Q & A: Bariatric Surgery and Psychiatric Problems?

Q: An increasing number of patients are seeking bariatric surgery these days. Is information available on how many of these patients have psychiatric problems in general and eating disorders in particular? (D.E., Philadelphia)

A: The most recent large-scale study suggests that psychiatric disorders and eating disorders per se are not uncommon among patients seeking bariatric surgery. In a study by Rosenberger and colleagues of 174 patients who were consecutively evaluated at Yale by means of the SCID (Structured Clinical interview for DSM-IV), 24% had a current psychiatric disorder and 10.3% had a current eating disorder (the ratio was roughly 2:1 eating disorders not otherwise specified, or EDNOS, over binge eating disorder, or BED). Lifetime rates of psychiatric co-morbidity were even higher: 36.8% and 13.8%, respectively. Of those who had eating disorders, 66.7% had some sort of psychiatric comorbidities, most often anxiety disorders (J Clin Psychiatry 2006; 67:1080). The take-home lesson for clinicians working with patients seeking bariatric surgery is that a good assessment for psychiatric disorders is indicated, and that monitoring these patients for psychiatric and eating disorder symptoms following surgery may improve long-term recovery.

— J.Y.