Obesity is defined as an excess of body fat, quantified by the body mass index. It is calculated by dividing your weight by your ² Size: BMI = body weight (kg) / height ² (m)
Morbid obesity whose definition meets specific criteria: BMI> 40 kg/m2, which corresponds approximately to a weight greater than or equal to 100% of the theoretical weight, exposed to morbid complications that involve the vital prognosis medium term. In these cases, often after failure of medical treatment, some teams offer surgery in order to reduce food intake and cause weight loss. The two most commonly used techniques are the sleeve and the gastric bypass. The practitioner must assess the time of surgery depending on the patient’s psychological profile that should always be appreciated. During the preoperative assessment, the psychiatrist intervention occurs at two levels, it must determine the type of feeding behavior, body image, impact the social, family and sex, which are often disturbed in obese and will change after surgery. It must, on the other hand, detect psychiatric conditions that would present a cons indications for surgery: personality disorders, depressive syndrome.
Intervention is successful when it permits a weight loss greater than 50% of the initial excess. Average reduction is 45 to 50% of overweight initial 6 months, 55 to 60% at 1 year and 45 to 70% depending on the techniques to 4 years. During the postoperative period, the psychiatrist responsible for the normalization of eating habits shift towards body patterns of non-obese subjects. Topics describe an important and spontaneous resistance to eating during periods of stress. It is observed less disturbance of body image, patients become more charming. Self-esteem, self-confidence, vocational and interpersonal effectiveness, physical activities are increased. Finally, relationships and sexual satisfactions are better. The effects are long lasting and prolonged observation can objectify maintaining this improvement; anxious or depressive episodes are less frequent after surgery.