Psychological aspects of bariatric surgery.

Severe obesity is a serious chronic condition associated with a variety of life-threatening medical illnesses. It also has a major impact on mental health and quality of life. A higher than normal prevalence of psychopathology is seen in this population, and there seems to be a direct relationship between body mass index and the degree of psychosocial impairment. This impact on the overall quality of life may have more serious implications on public health than even the clear medical risks of obesity. Among the various psychological disorders seen in the obese treatment-seeking population, there is a higher incidence of depression, anxiety, distorted body image, and eating disorders. This paper reviews the complex psychological issues related to bariatric surgery, offers recommendations regarding presurgical behavioral assessment, and reviews emerging data on the psychological impact of this important new treatment.