Current Obesity Reports

, Volume 8, Issue 1, pp 1–9 | Cite as

Psychosocial Concerns Following Bariatric Surgery: Current Status

  • Melissa A. KalarchianEmail author
  • Marsha D. Marcus
Psychological Issues (V Drapeau and V Ivezaj, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Psychological Issues


Purpose of Review

The purpose of this paper is to review the current status of research on psychosocial concerns following bariatric surgery.

Recent Findings

Bariatric surgery has a positive overall impact on weight and obesity-related comorbidities, as well as a positive short-term impact on mental health and psychosocial functioning. Nonetheless, research has documented a number of different psychosocial concerns that may emerge following surgery including maladaptive eating, substance use disorders, suicide, lack of social support, and excess skin. Moreover, special populations of patients may have distinctive psychosocial concerns based on sociodemographic factors such as age or severity of obesity. Available studies suggest that psychosocial interventions have a positive impact on post-surgery outcomes, particularly maladaptive eating. However, research is limited, and long-term data are lacking.


Monitoring patients after bariatric surgery for negative psychosocial outcomes is warranted. Research is needed to develop and evaluate personalized approaches to optimize long-term weight loss and psychosocial adjustment.


Bariatric surgery Psychosocial factors Maladaptive eating Substance use Suicide Social support 


Compliance with Ethics Guidelines

Conflict of Interest

Melissa A. Kalarchian declares that she has no conflict of interest.

