In March 2015, Kelly Burndred, a 34-year-old woman from Stoke-on-Trent, believed she was on the path to happiness. After undergoing weight-loss surgery and losing an incredible 20 stone, she finally felt free from the burden of her size. However, instead of finding relief, Kelly’s life took a dark turn. Three years after her surgery, Kelly’s husband found her on the floor, having tragically taken her own life.
Kelly had struggled with mental health issues for years, but the surgery seemed to exacerbate her problems. Despite slimming down to 10.5 stone, she still faced the same issues she had blamed on her weight her entire life. Kelly’s story is not an isolated incident. Research consistently shows that the risk of suicide increases significantly in the decade following weight-loss surgery, with those aged 18 to 34 at the highest risk. Other studies have also highlighted a decline in mental health in the two years after the procedure. Approximately one in four teenage bariatric surgery patients experience depression within five years of the operation.
Patients have taken to online forums, such as the Facebook group Obesity UK Bariatric And Metabolic Surgery Support Group, to express their psychological distress. Many describe feeling depressed or lost after their surgery. As health professionals continue to offer weight-loss surgery to more individuals, there is a growing concern for the mental health risks involved. Experts argue that greater support and monitoring of patients’ mental health is necessary to recognize warning signs and manage any complications that may arise.
In March of this year, the National Institute for Health and Care Excellence (NICE) updated its guidance on weight-loss surgery, stating that it no longer needs to be a last resort and that doctors can refer patients who haven’t tried other weight-loss methods. While this change will likely lead to an increase in surgeries, including in previously overlooked groups, specialists are worried about the lack of support for patients’ mental health.
Weight-loss surgery, also known as bariatric surgery, has become increasingly popular in the UK, with approximately 4,000 procedures performed last year. These surgeries are typically offered to individuals with a body mass index (BMI) of 40 or higher, or a BMI of 35 to 40 with weight-related health issues like high blood pressure or type 2 diabetes. There are various types of procedures, but they all aim to reduce hunger by making the stomach smaller. The most common surgery is the sleeve gastrectomy, where a large portion of the stomach is removed. The gastric bypass is also common, involving the reduction of the stomach’s size using staples and a gastric band.
On average, patients can lose 20 to 30 percent of their body weight after surgery, and three-quarters of them are able to maintain this weight loss long-term. These procedures significantly reduce the risk of heart attacks, strokes, and even cancer. In fact, research shows that the risk of dying within five years is reduced by 89 percent for individuals who undergo bariatric surgery.
While weight-loss drugs are available, they are not as effective as surgery. Newer and more effective drugs may become available in the future, but for now, surgery remains the most successful long-term solution for obesity.
However, weight-loss surgery is not without its risks. The most common procedures carry a one in 500 risk of death and a three in 1,000 chance of complications. Around five percent of patients may develop severe nutritional deficiencies, and other side effects like bone fractures, hair loss, and nail loss can occur. The psychological risks, although less discussed, are also present. Many patients struggle with the loss of the comfort they once found in food. This often leads to seeking comfort in other ways, such as gambling, drugs, or alcohol. For some, this can spiral into severe depression and, in extreme cases, suicide.
Patients may also experience feelings of failure if they regain a small amount of weight after a year or two. Additionally, pre-existing psychological issues may persist even after surgery. Major life changes are common, and relationships may strain as partners adjust to the physical transformation of their loved ones.
Overall, long-term psychological support is lacking in many obesity services across the UK. This leaves patients vulnerable to mental health issues following weight-loss surgery. It is crucial for healthcare providers to better monitor patients’ mental well-being and provide adequate support to mitigate any complications that may arise. By doing so, patients can safely navigate the physical and emotional challenges that come with post-surgery life.
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