 |
|
1 in 5 bariatric surgery candidates not psychologically cleared for surgery
October 15, 2007Largest study of its kind to determine reliability and reasons for psychological exclusions
Providence, RI - A new study by Rhode Island Hospital and Brown University researchers reported that 18 percent of 500 candidates for bariatric surgery did not receive the initial psychiatric clearance for the surgery. The study is the first to examine the reliability of decisions to clear candidates for surgery, and the largest to determine the percentage of candidates who are not cleared and detail the reasons for exclusion. It was published in the October edition of the Journal of Clinical Psychiatry.
Findings indicate the most common reasons for not receiving psychiatric clearance were frequent overeating to cope with stress/emotional distress, a current eating disorder and uncontrolled psychiatric disorders. Researchers also found that the decision to clear candidates for bariatric surgery is made with high reliability, meaning independent reviews of available information by independent psychiatrists will result in the same decision.
Most bariatric surgery programs include psychiatric evaluations as part of the pre-operative screening procedure. Some of the psychological factors considered important in determining appropriate surgical candidates include the presence of eating, mood psychotic, personality and substance abuse disorders; eating to regulate negative affect (using food as a method to cope with psychological stress); history of noncompliance with treatment; and inappropriate expectations of life change due to surgery.
Lead author Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital and associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, emphasized, "The goal of the psychiatric evaluation is not to keep patients from having the surgery. Rather, the goal is to determine if there are any problems that might interfere with the success of surgery, and have the patient get treatment for these problems." Zimmerman continues, "In so doing, the patient is more likely to have a positive outcome from surgery that is delayed to allow time to address the problems."
Caren Francione, a post-doctoral fellow and co-author of the report, noted that they have conducted a follow-up study of the patients who were initially screened out from having the surgery. Preliminary analysis of the data found that most of these patients followed the psychiatrists' recommendation to have counseling before surgery and subsequently went on to have surgery.
The report is from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) Project, for which Zimmerman is the principal investigator. Zimmerman said, "The MIDAS project is unique in its integration of research quality diagnostic methods into a community-based outpatient practice affiliated with an academic medical center."
Lifespan
Most bariatric surgery programs include psychiatric evaluations as part of the pre-operative screening procedure. Some of the psychological factors considered important in determining appropriate surgical candidates include the presence of eating, mood psychotic, personality and substance abuse disorders; eating to regulate negative affect (using food as a method to cope with psychological stress); history of noncompliance with treatment; and inappropriate expectations of life change due to surgery.
Lead author Mark Zimmerman, MD, director of outpatient psychiatry at Rhode Island Hospital and associate professor of psychiatry and human behavior at The Warren Alpert Medical School of Brown University, emphasized, "The goal of the psychiatric evaluation is not to keep patients from having the surgery. Rather, the goal is to determine if there are any problems that might interfere with the success of surgery, and have the patient get treatment for these problems." Zimmerman continues, "In so doing, the patient is more likely to have a positive outcome from surgery that is delayed to allow time to address the problems."
Caren Francione, a post-doctoral fellow and co-author of the report, noted that they have conducted a follow-up study of the patients who were initially screened out from having the surgery. Preliminary analysis of the data found that most of these patients followed the psychiatrists' recommendation to have counseling before surgery and subsequently went on to have surgery.
The report is from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) Project, for which Zimmerman is the principal investigator. Zimmerman said, "The MIDAS project is unique in its integration of research quality diagnostic methods into a community-based outpatient practice affiliated with an academic medical center."
Lifespan
Bariatric Surgery Current Events and Bariatric Surgery News RSSDiabetes surgery summit consensus lays foundation for new field of medicine
A first-of-its-kind consensus statement on diabetes surgery is published online today in the Annals of Surgery.
Energy gap useful tool for successful weight loss maintenance strategy
Americans continue to get heavier. Most weight control methods short of bariatric surgery are generally considered ineffective in preventing obesity or reducing weight.
Addressing obesity via the 'energy gap'
The November issue of the Journal of the American Dietetic Association features a commentary by James O. Hill, an honorary ADA member, professor of pediatrics and medicine and director of the Center for Human Nutrition at the University of Colorado-Denver.
