Karen Grothe, Ph.D., L.P., assistant professor of psychology, Mayo Clinic, discusses patients with bipolar disorder who are seeking bariatric surgery. Many patients who struggle with serious mental illness have a difficult time managing their weight. Mayo offers a thorough assessment for patients prior to surgery.
KAREN GROTHE: I'm Karen Grothe from the Department of Psychiatry and Psychology at Mayo Clinic, and today we're discussing patients with bipolar disorder who are seeking bariatric surgery. Unfortunately, a lot of patients who struggle with serious mental illness like bipolar disorder really have a difficult time managing their weight. And this can be for a variety of reasons, including weight liable psychotropic medications, an increased appetite or sedentariness that comes with major depression at times. Some of these patients will be interested in bariatric surgery, and a study we conducted here recently, we found that about 6% of the patients seeking bariatric surgery here met full criteria for a bipolar disorder. Now that's about two to three times the prevalence rate of bipolar illness that you might find in community dwelling adults. Unfortunately, there is not a lot of data out there about how bariatric patients-- how bipolar patients do after bariatric surgery. The concerns are difficulty with adhering to the post bariatric regimen, impulse control or addiction concerns, or malabsorption of psychotropic medications, which are really needed for many of these patients to achieve their mental health stability. What psychiatrists and psychologists can do for their patients with bipolar or serious mental illness who are struggling with weight is really twofold. Number one, if you are a prescribing provider, you can be really aware of the weight side effect profile of the medications you're prescribing, and trying to optimize weight neutral medications when possible. For non-prescribing providers, helping patients change their eating behaviors can really be helpful for managing their weight, especially starting with self-monitoring of their food intake. Here at Mayo Clinic, what we do for patients who are interested in a higher level procedure like a bariatric surgery is a very thorough assessment, psychological and psychiatric, if needed. We have patients complete a three month lifestyle modification program prior to surgery, and we closely follow up with them after surgery and work with their local mental health providers. So I'm Karen Grothe, and we've been discussing patients with bipolar illness seeking bariatric surgery at the Mayo Clinic.