Journal de thérapie contre l'obésité et la perte de poids

Abstrait

Shame, Psychiatric Disorders and Health Promoting Life Style after Bariatric Surgery

Haldis ?kland Lier, Eva Biringer, Jofrid Bj?rkvik, Jan H. Rosenvinge, Bjarte Stubhaug and Tone Tangen

Objective: Postoperative outcomes after bariatric surgery depend greatly on engagement in health promoting behaviour, including regular physical activity and healthy eating behaviour. Adherence to these guidelines varies among patients after bariatric surgery. The present study examined associations between shame, psychiatric disorders and engagement in health promoting behaviour in patients with severe obesity that have undergone bariatric surgery.

Method:One-hundred and twenty-seven patients (F/M: 74/ 26) with median Body Mass Index (BMI) 44.1 kg/m2 (IQR=6.0) and median age 40.0 years (IQR=15.0) were examined for psychiatric disorders and personality disorders. The participants completed the Eating Disorder Examination Questionnaire (EDE-Q) and Internalized Shame Scale (ISS) pre- and postoperatively. At one year follow-up, they also reported their compliance with postoperative guidelines regarding eating habits and physical activity.

Results: The median ISS-score was significantly higher in patients with comorbid psychiatric disorders compared to patients without comorbid psychiatric disorders (median ISS score 36.0 and 9.0 respectively, p<.001). ISS score and self-evaluation based on body shape and weight were significantly correlated. Furthermore, preoperative ISS score was negatively correlated with level of physical activity (r=-.25, p=.022) one year after surgery.

Conclusion:The present findings suggest that patients with a high level of shame should be given priority for postoperative follow-up, in order to improve the patients’ ability to establish life-style changes associated with sustained positive postoperative outcome.