Psychotherapeutic treatment of morbidly obese patients after gastric banding

Background: Surgery is the most effective therapeutic option for weight reduction in carefully selected patients with morbid obesity resistant to conventional treatment. However, surgical treatment is not the solution but an important precondition for successful management of morbid obesity. Methods: All patients undergo a psychiatric examination before laparoscopic gastric banding. At the first examination we inform all patients about the various forms of psychological support offered before and especially after gastric banding. Results: A majority of the obese individuals are interested in psychological support postoperatively, but only a minority of this patient group (about one-quarter) ultimately enlists psychological support on a regular or irregular basis. Some specific psychological topics have proved to be particularly important such as change of self-esteem as a consequence of weight loss, problems in adopting new eating behaviors and the risk for developing a new eating disordered behavior, and problems involving adequate problem-solving. Conclusions: In many cases, some form of psychological support is necessary in order to cope with the new postoperative demands and to find more adequate coping strategies for underlying psychological, psychosocial and environmental problems. The different kinds of psychological support and psychotherapeutic treatment available at Innsbruck University Hospital for obese patients after gastric banding are discussed here.