Marsha D. Marcus has received compensation from Weight Watchers International, Inc., for serving on Scientific Advisory Boards.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, et al. American Association of Clinical Endocrinologists and American College of endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract. 2016;22:1–203.CrossRefPubMedGoogle Scholar
  2. 2.
    American College of Cardiology. American Heart Association task force on practice guidelines, Obesity Expert Panel, 2013. Expert panel report: guidelines (2013) for the management of overweight and obesity in adults. Obesity (Silver Spring). 2014;22:S41–410.Google Scholar
  3. 3.
    Maggard-Gibbons M, Maglione ML. Masha, Ewing B, Ruelaz a, Hu J, Li Z, et al. Bariatric surgery for weight loss and glycemic control in nonmorbidly obese adults with diabetes: a systematic review. JAMA. 2013;309:2250–61.CrossRefPubMedGoogle Scholar
  4. 4.
    Dixon JB, Zimmet P, Alberti KG, Rubino F. International Diabetes Federation Taskforce on Epidemiology and Prevention. Bariatric surgery: an IDF statement for obese type 2 diabetes. Diabetic Med. 2011;28:628–42.CrossRefPubMedGoogle Scholar
  5. 5.
    Courcoulas AP, Belle SH, Neiberg RH, Pierson SK, Eagleton JK, Kalarchian MA, et al. Three year outcomes of bariatric surgery vs. lifestyle intervention for type 2 diabetes mellitus treatment: a randomized trial. JAMA Surg. 2015;150:931–40.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Maggard MA, Shugarman LR, Suttorp M, Maglione M, Sugarmen HJ, Livingston EH, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.CrossRefPubMedGoogle Scholar
  7. 7.
    Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–190.CrossRefPubMedGoogle Scholar
  9. 9.
    Puzziferri N, Roshek TB, Mayo HG, Gallagher R, Belle SH, Livingston EH. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312:934–42.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Courcoulas AP, King WC, Belle SH, Berk P, Flum DR, Garcia L, et al. Seven-year weight trajectories and health outcomes in the longitudinal assessment of bariatric surgery (LABS) study. JAMA Surg. 2018;153:427–34.CrossRefPubMedGoogle Scholar
  11. 11.
    O'Brien PE, MacDonald L, Anderson M, Brennan L, Brown WA. Long-term outcomes after bariatric surgery: fifteen-year follow-up of adjustable gastric banding and a systematic review of the bariatric surgical literature. Ann Surg. 2013;257:87–94.CrossRefPubMedGoogle Scholar
  12. 12.
    Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database of Syst Rev. 2014:CD003641.Google Scholar
  13. 13.
    Courcoulas AP, Christian NJ, Belle SH, Berk PD, Flum DR, Garcia L, et al. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310:2416–25.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23:1922–33.CrossRefPubMedGoogle Scholar
  15. 15.
    Beckman LM, Beckman TR, Earthman CP. Changes in gastrointestinal hormones and leptin after roux-en-Y gastric bypass procedure: a review. J Am Diet Assoc. 2010;110:571–84.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Coulman KD, MacKichan F, Blazeby JM, Owen-Smith A. Patient experiences of outcomes of bariatric surgery: a systematic review and qualitative synthesis. Obes Res. 2017;18:547–59.CrossRefGoogle Scholar
  17. 17.
    Lindekilde N, Gladstone BP, Lübeck M, Nielsen J, Clausen L, Vach W, et al. The impact of bariatric surgery on quality of life: a systematic review and meta-analysis. Obes Res. 2015;16:639–51.CrossRefGoogle Scholar
  18. 18.
    Adil MT, Jain V, Rashid F, Al-taan O, Whitelaw D, Jambulingam P. Meta-analysis of the effect of bariatric surgery on physical function. Br J Surg. 2018;105:1107–18.CrossRefPubMedGoogle Scholar
  19. 19.
    Sharples AJ, Cheruvu CVN. Systematic review and meta-analysis of occupational outcomes after bariatric surgery. Obes Surg. 2017;27:774–81.CrossRefPubMedGoogle Scholar
  20. 20.
    Sarwer DB, Steffen KJ. Quality of life, body image and sexual functioning in bariatric surgery patients. Eur Eat Disord Rev. 2015;23:504–8.CrossRefPubMedGoogle Scholar
  21. 21.
