Obesity is a major health problem across the globe, and it has become increasingly common among children, teens, and adults. In addition, obesity is  believed to be a major risk factor for polycystic ovary syndrome, infertility, sleep apnea, reduced lung function, diabetes, heart disease, stroke, hypertension, atherosclerosis, various types of cancer, just to mention, but a few.  Obesity is also known to contribute to mental health illnesses such as mood disorders, binge eating, and anxiety.

Most people try to lose weight without success, but bariatric surgery, which is also known as weight loss surgery has been shown to be a viable treatment option for morbid obesity. Weight loss surgery is often used with some success, but some individuals continue to suffer from mental health conditions following surgery.

This article will help you gain insights on mental health conditions associated with obesity surgery.

Effects of Obesity and Weight Loss Surgery on Mental Health

  • Anxiety and PTSD

Anxiety and ptsd are very common following weight loss surgery. This is  due to the profound transitions in ones lifestyle, eating habits, and the general behavioral changes, which tend to create tension and stress. Exercise goals can also provoke stress and anxiety.

  • Depression

Obese people often suffer from depressive episodes due to prejudice and dissatisfaction with their body image. In addition, unsuccessful attempts to lose weight also tend to aggravate symptoms of depression.

Bariatric surgery is considered to decrease the prevalence of depression, as well as the severity of depressive symptoms following the procedure. However, a good number of patients often have a lifetime history of mood disorders due to postoperative weight regain.

  • Binge eating and bulimia

Binge eating is common preoperative and postoperative.  Some individuals tend to engage in self induced vomiting more so when their weight loss stalls. What’s more, some individuals also consume laxatives after eating so that they can lose more weight.

On the other hand, binge eating behavior tends to be alleviated following weight loss surgery. This is because individuals are encouraged to adhere to eating small food, which tends to eventually normalize eating patterns.

  • Suicidal ideation and self harm

People who undergo bariatric surgery are more likely to have suicidal thoughts and inflict harm on themselves more than the general population of obese people who haven’t gone through surgery. Suicidal risks following surgery increase due to surgery misconceptions more so when individuals stop losing substantial weight. Substance misuse is also very common in suicidal patients.

  • Personality disorders

Personality disorders are also prevalent due to the attitude that some individuals have regarding their self concept including self esteem, self confidence, body image, and assertiveness. Weight loss surgery has been shown to boost the self confidence and self esteem of bariatric clients due to improved body image and feelings satisfied with the weight loss surgery. However, some clients tend to be dissatisfied with their body image due to sagging skin postoperative, which is a major cause of psychological distress.

In addition, obesity surgery tends to significantly reduce conditions such as defensiveness, neuroticism, and immature identity.

  • Substance abuse disorders

Increased alcohol consumption is often seen in some individuals after bariatric procedures. For instance, some studies have shown that two years following the Roux-en-Y gastric bypass, young men tend to engage in alcohol use disorders than they did before the procedure. The increase in alcohol and substance use disorders is often associated with physiologic changes due to intestinal bypass.

  • Psychosis

Acute or severe psychotic disorders such as wernicke’s korsakoff and encephalopathy syndrome have also been reported following gastric bypass surgery.

Why is Counseling is Important Before and After Weight Loss Surgery?

Counseling is important because the therapist is able to do a mental health screening or a pre-surgery psychological assessment. After the assessment, the counselor is able to inform the bariatric surgeons on whether the client has psychiatric conditions, which enables them to make a decision on how they should proceed with the procedure.

In other words, a person with depression can have the surgery and then have postoperative depression therapy, and such a person should be  managed different from a person with suicidal thoughts.

On the other hand, Counseling is important because it enables clients to be more aware of the body and skin changes that will take place after bariatric surgery. In addition, it enables clients to learn more about the risk of self harm following bariatric surgery, and the need for long term follow-up.

What’s more, counseling helps clients with binge eating disorder to be aware of the need to strictly reduce food intake postoperative. It also prepares them psychologically for the consequences associated with weight loss such as stigma, low-self esteem and shame. It also reduces the risk of transferring the food addiction to alcohol or drug addiction.

In general, psychotherapy prepares and enables clients preoperative and postoperative to adapt to the changes, and to be accountable for their lifestyle changes following bariatric surgery. It is also effective in reducing depression symptoms.

Parting Shot!

Bariatric surgery is a cost effective and viable treatment option for morbid obesity. What’s more, obese individuals with mental health challenges can undergo obesity surgery, but it is important that they have adequate therapeutic support pre and post-surgery. In other words, it is important that bariatric patients seek therapeutic help before and after surgery so that they can be helped to cope with pre-existing and unexpected mental health conditions,  and to adapt to  lifestyle and body changes.

Written by:

Charles Cox LCSW-R, CBC