'Superobesity,' chronic disease burden associated with risk of death following bariatric surgery
Veterans classified as superobese and those with a higher chronic disease burden appear more likely to die within a year of having bariatric surgery, according to a report in the October issue of Archives of Surgery, one of the JAMA/Archives journals.
NIH study finds low short-term risks after bariatric surgery for extreme obesity
Short-term complications and death rates were low following bariatric surgery to limit the amount of food that can enter the stomach, decrease absorption of food or both, according to the Longitudinal Assessment of Bariatric Surgery (LABS-1).
Study: Bariatric surgery patients have 67 percent lower chance of complications at top hospitals
The HealthGrades Fourth Annual Bariatric Surgery Trends in American Hospitals Study released today identifies 88 hospitals as "best" performers (five-star rated), with mortality rates, complication rates and patient lengths of stay that are dramatically lower than poorly rated hospitals.
A simpler definition for major depressive disorder
Researchers from Rhode Island Hospital's department of psychiatry propose that the definition for major depressive disorder (MDD) should be shortened to include only the mood and cognitive symptoms that have been part of the definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM) for the past 35 years.
Roux-en-Y weight loss surgery raises kidney stone risk
The most popular type of gastric bypass surgery appears to nearly double the chance that a patient will develop kidney stones, despite earlier assumptions that it would not, Johns Hopkins doctors report in a new study.
Physiological response may explain why some severely obese patients overeat
Don't feel like you are getting full when eating a large meal? New research from The Miriam Hospital suggests that a physiological response may partially explain why severely obese individuals may not feel satisfied after eating and often have difficulty controlling the amount of food they consume during a meal.
Waiting times too long for bariatric surgery
Obesity is now acknowledged as a chronic disease with a number of related complications, and its prevalence has reached alarming epidemic proportions.
More Bariatric Surgery Current Events and Bariatric Surgery News Articles
 |
Weight Loss Surgery For Dummies by Marina S. Kurian (Author), Barbara Thompson (Author), Brian K. Davidson (Author) Get the scoop on weight loss surgery Your authoritative guide to weight loss surgery -- before, during, and after Considering weight loss surgery? This compassionate guide helps you determine whether you qualify and gives you the scoop on selecting the best center and surgical team, understanding today's different procedures, and achieving the best results. You also get tips on eating properly post-op and preparing appetizing meals, as well as easing back into your day-to-day life. Discover how to * Evaluate your surgical options * Understand the risks * Prepare for surgery * Handle post-op challenges * Find sources of support |
 |
The Emotional First Aid Kit: A Practical Guide to Life After Bariatric Surgery by Cynthia L. Alexander (Author) A must read before weight loss surgery...A life-long resource after weight loss surgery The second edition of this book (244 pages, paperback) is written for anyone who wants to change his or her life through bariatric weight loss surgery. Learn realistic and practical strategies for dealing with emotional difficulties encountered before and after your weight loss surgerystrategies that help you: Relieve stress without using food Modify unhealthy behavior Overcome hurdles to establishing a consistent exercise program Deal with negative reactions by friends, family, and spouse to your weight loss Prevent relapse...and more. These psychological tricks of the trade will help you make your weight loss journey a successful one. |
 |
The Success Habits of Weight-Loss Surgery Patients by Colleen M. Cook (Author) These time and people tested principles are the results of years of research of long-term weight loss surgery patients. They work regardless of the particular type of weight-loss surgery you may have had. Whether you are investigating weight-loss surgery, a new patient, out a few years, or a bariatric professional, you'll find this book educational and motivational. |
 |
The SAGES Manual: A Practical Guide to Bariatric Surgery (Sages Manuals) by Ninh T. Nguyen (Editor), Eric DeMaria (Editor), Sayeed Ikramuddin (Editor), Matthew M. Hutter (Editor) Bariatric surgery is an increasingly common procedure, but far from an easy one. Patient assessment and selection must be careful. Complications can arise quite often. Training levels can be uneven among clinicians. The SAGES Manual of Bariatric Surgery bridges the gaps and serves as a practical and concise starting point for the surgeon adding these procedures to his skill set. |
 |
