Türkiye’de obezite cerrahisinde psikiyatrik değerlendirme: Uzlaşma ve kılavuz gereksinmesi

Obezite cerrahisi dünyada olduğu gibi Türkiye'de de giderek yaygınlık kazanmaktadır. Obezite cerrahisinde ruhsaltoplumsal değerlendirmenin önemli olduğu her geçen gün artan literatürle de desteklenmektedir. Bu doğrultuda birçok kilo verme cerrahisi merkezi ruhsal-toplumsal değerlendirmeyi de içeren multidisipliner hasta değerlendirme yaklaşımını uygulamaktadır. Ancak bu konuda henüz dünyada kabul görmüş tek bir uzlaşma kılavuzu yoktur. Bu çerçeveObezite cerrahisi dünyada olduğu gibi Türkiye'de de giderek yaygınlık kazanmaktadır. Obezite cerrahisinde ruhsaltoplumsal değerlendirmenin önemli olduğu her geçen gün artan literatürle de desteklenmektedir. Bu doğrultuda birçok kilo verme cerrahisi merkezi ruhsal-toplumsal değerlendirmeyi de içeren multidisipliner hasta değerlendirme yaklaşımını uygulamaktadır. Ancak bu konuda henüz dünyada kabul görmüş tek bir uzlaşma kılavuzu yoktur. Bu çerçevede farklı merkezler tarafından yayımlanmış farklı uzman uzlaşma metinleri olup sağlık otoriteleri tarafından dikkate alınmaktadır. Türkiye'de ise henüz böyle bir uzman uzlaşması ve kılavuzu yoktur. Türkiye'de obezite cerrahisinde ruhsal-toplumsal değerlendirmenin önemi obezite cerrahları, hastalar ve hatta ruh sağlığı çalışanları tarafından bile henüz hak ettiği ilgiyi görmemektedir. Ruhsal-toplumsal değerlendirmenin gerekli olup olmadığı, değerlendirme yöntemlerinin nasıl olması gerektiği, değerlendirmeyi yapacak kişilerin niteliği ve yetkinlikleri, yapılan değerlendirmenin kalitesi ve yeterliliği tartışılmaya gerek duyulan konulardan başlıcalarıdır. Obezite cerrahisi hastalarının gerek cerrahi işlem öncesi, gerekse cerrahi sonrası yeme bozuklukları, duygudurum bozuklukları, madde kullanım bozuklukları ve diğer ruhsal bozukluklar açısından rutin olarak değerlendirilmeleri ve gerekli olguların daha dikkatli tedavi ve izleme sürecine alınması için ruhsal değerlendirmeye sunulması gerekmektedir. Bu hastaların ruhsal-toplumsal yönden dikkatle ele alınması, bireysel olarak yaşam kalitesini artırdığı gibi, ameliyat sonrası kilo verme üzerine olumsuz etkileri engellemesi bakımından da önemli bir konudur. Bu yazıda ulaşılabilen literatür ve kılavuzlar gözden geçirilip, obezite cerrahisinde ruhsal değerlendirmedeki temel konuların bir derleme biçiminde sunulması ve Türkiye'de yapılacak olan uzman uzlaşı metinleri için rehberlik etmesi amaçlanmıştır. Makalede obezite cerrahisi öncesinde ve sonrasında rastlanan psikiyatrik durumların değerlendirilmesine odaklanılmış olup gerek psikofarmakoloji, gerek psikoterapi, gerekse ruhsal-toplumsal girişimlerin etkinliği, seçimi, avantaj ve dezavantajları bu makalenin kapsamı dışında bırakılmıştır. Bu konuların ilgili platformlarda tartışılması ve ortak bir yaklaşım ortaya konabilmesi için uzman uzlaması kılavuzlarının geliştirilmesinin gerekliliği açıktır. (Anadolu Psikiyatri Derg 2016; 17(Ek sayı.2):5-45)de farklı merkezler tarafından yayımlanmış farklı uzman uzlaşma metinleri olup sağlık otoriteleri tarafından dikkate alınmaktadır. Türkiye'de ise henüz böyle bir uzman uzlaşması ve kılavuzu yoktur

