Psychological assessment and management of the weight loss surgery patient
Abstract
Psychological evaluation of the weight loss surgery patient is recommended because of the prevalence of psychiatric comorbidities in persons with severe obesity and the behavioral adaptations required for successful surgical outcomes. Although there is currently no national standard for the specific components of these evaluations, there is general agreement in the literature about the objectives and the kinds of assessment methods that are most useful. This paper summarizes the current literature on psychological evaluation of weight loss surgery patients. Methods of assessment relevant to the major behavioral health characteristics of surgical candidates are reviewed, and results from several studies examining weight loss and quality of life outcomes in relation to pre-surgery psychological characteristics are discussed.
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In bariatric patients, emotional eating has been reported as an important contributor to weight gain and a risk factor for poor post-surgical outcomes.
“Among bariatric patients, emotional eating has been reported as an important factor contributing to weight gain25 and a risk factor for poor post-surgical outcomes.26”
From A Mindfulness-Based Intervention to Control Weight After Bariatric Surgery: Preliminary Results From a Randomized Controlled Pilot Trial (2016) · cites this paper as [26]
Cites
(1970) · Cited by 24,983 · see citing works
Bariatric Surgery: A Systematic Review and Meta-analysis
Buchwald, H., Avidor, Y., Braunwald, E., Jensen, M. D., Pories, W., Fahrbach, K., & Schoelles, K. (2004) · JAMA · doi:10.1001/jama.292.14.1724 · Cited by 6,800 · see citing works
The Eating Attitudes Test: psychometric features and clinical correlates
Garner, D. M., Olmsted, M., Bohr, Y., & Garfinkel, P. (1982) · Psychological Medicine · doi:10.1017/s0033291700049163 · Cited by 4,902 · see citing works
The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger
Stunkard, A. J., & Messick, S. (1985) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(85)90010-8 · Cited by 4,687 · see citing works
(1998) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.4.899 · Cited by 2,705 · see citing works
Gastrointestinal Surgery for Severe Obesity
Panel, C. D. C. (1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-115-12-956 · Cited by 2,163 · see citing works
The assessment of binge eating severity among obese persons
Gormally, J., Black, S., Daston, S., & Rardin, D. (1982) · Addictive Behaviors · doi:10.1016/0306-4603(82)90024-7 · Cited by 2,129 · see citing works
(1998) · PubMed · Cited by 1,264 · see citing works
Development and validation of the sociocultural attitudes towards appearance questionnaire
Heinberg, L. J., Thompson, J. K., & Stormer, S. M. (1995) · International Journal of Eating Disorders · doi:10.1002/1098-108x(199501)17:1 · Cited by 946 · see citing works
Karlsson, J., Sjöström, L., & Sullivan, M. (1998) · International Journal of Obesity · doi:10.1038/sj.ijo.0800553 · Cited by 518 · see citing works
Psychosocial and Behavioral Aspects of Bariatric Surgery
Sarwer, D. B., Wadden, T. A., & Fabricatore, A. N. (2005) · Obesity Research · doi:10.1038/oby.2005.71 · Cited by 444 · see citing works
Nonsurgical Factors That Influence the Outcome of Bariatric Surgery: A Review
Hsu, L. K. G., Benotti, P. N., Dwyer, J., Roberts, S. B., Saltzman, E., Shikora, S., Rolls, B. J., & Rand, W. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199805000-00021 · Cited by 440 · see citing works
Prochaska, J. O., Norcross, J. C., Fowler, J. L., Follick, M. J., & Abrams, D. B. (1992) · Addictive Behaviors · doi:10.1016/0306-4603(92)90051-v · Cited by 406 · see citing works
The Distribution of Body Mass Index Among Individuals With and Without Schizophrenia
Allison, D. B., Fontaine, K. R., Heo, M., Mentore, J. L., Cappelleri, J. C., Chandler, L. P., Weiden, P. J., & Cheskin, L. J. (1999) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v60n0402 · Cited by 390 · see citing works
Herpertz, S., Kielmann, R., Wolf, A. M., Hebebrand, J., & Senf, W. (2004) · Obesity Research · doi:10.1038/oby.2004.195 · Cited by 362 · see citing works
