PSY56 - A Systematic Review on the Effect of Behavioral Versus Surgical Intervention on Obese Patients’ Psychological Well-Being

Abstract

Approximately 400 million people worldwide are considered obese as defined by the World Health Organization. In Europe, 15.5% of adults have a body mass index of ≥30 kg/m2. Diabetes, heart disease, and stroke, are among the most common obesity-related comorbidities. Furthermore, obesity has also been found to cause depression and emotional distress, negatively affecting the quality of life of obese patients. With obesity at the forefront of many social and health care dialogues, treatment guidelines currently suggest exercise (often linked with changes in diet) or weight loss surgery to effectively treat obesity. This review seeks to understand which of these two types of interventions, exercise or surgical, have a greater impact on obese patients’ emotional and psychological well-being. A systematic review of peer-reviewed literature was conducted to identify RCTs and observational studies that measure any type of emotional or psychological change in patients who underwent either of the interventions of interest for weight loss: exercise or weight loss surgery. Embase and Medline databases were searched for articles published from 2004 to 2013. Search terms were used to identify studies that assessed psychological well-being of obese patients who either exercised or underwent weight loss surgery. The search identified 40 studies, of which 11 measured relevant interventions and measures of psychological well-being. Of those, 9 investigated patients undergoing bariatric surgery, while only 2 explored exercise interventions. All of the studies indicated improvements in patients’ emotional health, except for 1 bariatric surgery study, where patients were shown to have no change in symptoms after weight loss plateaued. While both interventions, when they lead to weight loss, seem to result in improvements in patients’ psychological well-being, there is limited data to conclude whether one intervention is more effective in improving psychological well-being. Further study is needed, especially for exercise interventions.