Psychiatric management of obesity surgery in Turkey: the need for consensus and a guideline

Bariatric surgery operations in Turkey increasingly expands as well as in the world. Growing literature supports that psychiatric and psychosocial assessment of obesity surgery patients are crucial. Many of the weight loss surgery centers applies multidisciplinary approach including psychiatric and psychological assessments. However, a worldwide accepted guideline to manage obesity surgery patients regarding psychiatric and psychosocial assessment, is not available. Instead, there are variety of expert consensus texts are used by different centers which taken into account by the health authorities. Unfortunately, neither expert consensus texts nor a guideline are available yet, in Turkey. Patients, bariatric surgeons and even mental health professionals have been underestimated the importance of psychiatric evaluation in bariatric surgery in Turkey. The main themes to be discussed in this context are the necessity of psychiatric evaluation, assessment methods, qualification and competency of the professionals and the quality of the assessments. Patients should be screened routinely in terms of the presence of eating disorders, mood disorders, substance use disorders and other psychiatric disorders in both pre- and surgical period and those who needed should be follow for further psychiatric evaluation and treatment. Careful psychiatric and psychosocial assessment of the patients is important with regard to the improvement of the quality of life as well as preventing adverse effects on weight loss in the post-operative period. This article is aimed to review the current literature and guidelines in order to explore the main issues in psychiatric aspects of the assessment of bariatric surgery patients. It is also aimed that this article provide an orientation for the guidelines will be prepared in Turkey. This article has focused on the assessment of the common psychiatric conditions before and after bariatric surgery. Effectiveness of the treatments, selection of the interventions and advantages/disadvantages of psychopharmacologic, psychotherapeutic or psychosocial interventions are excluded from the scope of this article. It is obvious that to discuss these issues in the relevant platforms and to develop a guideline, are needed in order to reach a common approach. (Anatolian Journal of Psychiatry 2016; 17(Suppl.2):5-45)

___

1. World Health Organization. Obesity: Preventing and Managing the Global Epidemic. Technical Report Series No. 894, Geneva: The World Health Organization, 2000.

2. Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K. Educational level, relative body weight, and changes in their association over 10 years: an international perspective from the WHO MONICA Project. Am J Public Health 2000; 90:1260-1268.

3. T.C. Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Mü dü rlü ğü . Beslenme ve Fiziksel Aktiviteler Daire Başkanlığı, http://beslenme.gov.tr/index.php?lang=tr&page =40

4. Giskes K, van Lenthe F, Avendano-Pabon M, Brug J. A systematic review of environmental factors and obesogenic dietary intakes among adults: are we getting closer to understanding obesogenic environments? Obes Rev 2011; 12:e95-e106.

5. Marcus MD, Wildes JE. Obesity: is it a mental disorder? Int J Eat Disord 2009; 42:739-753.

6. Bray GA. Medical consequences of obesity. J Clin Endocrinol Metab 2004; 89:2583-2589.

7. Puhl RM, Brownell KD. Confronting and coping with weight stigma: An investigation of overweight and obese adults. Obesity 2006; 14:1802-1815.

8. Bergman RN. What for genetics? Obesity 2008; 16:507-508.

9. Darby A, Hay P, Mond J, Quirk F, Buttner P, Kennedy L. The rising prevalence of comorbid obesity and eating disorder behaviors from 1995 to 2005. Int J Eat Disord 2009; 42:104-108.

10. O'Reardon JP, Peshek A, Allison KC. Night eating syndrome: diagnosis, epidemiology and management. CNS Drugs 2005; 19:997-1008.

11. Van Strien T, Rookus MA, Bergers GP, Frijters JE, Defares PB. Life events, emotional eating and change in body mass index. Int J Obes 1986; 10:29-35.

12. Gearhardt AN, Corbin WR, Brownell KD. Food addiction: An examination of the diagnostic criteria for dependence. J Addict Med 2009; 3:1-7.

13. John U, Meyer C, Rumpf HJ, Hapke U. Relationships of psychiatric disorders with overweight and obesity in an adult general population. Obes Res 2005; 13:101-109.

