Bariatric surgery in a patient with possible psychiatric contraindications.
Grade III obesity (BMI > 39.9 kg/m2) is considered a chronic disease where clinical and diet therapy show poor results, with high rates of relapse. The most consistent results are those obtained through surgical procedures. Several authors discuss the contraindications for the performance of anti-obesity operations. Psychiatric disorders are often considered contraindications to these operations, especially affective disorders, psychotic disorders and personality disorders. The authors report the case of a 37-year-old patient, with obesity history since the age of 12, and anorexiant abuse (amphetamine-derived substances) during 20 years, binge-eating episodes, purgative compensatory behaviors and recurrent depressive symptoms. She was submitted to anti-obesity surgery in August 2000 (BMI 40.2). The outcome is reported and a discussion of the possible psychiatric contraindications for the anti-obesity surgeries is proposed.
Obesity and Psychiatric Co-Morbidity Outpatient Service (AMBESO), Institute of Psychiatry, Hospital das Clinicas, Medical College of São Paulo University, São Paulo, Brazil. segal@uol.com.br
Adriano
A
Segal
Hilton Telles
HT
Libanori
Alexandre
A
Azevedo
D000328:Adult; D015992:Body Mass Index; D002032:Bulimia / Q000150:complications / Q000628:therapy; D000075202:Contraindications; D003866:Depressive Disorder / Q000209:etiology / Q000628:therapy; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D019966:Substance-Related Disorders / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D015431:Weight Loss