A recent study has revealed that suicide and self-harm are much more prevalent following weight loss surgery, which suggests that patients should be more closely monitored following such interventions.
In an effort to improve their lives, people affected by obesity sometimes resort to bariatric surgery, which includes a variety of procedures meant to produce weight loss.
Although normally insurance companies require patients to take a mental health test prior to the operation, few of these individuals show up for follow-up examinations concerning their emotional well-being.
Now this research shows that bariatric procedures may be greatly detrimental to some people, by disrupting their already unstable psychological balance even further.
The survey was carried out by Canadian experts, and included more than 8,800 adult patients, who had undergone weight-loss surgery between 2006 and 2011. Most of these people had opted for Roux-en-Y gastric bypass.
Researchers monitored the number of self-harm incidents that participants reported 3 years before and after their operation, and published the findings in the journal JAMA Surgery.
It was determined that prior to the surgery these subjects were twice more susceptible to physically hurting themselves or to overdosing on drugs. In total, 62 incidents had been recorded in the years before the bariatric procedure, the equivalent of 2.33 incidents per 1,000 patients every year.
However, the number soared following the intervention, 96 self-harm emergencies being reported, with intentional overdoses being the most common (73% of the cases). 3.63 incidents were recorded for every 1,000 participants, and a large number of them required immediate hospitalization.
Most of the self-harm events took place in the 2nd or 3rd year following the medical procedure, especially among those who couldn’t attend follow-up evaluations. More precisely, many cases involved people from lower incomes or rural areas, or patients over the age of 35.
Former studies have proven that mental health problems like depression or drug addiction are much more likely among obese people. For instance, weight-loss surgery candidates usually have a quadrupled risk of attempting suicide, compared to the general population.
Although no definite cause has been identified for these psychological issues, some experts speculate that they may be caused by inflammation, hormone disruption or elevated stress. Now, it appears that bariatric surgery may worsen the mental state of the patients even further.
“The operation affects so much physiologically but also socially for the patient and I think all of those are going to contribute to the increased risk”, explained Dr. Amir A. Ghaferi, director of bariatric surgery at the Ann Arbor Veterans Administration Healthcare System in Michigan.
As the researcher explains, some of the people who undergo gastric bypass or similar interventions often feel ostracized by society, because people judge them for not having lost weight naturally, through diets and exercise. In addition, patients sometimes feel abandoned by their loved ones, who sometimes envy or shun their slimmer figure.
These findings indicate that stricter follow-up guidelines should be introduced, in order to have more people attend physical and mental check-ups after the intervention.
Currently, although there are evaluations taking place periodically especially in the first year following the procedure, few people actually attend them. This leaves them without the essential assistance for coping with their emotional turmoil, and they eventually turn to desperate measures.
Even so, researchers don’t believe that mental health therapy would be recommendable to these patients, since that would mean unfairly singling them out from other people that undergo surgery.
Moreover, self-harm rates aren’t actually high enough to require psychological counselling for all bariatric subjects, so careful screening of the patients and post-surgery monitoring remain the safest bet.
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