervention Study. Obes Res 2001; 9: 188–195.

    PubMed  Google Scholar 

  101. Choban PS, Onyejekwe J, Burge JC, Flancbaum L . A health status assessment of the impact of weight loss following Roux-en-Y gastric bypass for clinically severe obesity. J Am Coll Surg 1999; 188: 491–497.

    CAS  PubMed  Google Scholar 

  102. Schok M, Geenen R, van Antwerpen T, de Wit P, Brand N, van Ramshorst B . Quality of life after laparoscopic adjustable gastric banding for severe obesity: postoperative and retrospective preoperative evaluations. Obes Surg 2000; 10: 502–508.

    CAS  PubMed  Google Scholar 

  103. Tenth revision of the international classification of diseases, chapter V, Mental and behavioral disorders. Clinical descriptions and diagnostic guidelines. World Health Organization: Geneva; 1991.

  104. Capella JF, Capella RF . The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass? Am J Surg 1996; 171: 74–79.

    CAS  PubMed  Google Scholar 

  105. Macgregor AM, Rand CS . Gastric surgery in morbid obesity. Outcome in patients aged 55 years and older. Arch Surg 1993; 128: 1153–1157.

    CAS  PubMed  Google Scholar 

  106. MacLean LD, Rhode BM, Forse RA . Late results of vertical banded gastroplasty for morbid and super obesity. Surgery 1990; 107: 20–27.

    CAS  PubMed  Google Scholar 

  107. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM . Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995; 222: 339–350.

    CAS  PubMed  PubMed Central  Google Scholar 

  108. Hsu LK, Benotti PN, Dwyer J, Roberts SB, Saltzman E, Shikora S, Rolls BJ, Rand W . Nonsurgical factors that influence the outcome of bariatric surgery: a review. Psychosom Med 1998; 60: 338–346.

    CAS  PubMed  Google Scholar 

  109. Kellum JM, Kuemmerle JF, O'Dorisio TM, Rayford P, Martin D, Engle K, Wolf L, Sugerman HJ . Gastrointestinal hormone responses to meals before and after gastric bypass and vertical banded gastroplasty. Ann Surg 1990; 211: 763–770.

    CAS  PubMed  PubMed Central  Google Scholar 

  110. Kojima M, Hosoda H, Date Y, Nakazato M, Matsuo H, Kangawa K . Ghrelin is a growth-hormone-releasing acylated peptide from stomach. Nature 1999; 402: 656–660.

    CAS  PubMed  Google Scholar 

  111. Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, Purnell JQ . Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002; 346: 1623–1630.

    PubMed  Google Scholar 

  112. Marcus MD, Wing RR . Binge eating among the obese. Ann Behav Med 1987; 9: 23–27.

    Google Scholar 

  113. Marcus MD, Wing RR, Ewing L, Kern E, Gooding W, McDermont M . Psychiatric disorders among obese binge eaters. Int J Eat Disord 1990; 9: 69–77.

    Google Scholar 

  114. Herbst CA, Hughes TA, Gwynne JT, Buckwalter JA . Gastric bariatric operation in insulin-treated adults. Surgery 1984; 95: 209–214.

    CAS  PubMed  Google Scholar 

  115. Charuzi I, Lavie P, Peiser J, Peled R . Bariatric surgery in morbidly obese sleep-apnea patients. Am J Clin Nutr 1992; 55: 594S–596S.

    CAS  PubMed  Google Scholar 

  116. Kral JG . Selection of patients for anti-obesity surgery. Int J Obes Relat Metab Disord 2001; 25(Suppl 1): S107–S112.

    PubMed  Google Scholar 

  117. Naslund I, Wickbom G, Christoffersson E, Agren G . A prospective randomized comparison of gastric bypass and gastroplasty. Complications and early results. Acta Chir Scand 1986; 152: 681–689.

    CAS  PubMed  Google Scholar 

  118. Cook CM, Edwards C . Success habits of long-term gastric bypass patients. Obes Surg 1999; 9: 80–82.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This work was supported by the German Research Foundation Grants: HE 26652-1, HE 26652-2.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S Herpertz.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Herpertz, S., Kielmann, R., Wolf, A. et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes 27, 1300–1314 (2003). https://doi.org/10.1038/sj.ijo.0802410

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ijo.0802410

Keywords

  • obesity surgery
  • psychiatric comorbidity
  • psychosocial outcome
  • quality of life
  • review

Further reading

Search

Quick links