14. Petry NM, Barry D, Pietrzak RH, Wagner JA. Overweight and obesity are associated with psychiatric disorders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychosom Med 2008; 70:288-297.

15. Altfas JR. Prevalence of attention deficit/hyperactivity disorder among adults in obesity treatment. BMC Psychiatry 2002; 2:9-16.

16. Schwartz TL, Nihalani N, Jindal S, Virk S, Jones N. Psychiatric medication-induced obesity: A review. Obes Rev 2004; 5:115-121.

17. Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA 2005; 294:1909-1917.

18. Ayyad C, Andersen T: Long-term efficacy of dietary treatment of obesity: a systematic review of studies published between 1931 and 1999. Obes Rev 2000; 1:113-119.

19. Poole NA, Al Atar A, Kuhanendran D, Bidlake L, Fiennes A, McCluskey S, et al. Compliance with surgical after-care following bariatric surgery for morbid obesity: a retrospective study. Obes Surg 2005; 15:26.

20. Muller A, Mitchell JE, Sondag C, de Zwaan M. Psychiatric aspects of bariatric surgery. Curr Psychiatry Rep 2013; 15:397-404.

21. NIH Consensus Development Conference Panel. Gastrointestinal surgery for severe obesity. Consensus development conference panel. Ann Intern Med 1991; 115:956-961.

22. Bauchowitz AU, Gonder-Frederick LA, Olbrisch ME, Azarbad L, Ryee MY, Wodson M, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med 2005; 67:825-832.

23. Lanyon R, Maxwell B. Predictors of outcome after gastric bypass surgery. Obes Surg 2007; 17:321-328.

24. Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res 2001; 9:788-805.

25. Greenberg I, Sogg S, M Perna F. Behavioral and psychological care in weight loss surgery: best practice update. Obesity (Silver Spring) 2009; 17:880-884.

26. Sogg S, Mori DL. Psychosocial evaluation for bariatric surgery: the Boston interview and opportunities for intervention. Obes Surg 2009; 19:369-377.

27. Fabricatore AN, Crerand CE, Wadden TA, Sarwer DB, Krasucki JL. How do mental health professionals evaluate candidates for bariatric surgery? Survey results. Obes Surg 2006; 16:567-573.

28. Meany G, Conceiçao E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: Effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev 2013; 22:87-91.

29. American Psychiatric Association. American Psychiatric Association Diagnostic and Statistical Manual of Mood Disorders, fifth ed., Washington, DC: American Psychiatric Association, 2013.

30. Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry 2007; 164:328- 334.

31. Niego SH, Kofman MD, Weiss JJ, Geliebter A. Binge eating in the bariatric surgery population: a review of the literature. Int J Eat Disord 2007; 40:349-359.

32. Wadden TA, Sarwer DB. Behavioral assessment of candidates for bariatric surgery: a patientoriented approach. Surg Obes Relat Dis 2006; 2:171-179.

33. White MA, Masheb RM, Rothschild BS, BurkeMartindale CH, Grilo CM. The prognostic significance of regular binge eating in extremely obese gastric bypass patients: 12-month postoperative outcomes. J Clin Psychiatry 2006; 67:1928-1935.

34. Bocchieri-Ricciardi LE, Chen EY, Munoz D, Fischer S, Dymek-Valentine M, Alverdy JC, et al. Pre-surgery binge eating status: Effect on eating behavior and weight outcome after gastric bypass. Obes Surg 2006; 16:1198-1204.

35. Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, et al. Long-term follow-up of patients' status after gastric bypass. Obes Surg 2001; 11:464-468.

36. Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res 2005; 13:639-648.

37. Saunders R. "Grazing": A high-risk behavior. Obes Surg 2004; 14:98-102.

38. Hsu LK, Betancourt S, Sullivan SP. Eating disturbances before and after vertical banded gastroplasty: A pilot study. Int J Eat Disord 1996; 19:23-34.

39. Larsen JK, van Ramshorst B, Geenen R, Brand N, Stroebe W, van Doornen LJ. Binge eating and its relationship to outcome after laparoscopic adjustable gastric banding. Obes Surg 2004; 14:1111-1117.