    • Ivezaj V, Grilo CM. The complexity of body image following bariatric surgery: a systematic review of the literature. Obes Res. 2018;19:1116–40 This comprehensive literature review of body image as a multidimensional construct documented that eating pathology is reated to greater body image dissatisfaction following surgery. Notably, however, most studies do not investigate concerns related to excess skin and body contouring surgery.CrossRefGoogle Scholar
  22. 22.
    • Kolotkin RL, Kim J, Davidson LE, Crosby RD, Hunt SC, Adams TD. 12-year trajectory of health-related quality of life in gastric bypass patients versus comparison groups. Surg Obes Relat Dis. 2018;14:1359–65 This prospective study evaluated changes in quality of life in bariatric surgery patients and 2 non-surgical comparsion groups. Improvements in weight-related and physical quality of life peaked at 2 years post-surgery, and remained improved relative to pre-surgery through 12 years following gastric bypass. CrossRefPubMedGoogle Scholar
  23. 23.
    White B, Doyle J, Colville S, Nicholls D, Viner RM, Christie D. Systematic review of psychological and social outcomes of adolescents undergoing bariatric surgery, and predictors of success. Clin Obes. 2015;5:312–24.CrossRefPubMedGoogle Scholar
  24. 24.
    Angrisani L, Santonicola A, Iovino P, Vitiello A, Zundel N, Buchwald H, et al. Bariatric surgery and endoluminal procedures: IFSO worldwide survey 2014. Obes Surg. 2017;27:2279–89.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Ettleson MD, Lager CJ, Kraftson AT, Esfandiari NH, Oral AE. Roux-en-Y gastric bypass versus sleeve gastrectomy: risks and benefits. Minerva Chir. 2017;72:505–19.PubMedGoogle Scholar
  26. 26.
    • Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, et al. Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA. 2016;315:150–63 Mental health conditions are common among bariatric surgery patients, but their relationship to weight loss is inconsistent as reported in the literature. However, moderate quality evidence supports an assocation between bariatric surgery and lower rates of depression post-surgery. CrossRefPubMedGoogle Scholar
  27. 27.
    Rosenberger PH, Henderson KE, Grilo CM. Psychiatric disorder comorbidity and association with eating disorders in bariatric surgery patients: a cross-sectional study using structured interview-based diagnosis. J Clin Psychiatry. 2006;67:1080–5.CrossRefPubMedGoogle Scholar
  28. 28.
    Mühlhans B, Horbach T, de Zwaan M. Psychiatric disorders in bariatric surgery candidates: a review of the literature and results of a German prebariatric surgery sample. Gen Hosp Psychiatry. 2009;31:414–21.CrossRefPubMedGoogle Scholar
  29. 29.
    Mitchell JE, Selzer F, Kalarchian MA, Devlin MJ, Strain GW, Elder KA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric Surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis. 2012;8:533–41.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Mauri M, Ruccic P, Calderone A, Santini F, Oppo A, Romano A, et al. Axis I and II disorders and quality of life in bariatric surgery candidates. J Clin Psychiatry. 2008;69:295–301.CrossRefPubMedGoogle Scholar
  31. 31.
    Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007;164:328–34.CrossRefPubMedGoogle Scholar
  32. 32.
    Faulconbridge LF, Bechtel CF. Depression and disordered eating in the obese person. Curr Obes Rep. 2014;3:127–36.CrossRefPubMedGoogle Scholar
  33. 33.
    Hudson JI, Hiripi E, Pope HG Jr, Kessler RC. The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 2007;61:348–58.CrossRefPubMedGoogle Scholar
  34. 34.
    Kalarchian MA, King WC, Devlin MJ, Marcus MD, Garcia L, Chen J-Y, et al. Psychiatric disorders and weight change in a prospective study of bariatric surgery patients: a 3-year follow-up. Psychosom Med. 2016;78:373–81.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Mitchell JE, King WC, Chen J-Y, Devlin MJ, Flum D, Garcia L, et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obesity. 2014;22:1799–806.CrossRefPubMedGoogle Scholar
  36. 36.
    Delvin MJ, King WC, Kalarchian MA, White GE, Marcus MD, Garcia L, et al. Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up. Int J Eat Disorder. 2016;49:1058–67.CrossRefGoogle Scholar
