SOME OF OUR RECENT PUBLICATIONS:

Gastric Bypass in a Low-Income, Inner-City Population: Eating Disturbances and Weight Loss

Obesity Research 12:956-961 (2004)
Janet D. Latner^*, Scott Wetzler**, Elliot R. Goodman*** and Juliet Glinski**

^* Department of Psychology, University of Canterbury, Christchurch, New Zealand and Departments of
Psychiatry and Behavioral Sciences, ** Department of Psychology, Albert Einstein College of Medicine, Bronx, NY and *** Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

Address correspondence to Janet D. Latner, Department of Psychology, University of Canterbury, Private Bag 4800, Christchurch, New Zealand. E-mail: janet.latner@canterbury.ac.nz

Objective: To examine the prevalence of eating disturbances and psychiatric disorders among extremely obese patients before and after gastric bypass surgery and to examine the relationship between these disturbances and weight outcomes.

Research Methods and Procedures: Sixty-five women patients (ages 19 to 67) with a mean BMI of 54.1 were assessed by semistructured psychiatric interview before surgery and by telephone interview after surgery (mean follow-up: 16.4 months) to determine psychiatric status, eating disturbances, and weight and health-related variables.

Results: Patients lost a mean of 71% of their excess BMI, with significantly poorer weight loss outcomes among African Americans. Psychiatric disorders remained prevalent before (37%) and after (41%) surgery. In contrast, binge eating disorder dropped from 48% to 0%. Psychiatric diagnosis did not affect weight outcomes. Instead, more frequent preoperative binge eating, along with greater initial BMI, follow-up length, and postoperative exercise, predicted greater BMI loss. Postsurgical health behaviors (exercise and smoking) and nocturnal eating episodes were also linked to weight loss. Exercise frequency increased and smoking frequency tended to decrease after surgery.

Discussion: These findings indicated that eating and psychiatric disturbances did not inhibit weight loss after gastric bypass and should not contraindicate surgery. Prior binge eating, eliminated after surgery, predicted BMI loss and, thus, may have previously been a maintaining factor in the obesity of these patients. The association between health behaviors and outcome suggests possible targets for intervention to improve surgical results. Poorer outcomes among African Americans indicate that these patients should be closely monitored and supported after surgery.

The Psychology of Gastric Bypass Surgery

Obesity Surgery 11:581-89 (2001)

Glinski J*, Wetzler S*, Goodman E**.

*Department of Psychology and ** Department of Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY.

 Address correspondence to Juliet Glinski. E-mail: jglinski@email.msn.com

BACKGROUND: This article discusses the importance of psychological evaluation of gastric bypass (GBP) surgery candidates and post-surgical psychological support services, using the Center for Weight Reduction Surgery at Montefiore Medical Center as a model. The study of psychological predictors of post-operative outcome is in its beginning stages, and the small body of literature on this topic is reviewed. METHODS: 115 GBP surgery candidates completed a clinical interview and a self-report measure, the MMPI-2. RESULTS AND CONCLUSIONS: A high prevalence of psychopathology and personality disturbance was found in this population. The impact that psychological disturbance may have on post-operative outcome is discussed. The authors also provide a qualitative analysis of the psychological themes commonly found among this population, as well as psychosocial interventions that have been found helpful.