Psychiatrische stoornis beïnvloedt het effect van bariatrische chirurgie niet

Objective

To review the literature on the predictive value of psychiatric comorbidity for weight loss following bariatric surgery in patients with morbid obesity.

Design

Systematic review.

Method

PubMed databases were searched for literature comparing weight loss following bariatric surgery in morbidly obese patients with and without preoperative psychiatric symptoms. General psychiatric disorders were distinguished from eating disorders.

Results

The search yielded 204 references, 6 of which complied with inclusion criteria. 2 studies were retrospective (169 patients in total; the other 4 were prospective (1140 patients in total). The average follow-up period varied between 12 and 60 months. In 2 studies (n = 528 patients), the influence of eating disorders on the outcome of bariatric surgery was specifically studied. The quality of the studies was low. Psychiatric disorders and eating disorders did not influencethe outcome of bariatric surgery. In 1 study, weight loss was less after surgery in patients diagnosed with more than 2 psychiatric disorders.

Conclusion

In 5 of the 6 studies, psychiatric comorbidity was not related to the weight loss following bariatric surgery. In view of the differences in design and the poor quality of the studies, definite conclusions cannot be drawn. There is no indication that routine psychiatric screening should form part of the work-up for bariatric surgery. We advise that note should be taken of the psychiatric history and any current psychiatric treatment.

Conflict of interest: none declared. Financial support: none declared.