title: Bariatric surgery: a viable treatment option for patients with severe mental illness.
abstract: BACKGROUND
  Although bariatric surgery has become a recognized treatment for obesity, its utility among patients with severe psychiatric disorders has not been extensively studied. A few studies have reported similar weight loss outcomes in these patients, but psychiatric status after bariatric surgery has been studied only minimally, and it is unknown if exacerbation of the mental illness affects weight loss.
  
  
  OBJECTIVE
  The aim of this study was to shed greater light on the issue of serious mental illness and bariatric surgery. Specifically, do patients with a diagnosis of schizophrenia, bipolar I, and bipolar II have poorer weight loss outcomes postbariatric surgery than the general bariatric surgery population? Also, do patients with these diagnoses experience an exacerbation of psychiatric symptoms after bariatric surgery, and if so, is the exacerbation of these disorders linked to poorer weight loss results?
  
  
  METHODS
  Midwest university medical center.
  
  
  METHODS
  A medical record review of approximately 1500 bariatric patients in a Midwest university medical center was conducted to identify those patients with diagnoses of schizophrenia, bipolar I, and bipolar II. Information was gathered on bariatric surgery outcomes and changes in psychiatric status postsurgery.
  
  
  RESULTS
  Eighteen patients were identified as undergoing bariatric surgery and having a diagnosis of schizophrenia, bipolar I, or bipolar II. Weight loss in this group was significant and comparable to expected outcomes of absolute weight lost, changes in body mass index, and percentage excess weight loss for patients in the typical bariatric population. Postsurgery psychiatric status was known on 10 patients. All 10 patients experienced some exacerbation of psychiatric problems yet weight loss outcomes were still as expected.
  
  
  CONCLUSIONS
  Bariatric surgery is a viable obesity treatment option for patients with schizophrenia, bipolar I, and bipolar II disorders. Symptom exacerbations occurred postsurgery, although it is not clear if these were due to the surgery or would have occurred in the normal course of the illness.
authors.affiliation: Department of Psychiatry, University of Illinois Hospital and Health Sciences System, Chicago, Illinois. Electronic address: sshelby@psych.uic.edu.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Shelby
authors.affiliation: Department of Psychiatry, University of Illinois Hospital and Health Sciences System, Chicago, Illinois.
authors.forename: Susan
authors.initials: S
authors.lastname: Labott
authors.affiliation: VAMC St. Louis, Primary Care Service Line, St. Louis, Missouri.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Stout
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000523:psychology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
keywords: Bariatric surgery; Bipolar; Schizophrenia; Weight loss