  37. 37.
    Meany G, Conceição E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev. 2014;22:87–91.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Beck N, Johannsen M, Støving R, Mehlsen M, Zachariae R. Do postoperative psychotherapeutic interventions and support groups influence weight loss following bariatric surgery? A systematic review and meta-analysis of randomized and nonrandomized trials. Obes Surg. 2012;22:1790–7.CrossRefPubMedGoogle Scholar
  39. 39.
    Conceição EM, Mitchell JE, Engel SG, Machado PPP, Lancaster K, Wonderlich SA. What is “grazing”? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition. Surg Obes Relat Dis. 2014;10:973–82.CrossRefPubMedGoogle Scholar
  40. 40.
    Pizato N, Botelho PB, Gonçalves VSS, Dutra ES, de Carvalho KMB. Effect of grazing behavior on weight regain post-bariatric surgery: a systematic review. Nutrients. 2017;9:1322.CrossRefPubMedCentralGoogle Scholar
  41. 41.
    • Li L, Wu L-T. Substance use after bariatric surgery: a review. J Psychiatr Res. 2016;76:16–29 This review of substance use following surgery (alcohol, tobacco, and illicit or non-medical drugs) doucumented that a considerable proportion of patients use substances post-surgery. Although results from prospective studies are limited, individuals with a history of substance use may be at risk for post-surgery use, which has been assocaited with medical complications and psychological problems. CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    King WC, Chen J-Y, Courcoulas AP, Dakin GF, Engel SG, Flum DR, et al. Alcohol and other substance use after bariatric surgery: prospective evidence from a U.S. multicenter cohort study. Surg Obes Relat Dis. 2017;13:1392–402.CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Steffen KJ, Engel SG, Wonderlich JA, Pollert GA, Sondag C. Alcohol and other addictive disorders following bariatric surgery: prevalence, risk factors and possible etiologies. Eur Eat Disord Rev. 2015;23:442–50.CrossRefPubMedGoogle Scholar
  44. 44.
    Spadola CE, Wagner EF, Dillon FR, Trepka MJ, de La Cruz Munoz N, Messiah SE. Alcohol and drug use among post-operative bariatric patients: a systematic review of the emerging research and its implications. Alcohol Clin Exp Res. 2015;39:1582–601.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    McPhee J, Freidl EK, Eicher J, Zitsman JL, Devlin MJ, Hildebrandt T, et al. Suicidal ideation and behaviors among adolescents receiving bariatric surgery: a case-control study. Eur Eat Disord Rev. 2015;23:517–23.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    • Castaneda D, Popov VB, Wander P, Thompson CC. Risk of suicide and self-harm is increased after bariatric surgery—a systematic review and meta-analysis. Obes Surg. 2019;29(1):322–33 This review found that risk for self-harm/suicide attempt is higher among bariatric surgery patients compared to age-, sex-, and BMI-matched controls. The authors highlight the pre- and post-surgery psychosocial, pharmacokinetic, physiologic, and medical factors that may be involved. Google Scholar
  47. 47.
    Bhatti JA, Nathens AB, Thiruchelvam D, Grantcharov T, Goldstein BI, Redelmeier DA. Self-harm emergencies after bariatric surgery: a poplulaiton-based cohort study. JAMA Surg. 2016;151:226–32.CrossRefPubMedGoogle Scholar
  48. 48.
    Neovius M, Bruze G, Jacobson P, Sjöholm K, Johansson K, Granath F, et al. Risk of suicide and non-fatal self-harm after bariatric surgery: results from two matched cohort studies. Lancet Diabetes Endocrinol. 2018;6:197–207.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Mitchell JE, Crosby R, de Zwaan M, Engel S, Roerig J, Steffen K, et al. Possible risk factors for increased suicide following bariatric surgery. Obesity (Silver Spring, MD). 2013;21:665–72.CrossRefGoogle Scholar
  50. 50.
    Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. Obes Res. 2011;12:142–8.CrossRefGoogle Scholar
  51. 51.
    Lent MR, Bailey-Davis L, Irving BA, Wood GC, Cook AM, Hirsch AG, et al. Bariatric surgery patients and their families: health, physical activity, and social support. Obes Surg. 2016;26:2981–8.CrossRefPubMedPubMedCentralGoogle Scholar
