Tuesday, March 13, 2007

Mental Health and WLS

I've been open about my diagnosis of Bipolar disorder. It is just a part of me. I do not define myself by it. I've also had WLS. Here again it is just a part of me. But the question is do the 2 things have anything in common.
Part of the pre-op course prior to being approved for WLS, you must undergo a psychological exam. The reasoning behind this is find out if you will be able to handle all the changes that will come about after losing so much weight in a relatively short period of time. Also they want to determine if you will be able to stick with the restrictions put on you post op.
WLS brings about a lifetime of change. Some adjust to it some don't.
I found this article recently in the American Journal of Psychiatry, Psychiatric Disorders Among Bariatric Surgery Candidates: Relationship to Obesity and Functional Health Status.
Approximately 66% of the participants had a lifetime history of at least one axis I disorder, and 38% met diagnostic criteria at the time of preoperative evaluation. In addition, 29% met criteria for one or more axis II disorders.

The therapist I see has numerous clients who have undergone WLS. So for me this raises the question of which came first--the mental illmess or the obesity. Did the obesity bring about the mental illness. Or is the obesity the result of a mental illness. Or could it be both.
An article from Reuters Health that I found on Medscape went into a little further detail

Overall, 66.3% of subjects had a lifetime history of at least one axis I disorder and 37.8% were currently diagnosed with such a disorder. The most common lifetime axis I disorder was major depressive disorder, seen in 42% of subjects. Binge eating disorder was the most common current disorder and had a prevalence of 16.0%.

A lifetime history of an axis II disorder was noted in 28.5% of subjects, the most common being avoidant personality disorder, which was seen in 17.0%.

There is alot of research dealing with this to be found online. One such study--Psychosocial and Behavioral Aspects of Bariatric Surgery goes into a lot of detail--even stating that some see improvement in their mental illness post op.

With more and more people looking to have WLS--there needs to be more followup post op. As it stands right now---after the first year post op most patients are typically on their own.

I would love to hear from any one who has had WLS and is willing to share their experience.


Anonymous said...

The WLS provides an opportunity to study the life course, intergenerational transfers and relationships and family functioning. Living life after having WLS is difficult enough on your mental health.The rapid weight loss phase can trigger depression without a mental illness.

Dual Diagnosis
Dual Diagnosis