Prevalence of mental disorder in 88 morbidly obese bariatric clinic patients
Black, D. W., Goldstein, R. B., & Mason, E. E. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.2.227 · Cited by 281 · see citing works
FELITTI, V. J. (1993) · Southern Medical Journal · doi:10.1097/00007611-199307000-00002 · Cited by 219 · see citing works
PSYCHOSOCIAL ASPECTS OF OBESITY AND OBESITY SURGERY
Wadden, T. A., Sarwer, D. B., Womble, L. G., Foster, G. D., McGuckin, B. G., & Schimmel, A. (2001) · Surgical Clinics of North America · doi:10.1016/s0039-6109(05)70181-x · Cited by 210 · see citing works
Balsiger, B. M., Kennedy, F. P., Abu-Lebdeh, H. S., Collazo–Clavell, M. L., Jensen, M. D., O’Brien, T., Hensrud, D. D., Dinneen, S. F., Thompson, G. B., Que, F. G., et al. (2000) · Mayo Clinic Proceedings · doi:10.4065/75.7.673 · Cited by 160 · see citing works
Long-term studies of mental health after the greenville gastric bypass operation for morbid obesity
Waters, G. S., Pories, W. J., Swanson, M. S., MEELHEIM, H. D., Flickinger, E. G., & May, H. J. (1991) · The American Journal of Surgery · doi:10.1016/0002-9610(91)90377-p · Cited by 153 · see citing works
Psychosocial Factors and 2-Year Outcome Following Bariatric Surgery for Weight Loss
Clark, M. M., Balsiger, B. M., Sletten, C. D., Dahlman, K. L., Ames, G. E., Williams, D. E., Abu-Lebdeh, H. S., & Sarr, M. G. (2003) · Obesity Surgery · doi:10.1381/096089203322509318 · Cited by 133 · see citing works
The validity of the DSM-IV scheme for classifying bulimic eating disorders
Hay, P., & Fairburn, C. G. (1998) · International Journal of Eating Disorders · doi:10.1002/(sici)1098-108x(199801)23:1 · Cited by 125 · see citing works
Behavioral and Psychological Factors in the Assessment and Treatment of Obesity Surgery Patients
Greenberg, I., Perna, F. M., Kaplan, M., & Sullivan, M. A. (2005) · Obesity Research · doi:10.1038/oby.2005.33 · Cited by 121 · see citing works
Gastric Bypass in a Low‐Income, Inner‐City Population: Eating Disturbances and Weight Loss
Latner, J. D., Wetzler, S. E., Goodman, E. R., & Glinski, J. (2004) · Obesity Research · doi:10.1038/oby.2004.117 · Cited by 118 · see citing works
Psychiatric diagnosis of morbidly obese gastric bypass patients
Halmi, K. A., Long, M., Stunkard, A. J., & Mason, E. E. (1980) · American Journal of Psychiatry · doi:10.1176/ajp.137.4.470 · Cited by 115 · see citing works
Great Expectations: "I'm Losing 25% of My Weight No Matter What You Say".
Wadden, T. A., Womble, L. G., Sarwer, D. B., Berkowitz, R. I., Clark, V. L., & Foster, G. D. (2003) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.71.6.1084 · Cited by 98 · see citing works
Reduction in Psychopathology following Bariatric Surgery for Morbid Obesity
Maddi, S. R., Fox, S. R., Harvey, R. H., Lu, J. L., Khoshaba, D. M., & Persico, M. (2001) · Obesity Surgery · doi:10.1381/09608920160558605 · Cited by 89 · see citing works
Sogg, S., & Mori, D. L. (2004) · Obesity Surgery · doi:10.1381/096089204322917909 · Cited by 86 · see citing works
History of sexual abuse and obesity treatment outcome
King, T. K., Clark, M. M., & Pera, V. (1996) · Addictive Behaviors · doi:10.1016/0306-4603(95)00058-5 · Cited by 85 · see citing works
Metabolic correlates of eating behavior in severe obesity
Kral, J., Buckley, M., Kissileff, H. R., & Schaffner, F. (2001) · International Journal of Obesity · doi:10.1038/sj.ijo.0801469 · Cited by 82 · see citing works
Effects of Participation in Bariatric Support Group After Roux-en-Y Gastric Bypass
Hildebrandt, S. E. (1998) · Obesity Surgery · doi:10.1381/096089298765554115 · Cited by 75 · see citing works
Psychiatric Diagnosis and Weight Loss following Gastric Surgery for Obesity
Black, D. W., Goldstein, R. B., & Mason, E. E. (2003) · Obesity Surgery · doi:10.1381/096089203322509327 · Cited by 74 · see citing works
Surgical Treatment of Morbid Obesity in Schizophrenic Patients
Hamoui, N., Kingsbury, S. J., Anthone, G. J., & Crookes, P. F. (2004) · Obesity Surgery · doi:10.1381/096089204322917873 · Cited by 59 · see citing works
Selection of patients for anti-obesity surgery
Jg, K. (2001) · International Journal of Obesity · doi:10.1038/sj.ijo.0801712 · Cited by 58 · see citing works
Management of the bariatric surgery patient: Is there a role for the cognitive behavior therapist?