  52. 52.
    Wallwork A, Tremblay L, Chi M, Sockalingam S. Exploring partners’ experiences in living with patients who undergo bariatric surgery. Obes Surg. 2017;27:1973–81.CrossRefPubMedGoogle Scholar
  53. 53.
    Pories ML, Hodgson J, Rose MA, Pender J, Sira N, Swanson M. Following bariatric surgery: an exploration of the couples’ experience. Obes Surg. 2016;26:54–60.CrossRefPubMedGoogle Scholar
  54. 54.
    Ferriby M, Pratt KJ, Balk E, Feister K, Noria S, Needleman B. Marriage and weight loss surgery: a narrative review of patient and spousal outcomes. Obes Surg. 2015;25:2436–42.CrossRefPubMedGoogle Scholar
  55. 55.
    • Bruze G, Holmin TE, Peltonen M, Ottosson J, Sjöholm K, Näslund I, et al. Associations of bariatric surgery with changes in interpersonal relationship status: results from 2 Swedish cohort studies. JAMA Surg. 2018;153:654–61 In two large Swedish cohorts with long-term follow-up, baritric surgery was associated with changes in relationship status. Specifically, surgery was associed with increased incidence of divorce/separation for those who were married, as well as increased incidence of marriage and new relationships for those who were single. CrossRefPubMedPubMedCentralGoogle Scholar
  56. 56.
    Wedin S, Madan A, Correll J, Crowley N, Malcolm R, Karl Byrne T, et al. Emotional eating, marital status and history of physical abuse predict 2-year weight loss in weight loss surgery patients. Eat Behav. 2014;15:619–24.CrossRefPubMedGoogle Scholar
  57. 57.
    Mehta A, Hutfless S, Blair AB, Karcher M, Nasatka S, Schweitzer M, et al. Outcomes of partnered individuals undergoing bariatric surgery together: a single institution case series. Obes Surg. 2017;27:2207–10.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    • Baillot A, Brais-Dussault E, Bastin A, Cyr C, Brunet J, Aimé A, et al. What is known about the correlates and impact of excess skin after bariatric surgery: a scoping review. Obes Surg. 2017;27:2488–98 Women report more excess skin and greater inconveniences related to excess skin than men following surgery. Although excess skin may adversely impact physical and psychosocial functionig, as well as activites of daily living, it has not been possible to determine which individuals are at risk. CrossRefPubMedGoogle Scholar
  59. 59.
    Ramalho S, Bastos AP, Silva C, Vaz AR, Brandão I, Machado PPP, et al. Excessive skin and sexual function: relationship with psychological variables and weight regain in women after bariatric surgery. Obes Surg. 2015;25:1149–54.CrossRefPubMedGoogle Scholar
  60. 60.
    Gilmartin J, Bath-Hextall F, Maclean J, Stanton W, Soldin M. Quality of life among adults following bariatric and body contouring surgery: a systematic review. JBI Database System Rev Implement Rep. 2016;14:240–70.CrossRefPubMedGoogle Scholar
  61. 61.
    Azin A, Zhou C, Jackson T, Cassin S, Sockalingam S, Hawa R. Body contouring surgery after bariatric surgery: a study of cost as a barrier and impact on psychological well-being. Plast Reconstr Surg. 2014;133:776e–82e.CrossRefPubMedGoogle Scholar
  62. 62.
    Childerhose JE, Alsamawi A, Mehta T, Smith JE, Woolford S, Tarini BA. Adolescent bariatric surgery: a systematic review of recommendation documents. Surg Obes Relat Dis. 2017;13:1768–79.CrossRefPubMedGoogle Scholar
  63. 63.
    Shoar S, Mahmoudzadeh H, Naderan M, Bagheri-Hariri S, Wong C, Parizi AS, et al. Long-term outcome of bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis of 950 patients with a minimum of 3 years follow-up. Obes Surg. 2017;27:3110–7.CrossRefPubMedGoogle Scholar
  64. 64.
    Paulus GF, de Vaan LEG, Verdam FJ, Bouvy ND, Ambergen TAW, van Heurn LWE. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015;25:860–78.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Giordano S, Victorzon M. Bariatric surgery in elderly patients: a systematic review. Clin Interv Aging. 2015;10:1627–35.PubMedPubMedCentralGoogle Scholar
  66. 66.
    Caceres BA. Policy implications of a literature review of bariatric surgery in older adults. J Gerontol Nurs. 2014;40:14–9.CrossRefPubMedGoogle Scholar
