Bariatric Surgery

There are no published controlled trials for the use of surgical interventions for the treatment of obesity for patients with schizophrenia. However, there is a report of a case series of 5 patients with schizophrenia and morbid obesity and a comparison was made with 165 nonpsychotic patients who also underwent bariatric surgery during a 1-year period [103]. The median BMI was 54 and all had obesity-related comor-bidities, and all patients had been previously treated unsuccessfully with conservative methods of weight reduction. Median percent excess weight loss at 6 months was comparable to that achieved in the control group: excess weight loss was 39.5% in the patients with schizophrenia versus 46.9% in the controls (difference not statistically significant). In severely obese individuals with schizophrenia who have failed other attempts to address their disease, a careful individualized risk-to-benefit assessment for bariatric surgery should be considered. While having a history of a mental illness should not prevent people from getting bariatric surgery, evaluation of an individuals' preoperative psychiatric status may play an important role in maximizing successful postoperative outcomes [104].

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