OBJECTIVES: Weight loss surgery (WLS) is an effective treatment for morbidly obese patients. A pre- and postoperative multimodal team-based approach is essential for maximizing the efficacy of WLS. Although there is currently no standard psychiatric approach in WLS programs, this paper summarizes the value and methods of assessment and intervention suggested in the literature. METHODS: A Pubmed search of English-language reports (1985 to 2010) and a manual search of bibliographies of related papers were reviewed. Relevant clinical information was extracted. RESULTS: Patients receiving WLS show a substantial prevalence of psychopathology, including depression, anxiety, and eating disorders, and also impaired quality of life. Most psychiatric symptoms and impaired psychosocial functioning tend to be improved after WLS, and this improvement is one of the important goals of WLS besides weight loss. However, outcomes are not promising in all patients, and the literature suggests that some psychiatric variables have prognostic value. One of the most widely researched poor prognostic factors is postoperative binge eating disorder. The identification of vulnerable patients and the offer of an appropriate intervention may be critical for their future full recovery. CONCLUSION: There are several reasons why psychiatric evaluation and intervention are worthwhile in a WLS program. Further researches will be required for the establishment of prognostic psychological factors, their biological mechanisms, and clinical guidelines for psychiatric assessment and intervention.
Anxiety ; Binge-Eating Disorder ; Depression ; Feeding and Eating Disorders ; Humans ; Prevalence ; Psychopathology ; Quality of Life ; Weight Loss

OBJECTIVES: Weight loss surgery (WLS) is an effective treatment for morbidly obese patients. A pre- and postoperative multimodal team-based approach is essential for maximizing the efficacy of WLS. Although there is currently no standard psychiatric approach in WLS programs, this paper summarizes the value and methods of assessment and intervention suggested in the literature. METHODS: A Pubmed search of English-language reports (1985 to 2010) and a manual search of bibliographies of related papers were reviewed. Relevant clinical information was extracted. RESULTS: Patients receiving WLS show a substantial prevalence of psychopathology, including depression, anxiety, and eating disorders, and also impaired quality of life. Most psychiatric symptoms and impaired psychosocial functioning tend to be improved after WLS, and this improvement is one of the important goals of WLS besides weight loss. However, outcomes are not promising in all patients, and the literature suggests that some psychiatric variables have prognostic value. One of the most widely researched poor prognostic factors is postoperative binge eating disorder. The identification of vulnerable patients and the offer of an appropriate intervention may be critical for their future full recovery. CONCLUSION: There are several reasons why psychiatric evaluation and intervention are worthwhile in a WLS program. Further researches will be required for the establishment of prognostic psychological factors, their biological mechanisms, and clinical guidelines for psychiatric assessment and intervention.
Anxiety ; Binge-Eating Disorder ; Depression ; Feeding and Eating Disorders ; Humans ; Prevalence ; Psychopathology ; Quality of Life ; Weight Loss

Many therapeutic approaches for treafment of binge eating problem including cognitive-behavioral therapy, behavior therapy, focal psychotherapy. psychoanalysis, nutritional counseling, family intervention, psychoeducation, and medication have value. Nevertheless, current research suggest that the most important approant approach to date is a specific form of cognilive-behavioral therapy designed ariginally for patients with bulimia nervosa and recently adapfed for those with binge eating disorder and anorexia nervosa. But it is also important to stress that cognitive-behavioral therapy is not panacea, some patients fail to benefit and others made only limited gains. So there is a need for clinician not only to carefully assess the patient status before freatment start but also to become familiar with and be able to introduce other therapeutic approach.
Anorexia Nervosa ; Behavior Therapy ; Binge-Eating Disorder ; Bulimia Nervosa ; Bulimia* ; Counseling ; Humans ; Psychoanalysis ; Psychotherapy

Mindfulness training is growing in popularity as an adjunctive intervention in disordered eating and weight loss. Lifestyle modification, pharmacologic treatment, and surgical intervention have been widely used for weight reduction in obese persons, but these modifications are sometimes insufficient. In particular, stress-induced eating and binge-eating disorder have been frequently associated with increased risk of regaining weight. Initial research suggests that mindfulness training may be an effective intervention for binge eating. In this article, we reviewed 19 studies that investigated mindfulness training as an intervention for weight change and/or emotional eating. Results suggest that mindfulness training effectively decreases emotional eating in persons with good adherence to the training; evidence for its effect on weight reduction, however, is mixed. Further large-scale studies are warranted to explore the effectiveness of mindfulness training on long-term weight loss and emotional eating in persons with obesity.
Binge-Eating Disorder ; Bulimia ; Cognitive Therapy ; Eating ; Humans ; Life Style ; Mindfulness ; Obesity ; Overweight ; Weight Loss ; Weight Reduction Programs

As the physical abnormalities seen in eating disorders seem to be largely secondary to these patients' disturbed eating habits and their compromised nutritional state, most physical abnormalities associated with eating disorders are reversed by restoring healthy eating habits and sound nutrition. However, some medical consequences of eating disorders are irreversible or have later repercussions on health, especially those affecting the skeleton, the reproductive system, and the brain. Early medical intervention and psychiatric treatment are particularly important for those with or at risk of severe emaciation. Eating disorders are common among adolescent girls and young women and are associated with potentially serious medical complications, yet they often go undetected and untreated. All patients with eating disorders should be evaluated and treated for medical complications of the disease at the same time that psychotherapy and nutritional counseling are undertaken.
Adolescent ; Anorexia Nervosa ; Binge-Eating Disorder ; Brain ; Bulimia Nervosa ; Counseling ; Early Medical Intervention ; Eating ; Emaciation ; Feeding and Eating Disorders ; Female ; Humans ; Psychotherapy ; Skeleton