  67. 67.
    Han TS, Wu FCW, Lean MEJ. Obesity and weight management in the elderly: a focus on men. Best Pract Res Clin Endocrinol Metab. 2013;27:509–25.CrossRefPubMedGoogle Scholar
  68. 68.
    Anda RF, Felitti VJ, Bremner JD, Walker JD, Whitfield C, Perry BD, et al. The enduring effects of abuse and related adverse experiences in childhood: a convergence of evidence from neurobiology and epidemiology. Eur Arch Psychiatry Clin Neurosci. 2006;256:174–86.CrossRefPubMedGoogle Scholar
  69. 69.
    Alciati A, Gesuele F, Rizzi A, Sarzi-Puttini P, Foschi D. Childhood parental loss and bipolar spectrum in obese bariatric surgery candidates. Int J Psychiatry Med. 2011;41:155–71.CrossRefPubMedGoogle Scholar
  70. 70.
    Wildes JE, Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP. Childhood maltreatment and psychiatric morbidity in bariatric surgery candidates. Obes Surg. 2008;18:306–13.CrossRefPubMedPubMedCentralGoogle Scholar
  71. 71.
    Lodhia NA, Rosas US, Moore M, Glaseroff A, Azagury D, Rivas H, et al. Do adverse childhood experiences affect surgical weight loss outcomes? J Gastrointest Surg. 2015;19:993–8.CrossRefPubMedGoogle Scholar
  72. 72.
    Hulme PA, McBride CL, Kupzyk KA, French JA. Pilot study on childhood sexual abuse, diurnal cortisol secretion, and weight loss in bariatric surgery patients. J Child Sex Abuse. 2015;24:385–400.CrossRefGoogle Scholar
  73. 73.
    Holgerson AA, Clark MM, Ames GE, Collazo-Clavell ML, Kellogg TA, Graszer KM, et al. Association of adverse childhood experiences and food addiction to bariatric surgery completion and weight loss outcome. Obes Surg. 2018;28:3386–92.CrossRefPubMedGoogle Scholar
  74. 74.
    Peterson K, Anderson J, Boundy E, Ferguson L, Erickson K. Rapid evidence review of bariatric surgery in super obesity (BMI ≥ 50 kg/m(2)). J Gen Intern Med. 2017;32:56–64.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Daigle CR, Andalib A, Corcelles R, Cetin D, Schauer PR, Brethauer SA. Bariatric and metabolic outcomes in the super-obese elderly. Surg Obes Relat Dis. 2016;12:132–7.CrossRefPubMedGoogle Scholar
  76. 76.
    Hennings DL, Baimas-George M, Al-Quarayshi Z, Moore R, Kandil E, DuCoin CG. The inequity of bariatric surgery: publicly insured patients undergo lower rates of bariatric surgery with worse outcomes. Obes Surg. 2018;28:44–51.CrossRefPubMedGoogle Scholar
  77. 77.
    • Takemoto E, Andrea SB, Wolfe BM, Nagel CL, Boone-Heinonen J. Weighing in on bariatric surgery: effectiveness among Medicaid beneficiaries—limited evidence and future research needs. Obesity. 2018;26:463–73 This systematic review documented that patients with Medicaid experience weight loss similar to patients with commercial insurance through 2-years post-surgery. However, future research is needed to understand baseline differences in health between the groups, as well as how they contribute to higher short-term health care utilization and mortaility among Medicaid beneficiaries. CrossRefPubMedGoogle Scholar
  78. 78.
    Johnson LP, Asigbee FM, Crowell R, Negrini A. Pre-surgical, surgical and post-surgical experiences of weight loss surgery patients: a closer look at social determinants of health. Clin Obes. 2018;8:265–74.CrossRefPubMedPubMedCentralGoogle Scholar
  79. 79.
    Snyder AG. Psychological assessment of the patient undergoing bariatric surgery. Ochsner J. 2009;9:144–8.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Kouidrat Y, Amad A, Stubbs B, Moore S, Gaughran F. Surgical management of obesity among people with schizophrenia and bipolar disorder: a systematic review of outcomes and recommendations for future research. Obes Surg. 2017;27:1889–95.CrossRefPubMedGoogle Scholar
  81. 81.
    Cazzo E. M.A. G, Utrini MP, Chaim FDM, Cândido EC, Jarolavsky LBDS, et al. bariatric surgery in individuals with severe cognitive impairment: report of two cases. Sao Paulo Med J. 2018;136:84–8.CrossRefPubMedGoogle Scholar
  82. 82.