A Complete Guide to Obesity Surgery: Everything You Need to Know About Weight Loss Surgery and How to Succeed by MPH, LCEP Bryan G. Woodward (Author) Currently, over fifteen million Americans are struggling, day-by-day, hoping for a healthier life and a means to shed massive amounts of weight. Morbid obesity is a deadly epidemic causing over 300,000 deaths annually and is second only to cigarette smoking as the leading cause of preventable death in the United States. Sufferers of morbid obesity "are sick and tired" of being "sick and tired". Feelings of desperation often lead them to attempt anything to lose 100 pounds plus of extra weight they carry, which makes them easy prey to fraudulent diet scams and untruthful advertising practices. For those who suffer with the disease of morbid obesity and have been unsuccessful at their diet attempts -- there is another answer. In this book, the answer to a better and longer life is not a... |
 |
Minimally Invasive Bariatric Surgery by Phillip R. Schauer (Editor), Bruce D. Schirmer (Editor), Stacy Brethauer (Editor) "Minimally Invasive Bariatric Surgery" covers the full spectrum of laparoscopic weight loss surgery and the pathophysiology of obesity. The chapter authors, all currently operating experts in the field, cover the essentials of establishing a bariatric surgery program, including equipment needs, guidelines for training, and patient selection. The operative chapters discuss in full detail the surgical techniques and outcomes, including laparoscopic VGB, laparoscopic adjustable gastric banding, laparoscopic Roux-en-Y, and laparoscopic malabsorption procedures. The text also tackles post-operative issues, such as complications, reoperation, plastic surgery after weight loss, nutritional issues, and pregnancy following obesity surgery. The text is graphically enhanced with over 175... |
 |
Bariatric Surgery: Psychosocial Assessment and Treatment by James E. Mitchell (Editor), Martina de Zwaan (Editor) The number of patients undergoing bariatric surgery has more than doubled in the last two years, and it is anticipated that approximately 100,000 such procedures will be performed around the world this year. As this area of surgery has become increasingly accepted as a safe and effective treatment option for morbid obesity, scores of surgeons have begun to specialize in bariatric surgery. Bariatric Surgery will serve as a guide to the unique psychosocial issues that surround this procedure. Among the topics covered are pre-surgical psychological assessment, weight and eating changes after surgery, nutritional problems that may develop post-operation, cognitive behavior therapy, and post-operative treatment and support. This book will provide mental health professionals with a basic... |
 |
Obesity Surgery: Stories Of Altered Lives by Marta Meana (Author), Lindsey Ricciardi (Author) The surprising and unpredictable story of the personal and social after-effects of rapid and dramatic weight loss. Using in-depth, first person accounts of 33 men and women who underwent weight-loss surgery, this book elaborates on the complexities of finally getting what you wished for – the good, the bad, and the totally unexpected. • Suddenly being treated well by previously dismissive strangers is embraced by some, yet it angers others who question a kindness reserved only for the non-obese. • Attention from the opposite sex is both flattering and scary, as many have little experience dealing with such advances. • Marriages and relationships are rocked for better and for worse, as... |
 |
Bariatric Surgery: A Primer for Your Medical Practice by Francis A. Farraye MD MSc (Editor), R. Armour Forse MD PhD (Editor) Obesity is a serious and rapidly increasing medical problem. Bariatric surgery is the only effective long-term treatment for morbid obesity and the performance of this surgery has increased dramatically over the years. Bariatric Surgery: A Primer for Your Medical Practice is a user-friendly, practical reference text that provides all the necessary information that the health care professional will need to assist in patient selection and preoperative assessment, as well as recommendations in dealing with complex postoperative care of the bariatric patient. Dr. Francis A. Farraye and Dr. R. Armour Forse, joined by leading experts, review what is required by today's practicing physician who will manage the care of obese adults. Inside the chapters of Bariatric Surgery,... |
 |
Outpatient Weight-Loss Surgery: Safe and Successful Weight Loss with Modern Bariatric Surgery by Kent Sasse (Author) Dr. Sasse's book, Outpatient Weight Loss Surgery is the perfect guide to today's weight loss surgery techniques. This information is presented to you so that you can make the right choices for yourself. There are many aspects of the weight loss surgery process that should be considered and this book presents them in clear easy to understand language. There are many rumors and untruths about bariatric surgery, Dr. Sasse's, Outpatient Weight Loss Surgery is the perfect source for all of the current information regarding the risks and rewards and everything in between when it comes to the available weight loss surgery options. |
| © 2009 BrightSurf.com |