40. Allison KC, Lundgren JD, O'Reardon JP, Geliebter A, Gluck ME, Vinai P, et al. Proposed diagnostic criteria for night eating syndrome. Int J Eat Disord 2010; 43:241-247.

41. American Academy of Sleep Medicine. International Classification of Sleep Disorders. Third ed., Darien: American Academy of Sleep Medicine, 2014, p.240-245.

42. Allison K, Wadden T, Sarwer D, Fabricatore AN, Crerand CE, Gibbons LM, et al. Night eating syndrome and binge eating disorder among persons seeking bariatric surgery: prevalence and related features. Obesity (Silver Spring) 2006; 14(Suppl.2):77-82.

43. Colles S, Dixon J. Night eating syndrome: impact on bariatric surgery. Obes Surg 2006; 16:811- 820.

44. Colles SL, Dixon JB, O'Brien PE. Grazing and loss of control related to eating: Two high-risk factors following bariatric surgery. Obesity 2008; 16:615-622.

45. Burgmer R, Grigutsch K, Zipfel S, Wolf AM. The influence of eating behavior and eating pathology on weight loss after gastric restriction operations. Obes Surg 2005; 15:684-691.

46. Scholtz S, Bidlake L, Morgan J. Long-term outcome following laparoscopic adjustable gastric banding: Postoperative psychological sequelae predict outcome at 5-year follow-up. Obes Surg 2007; 17:1220-1222.

47. Nicolau J, Ayala L, Rivera R, Speranskaya A, Sanchís P, Julian X, et al. Postoperative grazing as a risk factor for negative outcomes after bariatric surgery. Eat Behav 2015; 18:147-150.

48. Heinberg LJ, Ashton K, Windover A. Moving beyond dichotomous psychologicalevaluation: the Cleveland Clinic Behavioral Rating System for weight loss surgery. Surg Obes Relat Dis 2010; 6:185-190.

49. Miller AD, Smith KM. Medication and nutrient administration considerations after bariatric surgery. Am J Health Syst Pharm 2006; 63:1852-1857.

50. Elias MF, Elias PK, Sullivan LM, Wolf PA, D'Agostino RB. Obesity, diabetes and cognitive deficit: The Framingham Heart Study. Neurobiol Aging 2005; 26(Suppl.1):11-16.

51. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12:426-437.

52. Gunstad J, Paul RH, Cohen RA, Tate DF, Spitznagel MB, Grieve S, et al. Relationship between body mass index and brain volume in healthy adults. Int J Neurosci 2008; 118:1582-1593.

53. Sweat V, Starr V, Bruehl H, Arentoft A, Tirsi A, Javier E, et al. C-reactive protein is linked to lower cognitive performance in overweight and obese women. Inflammation 2008; 31:198-207.

54. Rosenberg GA. Inflammation and white matter damage in vascular cognitive impairment. Stroke 2009; 40(Suppl.3):20-23.

55. Alosco ML, Spitznagel MB, Strain G, Devlin M, Cohen R, Crosby RD, et al. Improved serum leptin and ghrelin following bariatric surgery predict better postoperative cognitive function. J Clin Neurol 2015; 11:48-56.

56. Pannacciulli N, Le DS, Chen K, Reiman EM, Krakoff J. Relationships between plasma leptin concentrations and human brain structure: a voxel-based morphometric study. Neurosci Lett 2007; 2:248-253.

57. Walther K, Birdsill AC, Glisky EL, Ryan L. Structural brain differences and cognitive functioning related to body mass index in older females. Hum Brain Mapp 2010; 31:1052-1064.

58. Stanek KM, Grieve SM, Brickman AM, Korgaonkar MS, Paul RH, Cohen RA, et al. Obesity is associated with reduced white matter integrity in otherwise healthy adults. Obesity (Silver Spring) 2011; 19:500-504.

59. Gazdzinski S, Kornak J, Weiner MW, Meyerhoff DJ. Body mass index and magnetic resonance markers of brain integrity in adults. Ann Neurol 2008; 63:652-657.

