Department of Internal Medicine, University of Missouri School of Medicine, Columbia, MO 65212, USA.
Obes Surg. 2011 Sep;21(9):1323-9. doi: 10.1007/s11695-011-0373-6.
Bariatric surgery is the most effective obesity treatment in terms of weight loss and resolution of comorbidities. Roux-en-Y bypass surgery achieves weight loss of 60% to 70% excess body weight in most morbidly obese individuals. Patients with psychological disorders are reported to have less optimal results and those with bipolar, possibly worse.
A retrospective survey of Roux-en-Y bypass bariatric surgery patient clinical records to assess weight loss outcomes for morbidly obese patients, including those with bipolar disorders, other psychiatric conditions, and those without psychiatric diagnoses, was conducted.
For all three study subgroups, the baseline mean weight exceeded 300 lbs, and mean BMI was 50. At 6 months, mean values for weight, percent weight loss, BMI, and percent change in BMI for all three groups were not significantly different. At 1 year, overall mean weight was less than 200 lbs, percent weight loss exceeded 35%, and mean BMI was 32. These outcomes were remarkably similar and not significantly different for those with bipolar disorder, other psychological conditions, and those without. The percent reaching follow-up at 12 months also did not differ between the three psychiatric status subgroups.
In patients who undergo Roux-en-Y gastric bypass surgery, those with bipolar disorder have successful weight loss outcomes at 12 months that are not significantly different than those who have other psychiatric diagnoses and those with no psychiatric disorder. Despite practices that suggest the contrary, well-managed morbidly obese bipolar patients should be considered as suitable candidates for bariatric surgery using established criteria for risk assessment.
就减重和并发症解决而言，减重手术是最有效的肥胖治疗方法。Roux-en-Y 旁路手术使大多数病态肥胖个体的体重减轻 60%至 70%的超重体重。有报道称，有心理障碍的患者结果不太理想，而双相情感障碍患者可能更差。
对 Roux-en-Y 旁路减重手术患者的临床记录进行回顾性调查，以评估病态肥胖患者（包括双相情感障碍、其他精神疾病和无精神疾病诊断的患者）的减重结果。
所有三组研究亚组的基线平均体重均超过 300 磅，平均 BMI 为 50。6 个月时，三组的体重平均值、体重减轻百分比、BMI 和 BMI 变化百分比均无显著差异。1 年后，总体平均体重低于 200 磅，体重减轻百分比超过 35%，平均 BMI 为 32。这些结果对于双相情感障碍、其他心理疾病和无心理疾病的患者非常相似，没有显著差异。三组精神状态亚组在 12 个月时的随访比例也没有差异。
在接受 Roux-en-Y 胃旁路手术的患者中，双相情感障碍患者在 12 个月时的减重效果显著，与其他精神诊断和无精神疾病的患者没有显著差异。尽管有实践表明相反，但经过良好管理的病态肥胖双相情感障碍患者应被视为符合既定风险评估标准的减重手术的合适候选者。
