Psychosocial Functioning, Personality, and Body Image Following Vertical Banded Gastroplasty

BACKGROUND: In addition to increased risks of morbidity and mortality, extreme obesity is substantially associated with psychosocial problems. Therefore, the ultimate goal of bariatric surgery should not only be reducing weight and counteracting comorbid conditions but also improving psychosocial functioning. In addition to being an important goal of bariatric surgery, enhanced psychosocial functioning may motivate patients to adhere to adequate health behavior to maintain the surgically established weight loss. METHODS: We evaluated early postoperative psychosocial functioning in several domains over time. Preoperatively as well as 6, 12, and 24 months after vertical banded gastroplasty, 104 patients were psychologically assessed using a semi-structured interview and psychological questionnaires focusing on psychosocial functioning, personality, and body image. RESULTS: Over time, we found significant changes in weight: 2 years excess weight loss was 58.6%. In addition, most aspects of psychosocial functioning showed significant improvements over time. However, initial improvements in depressive symptoms, sleeping problems, and neuroticism did not last. With respect to personality features, only short-term changes in self-esteem were found. The most robust improvements were seen in the case of body image. Finally, within the patient group, there was a wide variability in changes. CONCLUSION: Vertical banded gastroplasty not only leads to considerable weight loss but also to significant improvements in psychosocial functioning. However, some improvements waned over time, and successful postoperative functioning did not apply to all patients.