Psychosocial Outcome and Long-term Weight Loss after Gastric Restrictive Surgery for Morbid Obesity.

Forty-five of 60 consecutive morbidly obese patients who had a vertical banded gastroplasty carried out by the one surgeon between 1982 and 1988 were assessed by questionnaire at long-term follow-up in 1993. Eighteen patients (40%) had maintained their BMI at close to the lowest achieved levels. Twenty-seven patients (60%) had had a significant rise in BMI, and 14 of these (31%) had gained weight to return close to or above their pre-surgery BMI levels. No reliable predictors of successful long-term weight loss were detected in the pre-operative data. Forty-eight patients (84%) were satisfied with their surgical treatment. Twenty patients (44%) reported improved social life after surgery. Twenty-one patients (46%) reported a similar social life and only four patients (9%) a worse social life. At follow up five patients (12%) reported emotional problems related to their weight loss surgery and two of this group had had psychiatric counseling for depression. Pre-operative psychiatric assessment appeared to have facilitated intervention by the psychiatrist with these patients. Gastric restrictive surgery, however, remains unpredictable in its long-term weight loss effect.