Bariatric procedures: Managing patients after surgery

David B. Sarwer, PhD, Associate Professor of Psychology, Departments of Psychiatry and Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA

Lucy F. Faulconbridge, PhD, Assistant Professor of Psychology, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA

Kristine J. Steffen, PharmD, PhD, Research Scientist, Neuropsychiatric Research Institute, Fargo, ND

James L. Roerig, PharmD, BCPP, Associate Professor, Department of Clinical, Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND

James E. Mitchell, MD, President and Scientific Director, Neuropsychiatric Research Institute, Christoferson Professor and Chair, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, ND

Bariatric surgery is the most effective treatment for obesity (defined as a body mass index [BMI] >30 kg/m²) and is recommended for extremely obese individuals (BMI >40 kg/m²) age >18. Most patients experience significant weight loss accompanied by improvements in mood, physical comorbidities, and quality of life. Despite these favorable outcomes, several aspects of postoperative care—such as management of mental health issues—remain unclear. Bariatric surgery candidates show high rates of preoperative psychopathology, particularly depression and dysphoria. Little is known about how bariatric surgery affects absorption of psychiatric medications, leaving prescribing clinicians with minimal guidance when a postoperative patient reports changes in mood symptoms.

This article discusses the psychosocial status of bariatric surgery candidates and presents a rationale for increased medication monitoring after surgery.

Read full text (free access)

Comment on this article

Email the editor