title: The Role of the Multidisciplinary Conference in the Evaluation of Bariatric Surgery Candidates with a High-Risk Psychiatric Profile.
abstract: Background:Implementation of a multidisciplinary conference (MC) attended by medical, surgical, nutrition, bioethics, and psychology specialists may help identify treatment plans for bariatric surgery candidates with a high-risk psychiatric profile.Methods:Data were assessed for all bariatric candidates evaluated by the MC in an academic center between January 2009 and December 2010.Results:A total of 134 patients of 2798 patients assessed by four different psychologists were subsequently evaluated by the MC. The most frequent psychiatric diagnoses were mood disorders (n= 37, 27.6%), anxiety disorders (n= 24, 17.9%), and binge eating disorder (n= 19, 14.1%). More than one psychiatric diagnosis was observed in 95.6% of the cohort. Substance abuse issues were present in 25% patients. Fifteen patients (11.2%) were eventually cleared and underwent surgery, 35 (26.1%) left the program before completing their requirements, and 84 patients (62.7%) were still working toward their individualized goals in the program. For those who underwent surgery, mean preoperative management duration was 221 days (range, 111-366) with an average of 11 preoperative psychiatric visits (range, 9-15).Conclusions:Patients with a high-risk psychosocial profile seeking bariatric surgery require multiple visits and resources to determine their candidacy. The majority of these patients are either deemed ineligible for surgery or require prolonged preoperative evaluation.
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Esam
authors.initials: E
authors.lastname: Batayyah
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Gautam
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ali
authors.initials: A
authors.lastname: Aminian
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Hector
authors.initials: H
authors.lastname: Romero-Talamas
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zelisko
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Ashton
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
authors.affiliation: Bariatric and Metabolic Institute , Cleveland Clinic, Cleveland, Ohio.
authors.forename: Leslie
authors.initials: L
authors.lastname: Heinberg