    Hamad GG, Helsel JC, Perel JM, Kozak GM, McShea MC, Hughes C, et al. The effect of gastric bypass on the pharmacokinetics of serotonin reuptake inhibitors. Am J Psychiatry. 2012;169:256–63.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Elliott JP, Gray EL, Yu J, Kalarchian MA. Medication use among patients prior to bariatric surgery. Bariatr Surg Pract Patient Care. 2015;10:105–9.CrossRefPubMedPubMedCentralGoogle Scholar
  84. 84.
    Arterburn DE, Olsen MK, Smith VA, Livingston EH, Van Scoyoc L, Yancy WS, et al. Association between bariatric surgery and long-term survival. JAMA. 2015;313:62–70.CrossRefPubMedGoogle Scholar
  85. 85.
    Strong J, Ray K, Findley PA, Torres R, Pickett L, Byrne RJ. Psychosocial concerns of veterans of Operation Enduring Freedom/Operation Iraqi Freedom. Health Soc Work. 2014;39:17–24.Google Scholar
  86. 86.
    Gibbons MM, Maher AR, Dawes AJ, Booth MS, Miake-Lye IM, Beroes JM, et al. Mental health assessment and psychosocial interventions for bariatric surgery [Internet]. Washington (DC): Department of Veterans Affairs (US); 2014. VA Evidence-based Synthesis Program ReportsGoogle Scholar
  87. 87.
    Rutledge T, Braden AL, Woods G, Herbst KL, Groesz LM, Savu M. Five-year changes in psychiatric treatment status and weight-related comorbidities following bariatric surgery in a veteran population. Obes Surg. 2012;22:1734–41.CrossRefPubMedGoogle Scholar
  88. 88.
    • Funk LM, Gunnar W, Dominitz JA, Eisenberg D, Frayne S, Maggard-Gibbons M, et al. A health services research agenda for bariatric surgery within the Veterans Health Administration. J Gen Intern Med. 2017;32:65–9 The Veterans Health Adminstration held a conference to develop a research agenda for population-based weight management for veterans. Priority evidence gaps identified by the bariatric surgery work group included (but were not limited to) long-term impact on mental health and substance abuse, as well as health services interventions to optimize outcomes. CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Leahey TM, Crowther JH, Irwin SR. A cognitive-behavioral mindfulness group therapy intervention for the treatment of binge eating in bariatric surgery patients. Cogn Behav Pract. 2008;15:364–75.CrossRefGoogle Scholar
  90. 90.
    Weineland S, Arvidsson D, Kakoulidis TP, Dahl J. Acceptance and commitment therapy for bariatric surgery patients, a pilot RCT. Obes Res Clin Pract. 2012;6:e21–30.CrossRefGoogle Scholar
  91. 91.
    Bradley LE, Forman EM, Kerrigan SG, Butryn ML, Herbert JD, Sarwer DB. A pilot study of an acceptance-based behavioral intervention for weight regain after bariatric surgery. Obes Surg. 2016;26:2433–41.CrossRefPubMedGoogle Scholar
  92. 92.
    Bradley LE, Forman EM, Kerrigan SG, Goldstein SP, Butryn ML, Thomas JG, et al. Project HELP: a remotely delivered behavioral intervention for weight regain after bariatric surgery. Obes Surg. 2017;27:586–98.CrossRefPubMedGoogle Scholar
  93. 93.
    Himes SM, Grothe KB, Clark MM, Swain JM, Collazo-Clavell ML, Sarr MG. Stop regain: a pilot psychological intervention for bariatric patients experiencing weight regain. Obes Surg. 2015;25:922–7.CrossRefPubMedGoogle Scholar
  94. 94.
    Bradley LE, Thomas JG, Hood MM, Corsica JA, Kelly MC, Sarwer DB. Remote assessments and behavioral interventions in post-bariatric surgery patients. Surg Obes Relat Dis. 2018;14:1632–44.CrossRefPubMedGoogle Scholar
  95. 95.
    Sockalingam S, Cassin SE, Wnuk S, Du C, Jackson T, Hawa R, et al. A pilot study on telephone cognitive behavioral therapy for patients six-months post-bariatric surgery. Obes Surg. 2017;27:670–5.CrossRefPubMedPubMedCentralGoogle Scholar
  96. 96.
    Conceição EM, Machado PPP, Vaz AR, Pinto-Bastos A, Ramalho S, Silva C, et al. APOLO-Bari, an internet-based program for longitudinal support of bariatric surgery patients: study protocol for a randomized controlled trial. Trials. 2016;17:114.CrossRefPubMedPubMedCentralGoogle Scholar
  97. 97.
    Kalarchian MA, Marcus MD. The case for stepped care for weight management after bariatric surgery. Surg Obes Relat Dis. 2018;14:112–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  1. 1.School of NursingDuquesne University School of NursingPittsburghUSA
  2. 2.Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghUSA

Personalised recommendations