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Therapeutic Patient Education 2006

 

BARIATRIC SURGERY IN OBESE PATIENTS: PSYCHOLOGICAL ASPECTS

  1. Garnier, C. Choleau, G. Reach

Department of Endocrinology, Diabetes and Metabolic Diseases, Avicenne Hospital, APHP, Bobigny, Laboratory of Health Pedagogy, Therapeutic Education and Observance, EA 3412, Paris 13 University,France

Bariatric surgery represents a solution for the patients whose morbid obesity is a threat for its health. À multi- disciplinary program including a psychological follow- up was set up in our department. The aim of the present study was to evaluate the psychological evolution of obese patients during the first year following gastric banding intervention. 84 patients were operated in our department, the indication complying to current French recommendations. We used quantitative analysis of questionnaires and qualitative analysis of semi- individual talks and behavioural groups. Results: 1- Before intervention, emotions like shame (37% of the patients), sadness (44%), anger (57%) and fear of complications (61%) were widely expressed by patients.

The degree of these emotions decreased six months after intervention, in relation with weight loss (minus 6.4 points of BMI). 3- One year after intervention (minus 7.9 points of BMI) these emotions totally disappeared and 72% of the patients felt less distressed than before intervention. 60% of the patients expressed new professional or private desires and 50 % expressed a feeling of well-being. Conclusion: If obesity leads to psychological disturbance, social isolation and loss of self-esteem, weight loss can modify deeply the psychological and social situation of the patient. In this context, it seems to be crucial to propose a psychological follow-up in any weight loss program to evaluate these changes and to assist patients.

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