Michele Amundson, FNP-BC, RNFA
Obesity is a significant risk factor for comorbid conditions including hypertension, dyslipidemia, stroke and heart attack and certain types of cancers. It is associated with overall increased mortality and a decrease in lifespan. The benefits of bariatric surgery include weight loss which improves high blood pressure, high cholesterol and triglycerides, diabetes, heart disease, respiratory illness such as sleep apnea and asthma, gastroesophageal reflux disease, degenerative joint disease, gout, stress urinary incontinence, polycystic ovarian syndrome, venous stasis disease, and migraine headaches. No other medical or surgical intervention simultaneously treats as many disease processes as bariatric surgery does. Bariatric surgery benefits are far beyond the visible results.
After surgery many chronic illnesses improve. After dieting, patients initially see promising results within the first few months of a weight loss program. We see this as patients are able to discontinue their previously required medications. We understand how surgery goes beyond weight loss. Studies have proven reduced mortality from morbid obesity after bariatric surgery.
Obesity is associated with a high prevalence of psychopathological conditions which have a negative impact on the quality of life. Similar to obesity related complications, psychological health appears to worsen with the increasing severity of obesity. The deterioration of psychological health in the obese can also be attributed to cardiovascular disease and type 2 diabetes.
Bariatric surgery is effective in achieving significant weight loss and therefore improving physical comorbidities, but its impact on psychological health has yet to be adequately scientifically proven. A high prevalence of psychological comorbidities exists in obese patients, particularly anxiety, depression and low self esteem. Body image dissatisfaction is related to depression. This is particularly true in women due to society’s emphasis on the female body. Obese patients are also subjected to prejudice and discrimination, which is likely to cause or aggravate depression.
Research suggests improvement in psychological health. Bariatric surgery patients consistently report a decrease in depression and anxiety, improved self esteem and a higher quality of life. The impact on psychological health is often overshadowed by the significant improvement in physical comorbidities. Postoperative psychological health is influenced by the patient’s sense of taking control of their life by taking an active role in changing their life. Patients understand that bariatric surgery is not a quick fix. They learn that it is a very powerful tool that can produce a significant amount of weight loss, resolve comorbid conditions and prolong life.
Repeated failed attempts to lose weight are likely to aggravate depression, hopelessness and poor self esteem and perhaps contribute to further weight gain. The majority of dieters regain most of their weight loss. Bariatric surgery produces a weight loss that patients are able to maintain over time.
As patients lose weight they gain a positive perception of “self” which includes self esteem, self confidence, positive body image, and a sense of attractiveness and assertiveness. Patients experience a better quality of life as they feel accepted by today’s society. Bariatric surgery offers hope.