Obesity and overweight are a serious health problem affecting nearly 2 billion people worldwide. These rates have increased even more with the Covid-19 pandemic. During this long pandemic period, most of us have been confined to our homes and we have been psychologically affected by this situation. We already knew about the close friendship between obesity and depression, but during this pandemic, we saw their friendship become even stronger. Studies have shown that 55% of people with obesity also have depression. If we read it backwards, we also know that depression causes obesity in 58% of people with depression.
Today, the most effective weapon in the fight against obesity is bariatric surgery. The most applied method among obesity surgeries is sleeve gastrectomy, that is, sleeve gastrectomy surgery. Obesity surgeries are actually a touch for people to lose weight effectively and regain their health. It is extremely important to correct the underlying psychological disorders as well as these surgeries. In some studies, it is stated that suicide attempts increase after bariatric surgery. If we give an example: A 35-year-old female patient had a body mass index of 38 kg/m2 and gained 20 kg in the last 4 months. She wants to have gastric sleeve surgery. When you question this person a little, you see that he has gained most of his weight in the last 4 months.
When we investigate the reason for this, a very stressful life and the emotional eating disorder (binge eating in the evenings) which is a reflection of this, are revealed. Performing gastric sleeve surgery on such a person, taking into account only their excess weight and co-morbidities due to weight, may worsen the psychological situation. One of the most important criteria to be considered before sleeve gastrectomy surgery is that the person who will be operated on is psychologically ready for the operation and the post-operative process. As in the example of this patient, in some people, first of all, depression and factors such as emotional eating disorder that it triggers need to be corrected. In this respect, it is necessary to be careful when deciding on surgery in such people and the timing of sleeve gastrectomy surgery.
To give another example, a 21-year-old student has been struggling with excess weight since childhood. His body mass index is 42 kg/m2, that is, he is in the morbid obesity group. In a quiet timid disposition. When you talk a little bit, you can guess that he has been under so much pressure from his environment for years because of his weight. Numerous diets, lost and regained weight.
The last point reached; emotional eating disorder and major depression. It would not be right to apply tube stomach surgery to such a person immediately. First of all, it would be better to recover this person psychologically, to hold his hand and to stand up, and then to perform the sleeve gastrectomy surgery at a certain stage. As a result, the fight against obesity does not only consist of obesity surgeries. It requires a multidisciplinary approach. Which treatment will be addressed first may vary from person to person. In this respect, obesity surgeons should also be good psychologists and psychiatrists.