60. Mrak RE. Alzheimer-type neuropathological changes in morbidly obese elderly individuals. Clin Neuropathol 2009; 28:40-45.

61. Jahangiri A, Wilson PG, Hou T, Brown A, King VL, Tannock LR. Serum amyloid A is found on ApoB-containing lipoproteins in obese humans with diabetes. Obesity (Silver Spring) 2013; 21:993-996.

62. Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12:426-437.

63. Gunstad J, Paul RH, Cohen RA, Tate DF, Gordon E. Obesity is associated with memory deficits in young and middle-aged adults. Eat Weight Disord 2006; 11:15-19.

64. Kurth F, Levitt JG, Phillips OR, Luders E, Woods RP, Mazziotta JC, et al. Relationships between gray matter, body mass index, and waist circumference in healthy adults. Human Brain Mapping 2013; 34:1737-1746.

65. Spitznagel MB, Hawkins M, Alosco M, Galioto R, Garcia S, Miller L, et al. Neurocognitive effects of obesity and bariatric surgery. Eur Eat Disord Rev 2015; 23:488-495.

66. Awad N, Gagnon M, Messier C. The relationship between impaired glucose tolerance, type 2 diabetes, and cognitive function. J Clin Exp Neuropsychol 2004; 26:1044-1080.

67. Elias MF, Goodell AL, Dore GA. Hypertension and cognitive functioning: a perspective in historical context. Hypertension 2012; 60:260-268.

68. Alosco ML, Cohen R, Spitznagel MB, Strain G, Devlin M, Crosby RD, et al. Older age does not limit postbariatric surgery cognitive benefits: a preliminary investigation. Surgery for Obesity and Related Disorders 2014; 10:1196-1201.

69. Hawkins MA, Alosco ML, Spitznagel MB, Strain G, Devlin MJ, Cohen RA, et al. The association between reduced inflammation and cognitive gains after bariatric surgery. Psychosom Med 2015; 77:688-696.

70. Karlsson J, Taft C, Rydén A, Sjöström L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond) 2007; 31:1248-1261.

71. Galioto R, King WC, Bond DS, Spitznagel MB, Strain G, Devlin M, et al. Physical activity and cognitive function in bariatric surgery candidates. Int J Neurosci 2014; 124:912-918.

72. Gunstad J, Mueller A, Stanek K, Spitznagel M. Cognitive function and impulsivity in bariatric surgery patients. J Mitchell, M de Zwaan (Eds.), Psychosocial Assessment and Treatment of Individuals Undergoing Bariatric Surgery, New York: Taylor and Francis, 2011, p.99-114.

73. Herpertz S, Kielmann R, Wolf A, Hebebrand J, Sent W. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res 2004; 12:1554-1569.

74. Powers PS, Perez A, Boyd F, Rosemurgy A. Eating pathology before and after bariatric surgery: a prospective study. Int J Eat Disord 1999; 25:295-300.

75. Wadden TA, Sarwer DB, Womble LG, Foster GD, McGuckin BG, Schimmel A. Psychosocial aspects of obesity and obesity surgery. Surg Clin North Am 2001; 81:1001-1024.

76. Wildes JE, Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP. Childhood maltreatment and psychiatric morbidity in bariatric surgery candidates. Obes Surg 2008; 18:306-313.

77. Kinzl JF, Schrattenecker M, Traweger C, Mattesich M, Fiala M, Biebl W. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg 2006; 16:1609-1614.

78. Larsen JK, Geenen R. Childhood sexual abuse is not associated with a poor outcome after gastric banding for severe obesity. Obes Surg 2005; 15:534-537.

79. Friedman MA, Brownell KD: Psychological correlates of obesity: moving to the next research generation. Psychol Bull 1995; 117:3-20.

80. Ostlund MP, Backman O, Marsk R, Stockeld D, Lagergren J, Rasmussen F, et al. Increased admission for alcohol dependence after gastric bypass surgery compared with restrictive bariatric surgery. JAMA Surg 2013; 148:374-377.

81. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al., American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient--2013 Update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring) 2013; 21(Suppl.1):1-27.

82. Marcus MD, Kalarchian MA, Courcoulas AP. Psychiatric evaluation and follow-up of bariatric surgery patients. Am J Psychiatry 2009; 166:285-291.

83. Wee CC, Jones DB, Davis RB, Bourland AC, Hamel MB. Understanding patients' value of weight loss and expectations for bariatric surgery. Obes Surg 2006; 16:496-500.

84. Kaly P, Orellana S, Torrella T, Takagishi C, SaffKoche L, Murr MM. Unrealistic weight loss expectations in candidates for bariatric surgery. Surg Obes Relat Dis 2008; 4:6-10.

85. Kral JG. Selection of patients for anti-obesity surgery. Int J Obes 2001; 25:107-112.

86. Suter M, Calmes JM, Paroz A, Giusti V. A 10- year experience with laparoscopic gastric banding for morbid obesity: High long-term complication and failure rates. Obes Surg 2006; 16:829-835.

87. Elder KA, Wolfe BM. Bariatric surgery: A review of procedures outcomes. Gastroenterology 2007; 132:2253-2271.

88. Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351:2683-2693.

89. Austin H, Smith K, Ward WL. Psychological assessment of the adolescent bariatric surgery candidate. Surg Obes Relat Dis 2013; 9:474-80.

90. Bulut I. Aile Değerlendirme Ölçeği El Kitabı. Ankara: Özgü zelifl Matbaası, 1990.

91. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292:1724-1737.

92. Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, Zaremba DL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg 2010; 20:349-356.

93. Mor A, Sharp L, Portenier D, Sudan R, Torquati A. Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke Weight Loss Surgery Chart. Surg Obes Relat Dis 2012; 8:556-560.

94. Wimmelmann CL, Dela F, Mortensen EL. Psychological predictors of mental health and health-related quality of life after bariatric surgery: a review of the recent research. Obes Res Clin Pract 2014; 8:314-324.

95. Courcoulas AP, Christian NJ, Belle SH, Berk PD, Flum DR, Garcia L, et al. Longitudinal Assessment of Bariatric Surgery (LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA 2013; 310:2416-2425.

96. Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al., Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351:2683-2693.

97. Herpertz S, Kielmann R, Wolf AM, Langkafel M, Senf W, Hebebrand J. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes Relat Metab Disord 2003; 27:1300-1314.

98. Conceição E, Mitchell JE, Vaz A, Bastos AP, Ramalho S, Silva C, et al. The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain. Eating Behaviors 2014; 15:558-562.

99. American Society for Metabolic and Bariatric Surgery Public/Professional Education Committee. Bariatric Surgery: Postoperative Concerns. May 23, 2007, revised Feb 27, 2008. http:// www.asbs.org/html/pdf/asbs_bspc.pdf

100. Pournaras DJ, le Roux CW. Obesity, gut hormones, and bariatric surgery. World J Surg 2009; 33:1983-1988.

101. Deitel, M. The change in the dumping syndrome concept. Obes Surg 2008; 18:1622-1624.

102. Vella A, Service FJ. Incretin hypersecretion in post-gastric bypass hypoglycemia: primary problem or red herring? J Clin Endocrinol Metab 2007; 92:4563-4565.

103. Conceição E, Orcutt M, Mitchell J, Engel S, Lahaise K, Jorgensen M, et al. Eating disorders after bariatric surgery: a case series. Int J Eat Disord 2013; 46:274-279.

104. Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, et al. Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA 2016; 315:150-163.

105. Dymek MP, le Grange D, Neven K, Alverdy J. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg 2001; 11:32-39.

106. Sandberg RM, Dahl JK, Vedul-Kjelsås E, Engum B, Kulseng B, Mårvik R, et al. Health-related quality of life in obese presurgery patients with and without binge eating disorder, and subdiagnostic binge eating disorders. J Obes 2013; 2013:878310.

107. de Zwaan M, Lancaster KL, Mitchell JE, Howell LM, Monson N, Roerig JL, et al. Health-related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg 2002; 12:773-780.

