Understanding morbid obesity |
Definition of morbid obesity
The two most used techniques are the ring and the gastric bypass surgeries. The general practitioner should consider the time for operation according to the psychological state of the patient, who should always be appreciated. During the pre-operative evaluation, the psychiatrist's intervention takes place at two levels: he should determine the type of feeding behavior, body image, and social, family and sexual impact, which are often disturbed in obese people and will be healed after the surgery. He should also identify psychological disorders which might impede the surgery: personality disorders and obvious depressive syndrome.
The operation is a success if it allows for losing over 50% of weight from the initial excess. The average reduction is 45 to 50% of the initial weight excess in 6 months, 55 to 60% in one year and 45 to 70%, depending on the techniques used, in 4 years. During this post-operative period, the psychiatrist ensures the normalization of eating habits, evolving towards body patterns of non-obese subjects. Subjects show a large and spontaneous resistance to eating during times of stress.
A less disturbance of body image is noted, and patients’ bodies become more stylish. Self-esteem, self-confidence, vocational and interpersonal efficiency, and physical activity all increase. Finally, relationships and sexual satisfaction are of better quality. The effects are long-lasting and a prolonged observation allows for maintaining this improvement. Moreover, the anxious or depressive periods become less frequent after the surgery.
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