PSYCHOLOGICAL ASPECTS OF À THERAPEUTIC PROGRAM FOR PATIENTS WITH À LAPAROSCOPIC ADJUSTABLE GASTRIC BAND
N Garnier, C Choleau, JM Catheline, R Cohen, G Reach. Avicenne Hospital, Bobigny, France
Background: Obese patients have a poor self-esteem with a body which may be the receptacle of feelings difficult to translate. A solution could be bariatric surgery. To help the patient in this choice, a multi-disciplinary program, including psychological fol- low-up, was set up in our department.
Methods: The psychological follow-up consists: before inter- vention of semni-directive individual talks, and after intervention of behavioral groups or individual talks asked by the surgeon or the patient. The objective of behavioral groups is to motivate patients for optimal success of this therapeutic approach to morbid obe- sity. To analyze the evolution of patients’ behaviors, question- naires for evaluation of outcomes are completed by the patients 6 months, 1 year and 2 years after intervention.
Results: Semi-directive individual talks make it possible to evaluate patients’ motivations and the consequences of the mor- bid obesity on their physical and psychological health. This study concerns 20 operated patients who have participated in the psy- chological follow-up for 1 to 2 years. During behavioral groups, they discussed eating pattern, seli-esteem, emotions, social situ- ation. The analysis of these exchanges and the questionnaires showed that the surgery generated somatic benefit and an improvement in their quality of life. They are particularly enthusiastic about their weight loss (minus 8 points of BMI, as a mean) but hope to lose more. However, the changes in the body, some- times deep, are not always acceptable by the patient in full phys- ical and psychological reorganization. The individual talks make it possible to help these patients find their identity.
Conclusions: Bariatric surgery can modify deeply the psycho- logical and social situation of the patient. The psychological fol- low-up of the operated patients makes it possible to evaluate the stake of such surgery and represents an important part of the therapeutic program.