108. White MA, Kalarchian MA, Masheb RM, Marcus MD, Grilo CM. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry 2010; 71:175-184.

109. de Zwaan M, Hilbert A, Swan-Kremeier L, Simonich H, Lancaster K, Howell LM, et al. Comprehensive interview assessment of eating behavior 18-35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis 2010; 6:79-85.

110. Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity (Silver Spring) 2010; 18:1938-1943.

111. Segal A, Kinoshita Kussunoki D, Larino MA. Post-surgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg 2004; 14:353-360.

112. de Zwaan M, Marschollek M, Allison KC. The night eating syndrome (NES) in bariatric surgery patients. Eur Eat Disord Rev 2015; 23:426-434.

113. Busetto L, Segato G, De Luca M, De Marchi F, Foletto M, Vianello M, et al. Weight loss and postoperative complications in morbidly obese patients with binge eating disorder treated by laparoscopic adjustable gastric banding. Obes Surg 2005; 15:195-201.

114. Busetto L, Segato G, De Marchi F, Foletto M, De Luca M, Caniato D, et al. Outcome predictors in morbidly obese recipients of an adjustable gastric band. Obes Surg 2002; 12:83-92.

115. Faria SL, Kelly EDO, Faria OP, Ito MK. Snack eating patients experience lesser weight loss after Roux-en-Y gastric bypass surgery. Obes Surg 2009; 19:1293-1296.

116. Lindroos AK, Lissner L, Sjöström L. Weight change in relation to intake of sugar and sweet foods before and after weight reducing gastric surgery. Int J Obes Relat Metab Disord 1996; 20:634-643.

117. Burgmer R, Petersen I, Burgmer M, de Zwaan M, Wolf AM, Herpertz S. Psychological outcome two years after restrictive bariatric surgery. Obes Surg 2007; 17:785-791. Erratum: Obes Surg 2007; 17:996.

118. Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW. Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol 2003; 158:1139-1147.

119. Dong C, Li WD, Li D, Price RA. Extreme obesity is associated with attempted suicides: Results from a family study. Int J Obes 2006; 30:388- 390.

120. Sarwer DB, Lavery M, Spitzer JC. A review of the relationships between extreme obesity, quality of life, and sexual function. Obes Surg 2012; 22:668-676.

121. Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis 2010; 6:608-614.

122. Karlsson J, Sjöström L, Sullivan M. Swedish obese subjects (SOS)—an intervention study of obesity. Two-year follow-up of health-related quality of life (HRQL) and eating behavior after gastric surgery for severe obesity. Int J Obes Relat Metab Disord 1998; 22:113-126.

123. Schwartz MB, Brownell KD. Obesity and body image. Body Image 2004; 1:43-56.

124. Ellison JM, Steffen KJ, Sarwer DB. Body contouring after bariatric surgery. Eur Eat Disord Rev 2015; 23:479-487.

125. Rizvi SJ, Kennedy SH, Ravindran LN, Giacobbe P, Eisfeld BS, Mancini D, et al. The relationship between testosterone and sexual function in depressed and healthy men. J Sex Med 2010; 7:816-825.

126. Sarwer DB, Spitzer JC, Wadden TA, Mitchell JE, Lancaster K, Courcoulas A, et al. Changes in sexual functioning and sex hormone levels in women following bariatric surgery. JAMA 2014; 149:26-33.

127. Malik S, Mitchell JE, Engel S, Crosby R, Wonderlich S. Psychopathology in bariatric surgery candidates: a review of studies using structured diagnostic interviews. Compr Psychiatry 2014; 55:248-59.

128. Mitchell JE, Selzer F, Kalarchain MA, Devlin MJ, Strain GW, Elder KA, et al. Psychopathology before surgery in the longitudinal assessment of bariatric surgery-3 (LABS-3) psychosocial study. Surg Obes Relat Dis 2012; 8:533-541.

129. Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry 2010; 67:220-229.

130. Kalarchian MA, Marcus MD, Levine MD, Soulakova JN, Courcoulas AP, Wisinski MS. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis 2008; 4:544-549.

