Kubik Jeremy F, Gill Richdeep S, Laffin Michael, Karmali Shahzeer
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T5H 3V9, Canada.
J Obes. 2013;2013:837989. doi: 10.1155/2013/837989. Epub 2013 Mar 28.
Obesity is associated with a relatively high prevalence of psychopathological conditions, which may have a significant negative impact on the quality of life. Bariatric surgery is an effective intervention in the morbidly obese to achieve marked weight loss and improve physical comorbidities, yet its impact on psychological health has yet to be determined. A review of the literature identified a trend suggesting improvements in psychological health after bariatric surgery. Majority of mental health gain is likely attributed to weight loss and resultant gains in body image, self-esteem, and self-concept; however, other important factors contributing to postoperative mental health include a patient's sense of taking control of his/her life and support from health care staff. Preoperative psychological health also plays an important role. In addition, the literature suggests similar benefit in the obese pediatric population. However, not all patients report psychological benefits after bariatric surgery. Some patients continue to struggle with weight loss, maintenance and regain, and resulting body image dissatisfaction. Severe preoperative psychopathology and patient expectation that life will dramatically change after surgery can also negatively impact psychological health after surgery. The health care team must address these issues in the perioperative period to maximize mental health gains after surgery.
肥胖与精神病理状况的相对高患病率相关，这可能对生活质量产生重大负面影响。减肥手术是对病态肥胖者进行的有效干预措施，可实现显著的体重减轻并改善身体合并症，但其对心理健康的影响尚未确定。对文献的回顾发现了一种趋势，表明减肥手术后心理健康有所改善。心理健康的改善大部分可能归因于体重减轻以及随之而来的身体形象、自尊和自我概念的改善；然而，术后心理健康的其他重要因素包括患者对自己生活的掌控感以及医护人员的支持。术前心理健康也起着重要作用。此外，文献表明肥胖儿童人群也有类似的益处。然而，并非所有患者在减肥手术后都能获得心理益处。一些患者在体重减轻、维持体重和体重反弹以及由此产生的身体形象不满方面仍存在困难。术前严重的精神病理学以及患者对手术后生活将发生巨大变化的期望也可能对术后心理健康产生负面影响。医疗团队必须在围手术期解决这些问题，以最大限度地提高术后的心理健康水平。
