[Psychological aspects of bariatric surgery]

Experience with gastro-restrictive obesity showed the necessity of detailed research in three main tasks: 1. characteristics of morbidly obese people 2. psychological effects of surgery 3. interaction of these characteristics and effects of surgery. We carried out 7 studies with a total of 650 participants. Clinical interviews and tests measuring personality, eating behaviour, self esteem, addiction factors and quality of life were performed. Morbidly obese differ significantly from normal weight people with the exception of most personality scales. Effects of surgery can be summarized that patients learn to avoid overeating but they do not learn to nourish on healthy solid nutrition and they do not learn to exercise more than before. By paradox learning process 30-50 % of gastric banding patients establish vomiting behaviour or eating pulp and sweets. These who show low self esteem, high addiction score and high disinhibition behaviour are more at risk. Different psychological, nutritional as well as physiotherapeutic interventions are needed to help these patients.