Kalarchian, M. A., & Marcus, M. D. (2003) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(03)80019-6 · Cited by 56 · see citing works
Outcome following Gastric Bypass Surgery: Impact of Past Sexual Abuse
Buser, A. T., Dymek-Valentine, M., Hilburger, J., & Alverdy, J. C. (2004) · Obesity Surgery · doi:10.1381/096089204322857519 · Cited by 45 · see citing works
Development of a Model for a Structured Support Group for Patients following Bariatric Surgery
Marcus, J. D., & Elkins, G. R. (2004) · Obesity Surgery · doi:10.1381/096089204772787383 · Cited by 40 · see citing works
Prevalence of Eating Disorders Among Bariatric Surgery Patients
Saunders, R., Johnson, L., & Teschner, J. (1998) · Eating Disorders · doi:10.1080/10640269808249267 · Cited by 34 · see citing works
Rowe, J. L., Downey, J. E., Faust, M. E., & Horn, M. J. (2000) · Psychological Reports · doi:10.2466/pr0.2000.86.3.1028 · Cited by 22 · see citing works
Transactions in a Support Group Meeting: A Case Study
Algazi, L. P. (2000) · Obesity Surgery · doi:10.1381/096089200321668668 · Cited by 12 · see citing works
Luce (1999) · doi:10.1002/(sici)1098-108x(199904)25:3
Flagged first, then by citations
Cited by
Sorted by citations
Rutledge, T. R., Groesz, L. M., & Savu, M. K. (2009) · Obesity Surgery · doi:10.1007/s11695-009-9923-6 · Cited by 122 · see citing works
Heinberg, L. J., Ashton, K. R., & Windover, A. K. (2009) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2009.10.004 · Cited by 64 · see citing works
Chacko, S. A., Yeh, G. Y., Davis, R. B., & Wee, C. C. (2016) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2016.07.001 · Cited by 60 · see citing works
Emotional Eating: A Virtually Untreated Risk Factor for Outcome Following Bariatric Surgery
Chesler, B. E. (2012) · The Scientific World JOURNAL · doi:10.1100/2012/365961 · Cited by 51 · see citing works
Personality and attrition from behavioral weight-loss treatment for obesity
De Panfilis, C., Torre, M., Cero, S., Salvatore, P., Dall'Aglio, E., Marchesi, C., Cabrino, C., Aprile, S., & Maggini, C. (2008) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2008.06.003 · Cited by 47 · see citing works
Nutritional and psychological considerations after bariatric surgery
SONG, A., & Fernstrom, M. H. (2008) · Aesthetic Surgery Journal · doi:10.1016/j.asj.2008.01.005 · Cited by 42 · see citing works
Quality of Life in Morbidly Obese Patients after Surgical Weight Loss
Kinzl, J. F., Schrattenecker, M., Traweger, C. M., Aigner, F., Fiala, M., & Biebl, W. (2007) · Obesity Surgery · doi:10.1007/s11695-007-9030-5 · Cited by 40 · see citing works
Gade, H., Rosenvinge, J. H., Hjelmesaeth, J. S., & Friborg, O. (2014) · Obesity Facts · doi:10.1159/000362257 · Cited by 33 · see citing works
Social Support for Women Who Have Undergone Bariatric Surgery