131. Bu Hington C, Balye D, Warthen M, Marema R. Changes in alcohol sensitivity and effects with gastric bypass. Surg Obes Relat Dis 2006; 2:313.

132. Sogg S. Alcohol misuse after bariatric surgery: epiphenomenon or “Oprah” phenomenon? Surg Obes Relat Dis 2007; 3:366-368.

133. Ertelt TW, Mitchell JE, Lancaster K, Crosby RD, Steffen KJ, Marino JM. Alcohol abuse and dependence before and after bariatric surgery: a review of the literature and report of a new data set. Surg Obes Relat Dis 2008; 4:647-650.

134. Suzuki J, Haimovici F, Chang G. Alcohol use disorders after bariatric surgery. Obes Surg 2012; 22:201-207.

135. Fogger SA, McGuinness TM. The relationship between addictions and bariatric surgery for nurses in recovery. Persp Psychi Care 2012; 48:10-15.

136. Hagedorn JC, Encarnacion B, Brat GA, Morton JM. Does gastric bypass alter alcohol metabolism? Surg Obes Relat Dis 2007; 3:543-548.

137. Klockhoff H, Näslund I, Jones AW. Faster absorption of ethanol and higher peak concentration in women after gastric bypass surgery. Br J Clin Pharmacol 2002; 54:587-591.

138. Woodard GA, Downey J, Hernandez-Boussard T, Morton JM. Impaired alcohol metabolism after gastric bypass surgery: a casecrossover trial. J Am Coll Surg 2011; 21:209-214.

139. Avena NA, Gold MS. Sensitivity to alcohol in obese patients: a possible role for food addiction. J Am Coll Surg 2011; 5:451.

140. Steffen KJ, Engel SG, Pollert GA, Li C, Mitchell JE. Blood alcohol concentrations rise rapidly and dramatically after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2013; 9:470-473.

141. Svensson P, Anveden A, Romeo S, Peltonen M, Ahlin S, Burza MA, et al. Alcohol consumption and alcohol problems after bariatric surgery in the Swedish Obese Subjects Study. Obesity 2013; 21:2444-2451.

142. Mitchell JE, Steffen K, Engel S, King WC, Chen JY, Winters K, et al. Addictive disorders after Roux-en-Y gastric bypass. Surg Obes Relat Dis 2015; 11:897-905.

143. Goldfeder LB, Ren CJ, Gill JR. Fatal complications of bariatric surgery. Obes Surg 2006; 16:1050-1056.

144. Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after longterm follow-up from bariatric surgery. Am J Med 2010; 123:1036-1042.

145. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007; 357:753-761.

146. Roerig JL, Steffen K, Zimmerman C, Mitchell JE, Crosby RD, Cao L. Preliminary comparison of sertraline levels in postbariatric surgery patients versus matched nonsurgical cohort. Surg Obes Relat Dis 2012; 8:62-66.

147. Túry F, Güleç H, Kohls E. Assessment methods for eating disorders and body image disorders. J Psychosom Res 2010; 69:601-611.

148. Fairburn CG, Brownell KD (Eds.). Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guilford Press, 2002.

149. Atasoy N, Saracli O, Konuk N, Ankarali H, Guriz SO, Akdemir A, et al. The reliability and validity of Turkish version of The Night Eating Questionnaire in psychiatric outpatient population. Anatolian Journal of Psychiatry 2014; 15:238-247.

150. Sevincer GM, Konuk N, Bozkurt S, Saracli O, Coskun H. Psychometric properties of the Turkish version of the Yale Food Addiction Scale among bariatric surgery patients. Anatolian Journal of Psychiatry 2015; 16(Suppl.1):44-53.

151. Yucel B, Polat A, Ikiz T, Dusgor, BP, AE Yavuz, Sertel Berk O. The Turkish version of the Eating Disorder Examination Questionnaire: reliability and validity in adolescents. Eur Eat Disord Rev 2011; 19:509-511.

152. Bozan N, Bas M, Asci FH. Psychometric properties of Turkish version of Dutch Eating Behaviour Questionnaire (DEBQ). A preliminary results. Appetite 2011; 56(3):564-566.