Obesity is associated with significant psychiatric comorbidity. Twenty to 60% of patients presenting for bariatric surgery suffer from Axis I psychiatric disorders with mood disorders including major depressive disorder and dysthymia predominating. Anxiety disorders, including generalized anxiety and social phobia are diagnosed in up to 50% of reports. Additionally, up to 72% of patients have been diagnosed with a personality disorder. It is not clear if all of these disorders predate severe obesity, begin concurrently or are a result of obesity. Interestingly, most psychiatric and personality disorders are not reliably predictive of weight loss following surgery. They are more predictive of overall well-being and quality of life measures following surgery.
The oral and maxillofacial surgeon, as all other physicians and dentists, sees an increasing number of obese patients. Certainly, surgical and sedative alterations are needed for these patients. However, it is important for the surgeon to understand their personal preconceived ideas regarding obesity, many of which may be false, in order to effectively communicate with the patient not only regarding upcoming surgery, but also as a means to help the patient’s overall health through appropriate weight loss discussion and referral.
FULL TEXT