Ogle, J. P., Park, J., Damhorst, M. L., & Bradley, L. (2016) · Qualitative Health Research · doi:10.1177/1049732315570132 · Cited by 37 · see citing works
Wnuk, S., Du, C., Exan, J. V., Wallwork, A., Warwick, K., Tremblay, L., Kowgier, M., & Sockalingam, S. (2017) · Mindfulness · doi:10.1007/s12671-017-0834-7 · Cited by 29 · see citing works
Steinig, J., Wagner, B., Shang, E., Dölemeyer, R., & Kersting, A. (2012) · Obesity Reviews · doi:10.1111/j.1467-789x.2012.01003.x · Cited by 27 · see citing works
Deliopoulou, K., Konsta, A., Penna, S., Papakostas, P., & Kotzampassi, K. E. (2013) · Obesity Surgery · doi:10.1007/s11695-012-0855-1 · Cited by 26 · see citing works
van Vuuren, M. J., Strodl, E. S., White, K. M., & Lockie, P. (2018) · British Journal of Health Psychology · doi:10.1111/bjhp.12302 · Cited by 24 · see citing works
Psychopathology in a sample of candidate patients for bariatric surgery
Martínez, E. P., González, S. T., Vicente, M. M., Román, C. J. V.-D. H., & Marín, J. R. (2012) · International Journal of Psychiatry in Clinical Practice · doi:10.3109/13651501.2012.704383 · Cited by 24 · see citing works
Christensen, B., Schmidt, J. B., Nielsen, M. S., Tækker, L., Holm, L., Lunn, S., Bredie, W. L. P., Ritz, C., Holst, J. J., Hansen, T. F., et al. (2018) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2018.02.002 · Cited by 20 · see citing works
Psychiatric Issues in Bariatric Surgery
Norris, L. (2007) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2007.07.011 · Cited by 18 · see citing works
The role of bariatric surgery in the management of female fertility
Scholtz, S., le Roux, C. W., & Balen, A. H. (2010) · Human Fertility · doi:10.3109/14647273.2010.492700 · Cited by 19 · see citing works
Wedin, S., & Edwards-Hampton, S. A. (2015) · Psychology Research and Behavior Management · doi:10.2147/prbm.s69132 · Cited by 18 · see citing works
Morbid obesity: significance of psychological treatment after bariatric surgery.
Kinzl, J. F. (2010) · PubMed · doi:10.3275/7080 · Cited by 17 · see citing works
Ethical issues in the psychosocial assessment of bariatric surgery candidates
Rouleau, C. R., Rash, J. A., & Mothersill, K. J. (2014) · Journal of Health Psychology · doi:10.1177/1359105314556160 · Cited by 16 · see citing works
La salud mental en el paciente con obesidad en protocolo para cirugía bariátrica
Esquivias, H. P., Reséndiz-Barragán, A. M., García, F. S. C., Elías-López, D., Centro de Atención Integral a la Salud Mental de León, G., & Departamento de Endocrinología y Metabolismo, I. N. D. C. M. Y. N. S. Z. (2016) · Salud Mental · doi:10.17711/sm.0185-3325.2016.015 · Cited by 8 · see citing works
Mindful Eating for Severe Obesity
Wnuk, S., & Du, C. (2017) · Psychiatric Care in Severe Obesity · doi:10.1007/978-3-319-42536-8_17 · Cited by 6 · see citing works
Bariatrische Chirurgie: Erwartungshaltung und Therapieziele – ein Gegensatz?
