Coping and distress in gastric bypass patients pre- and post -surgery

Abstract

Background. Obesity has reached epidemic proportions world-wide and the current treatment of choice is bariatric surgery. The population presenting for this type of intervention is known to be considerably more distressed than the general population or obese individuals seeking conventional behavioral treatment. Many factors influence the distress seen in this population before and after surgery, particularly, coping skills used to manage distress. Understanding the relationship between coping skills, particularly eating behaviors, and levels of distress, will facilitate the development of pre- and post-surgical interventions. Methods. The study population consisted of 37 patients, 31 women and 6 men, who received laparoscopic gastric bypass surgery. Patients were asked to complete 2 questionnaire packets, 1 prior to surgery and 1 several months following the procedure. Participants' coping styles, severity of distress, quality of life, psychopathology, and use of food as a coping mechanism were assessed. Results. Patients seeking gastric bypass surgery were significantly more depressed and anxious than normative samples. Psychopathology decreased significantly following surgery. Obesity-related distress and quality of life improved drastically post-operatively though there was no change in general stress. Emotion-focused coping decreased after surgery and problem-focused coping did not change significantly. Use of food as a coping mechanism significantly decreased after surgery. Overeating in response to negative emotions pre-surgery was related to greater decreases in depression. Conclusions. Gastric bypass patients experience more distress than the general population and demonstrate maladaptive coping skills before surgery. Wide-ranging benefits are achieved post-operatively, including improvements in distress, quality of life, and psychopathology, as well as a decrease in maladaptive coping skills and use of food as a coping mechanism. It is unclear whether overeating in response to negative emotion functions as a coping mechanism or as a source of distress. Future research should address this question and examine the utility of pre-surgery intervention, such as coping skills training, in improving surgical outcome.