Mental health evaluation of obese individuals according to their application to obesity surgery

Purpose: Since obesity is a multidisciplinary disease, treatment should be carried out by experts in the field. Obesity surgery is a treatment method applied to individuals with a Body Mass Index (BMI) over 30 kg/m2. Psychological disorders such as body image dissatisfaction, low self-esteem, eating disorders, depression and anxiety are more common in obese individuals. These disorders may improve or increase after surgery. Therefore, individuals applying for surgery should be evaluated psychiatrically. The aim of the research is to determine whether there is a difference in mental health between obese individuals who apply for bariatric surgery and those who do not. Method: The population of this descriptive and cross-sectional study consists of obese individuals between the ages of 18 and 65 who applied to the Department of General Surgery at a private hospital in Tokat for obesity surgery or due to any illness. The sample size from the group whose population was known was calculated using the G*Power 3.1.9.6 program. A mass gathering of at least 156 people was planned, including at least 78 of the group. In the study, a total of 176 individuals were included in the analysis, 93 individuals who applied for obesity surgery and 83 individuals who did not apply for surgery. A survey form asking demographic information and the "Mahony bariatric surgery applicants' mental health assessment scale (MPABS)" were administered to all individuals in the research group on a voluntary basis by face-to-face interview method. MPABS, consisting of 115 questions, was developed by Mahony and translated into Turkish by Oğuz et al. in 2022. This scale has four subscales: emotional and binge eating (EBE), weight-related dysphoric feelings (DFW), weight-related early life problems (ELPW), and positive treatment attitude and supportive environment (PATASE). In statistical analysis, data for continuous variables are expressed as mean±standard deviation; Data regarding categorical variables are given as n (%). In comparisons between groups, the significance test of the difference between two means, one-way analysis of variance, Chi-square test, Pearson correlation analysis and Logistic regression analysis were used. P values were considered statistically significant when calculated to be less than 0.05. Ready-made statistical software was used in the calculations. (SPSS 22.0 Chicago, IL, USA). Results: Of the 176 individuals participating in the study, 64.8% (114) were women and 35.2% (62) were men, and the average age was 36.48±11.86. 38.1% of the participants have a bachelor's degree or above, 79% have a medium income level, 55.7% consider themselves fat in appearance, 22.7% have a psychiatric history and 68.8% have a psychiatric history. There is an obese person in the family. The average BMI of the obese individuals participating in the study was 42.09±5.85 and 52.8% of them applied for obesity surgery. It was found that the rate of applying for obesity surgery was significantly higher in women (p<0.001), in those who considered themselves fat in appearance (p=0.001), in those with a psychiatric history (p=0.001) and in those with an obese family member (p<0.001) compared to those who did not apply (p <0.05). Total MPABS and subscale score averages were found to be significantly higher in those who applied for bariatric surgery, except for the EBE score, compared to those who did not apply for bariatric surgery (p<0.05). A significant difference was found between the status of applying for bariatric surgery and mental health according to gender, and the mean scores of Total MPABS and its subscales ELPW and DFW were found to be significantly higher in women than in men (p<0.05). In those who did not apply for bariatric surgery, the mean scores of all scales except the EBE scale were found to be significantly higher in women than in men (p <0.05). It was found that the risk of having bariatric surgery was statistically significantly 15.87 times higher in participants who did not skip meals frequently than in those who skipped meals. (p=0.002). Conclusion: Total MPABS score was found to be higher in individuals who applied for bariatric surgery than in those who did not apply, and this shows that the psychological status of individuals who applied for bariatric surgery is worse in terms of mental health. Psychiatrists' application of the Mahony Bariatric Surgery Referral Scale to individuals applying for obesity surgery allows them to make a standard common evaluation. Skipping meals is a significant variable on having obesity surgery. More research is needed to determine the variables affecting mental health according to the status of applying to bariatric surgery.