Hering, I., Stier, C. K., & Seyfried, F. (2018) · Der Chirurg · doi:10.1007/s00104-018-0662-x · Cited by 7 · see citing works
Predictors of Anxiety and Depression Symptoms in Bariatric Surgery Candidates
Román, C. J. V.-D. H., Leal‐Costa, C., González, S. T., Rodríguez, M. G., Martínez, E. P., & Marín, J. R. (2016) · Bariatric Surgical Practice and Patient Care · doi:10.1089/bari.2016.0014 · Cited by 5 · see citing works
Susan, F., & Kathryn, A. (2012) · InTech eBooks · doi:10.5772/32174 · Cited by 3 · see citing works
Quality of Life After Bariatric Surgery
Moly, K. T. (2021) · Medico-Legal Update · doi:10.37506/mlu.v21i1.2378 · Cited by 3 · see citing works
de Almeida, V. P., Kortchmar, E., Guerra, L. S. D., Neto, F. L., Santo, M. A., & Wang, Y. (2025) · Obesity Surgery · doi:10.1007/s11695-025-08066-2 · Cited by 3 · see citing works
Romero, F. B., Martínez, J. J. A., Pacheco, E. M., Meneses, A. L., Sáiz, M. Á. S., Gómez, A. G., & Arce, L. G. (2010) · Endocrinología y Nutrición · doi:10.1016/s1575-0922(10)70003-6 · Cited by 3 · see citing works
Hocaoğlu, Ç., & Berberoğlu, Z. (2023) · Turkish Journal of Psychiatry · doi:10.5080/u26831 · Cited by 2 · see citing works
Selbsthilfe, Psychoedukation und Gruppenpsychotherapie bei Adipositaschirurgie
Rieber, N., Wild, B., Sauer, H., Hain, B., Hünnemeyer, K., Bischoff, S., Herzog, W., Königsrainer, A., Zipfel, S., & Teufel, M. (2011) · Adipositas - Ursachen Folgeerkrankungen Therapie · doi:10.1055/s-0037-1618736 · Cited by 1 · see citing works
The Use Of Personality Inventories In Pre-surgical Psychological Evaluation Of Bariatric Patients
Cox, S. J. (2015) · Cited by 1 · see citing works
Prä- und postoperative Interventionen
Teufel, M., Teigelack, P., & Wild, B. (2022) · Springer eBooks · doi:10.1007/978-3-662-65556-6_17 · Cited by 1 · see citing works
Commentary on disordered eating symptoms and bariatric/metabolic surgery
Surgenor, L. J. (2019) · Australasian Psychiatry · doi:10.1177/1039856219871869 · Cited by 1 · see citing works
Bariatric Surgery for Obese Patients: Important Psychological Considerations
Lemmon, C. R., & Barbeau, P. (2007) · CRC Press eBooks · doi:10.1201/9781420008890-57
Huberman, W. L. (2016) · Springer eBooks · doi:10.1007/978-3-319-27114-9_24
Psychosocial presentation of revisional and primary bariatric surgery patients
van Vuuren, M. J. (2016) · Queensland University of Technology · doi:10.5204/thesis.eprints.99501
Prä- und postoperative Interventionen
Teufel, M., Teigelack, P., & Wild, B. (2018) · Springer eBooks · doi:10.1007/978-3-662-57364-8_17
Bariatric Surgery for Obese Patients
Barbeau, P., & Lemmon, C. R. (2007) · CRC Press eBooks · doi:10.1201/9781420008890.ch52
Psychological and nutritional evaluation
Fernstrom, M. H., Sebastian, J. L., & Landfair, A. S. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-0544-3.00055-6
- Authors
- Grothe, K. B., Dubbert, P. M., & O'Jile, J. R.
- Affiliations
- University of Mississippi Medical Center (US)
- Venue
- The American Journal of the Medical Sciences
- Publisher
- Elsevier BV
- Published
- 2006-04
- Volume
- 331
- Issue
- 4
- Pages
- 201-206
- ISSN
- 0002-9629 (ISSN-L)
- OpenAlex
- W2062984177
- Cited by
- 40
- References
- 41
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 6 · 2015: 3 · 2014: 2 · 2013: 2 · 2012: 5
- FWCI
- 0.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of the Medical Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- bariatric surgery, psychological assessment, morbid obesity, psychiatric comorbidity, behavioral health, surgical candidates, quality of life, weight loss outcomes
- MeSH terms
- Contraindications, Mental Disorders, Humans, Obesity, Obesity, Morbid, Patient Care Management, Quality of Life, Self-Help Groups, Weight Loss, Comorbidity, Treatment Outcome, Outcome Assessment, Health Care, Bariatric Surgery
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