{"id":1635,"date":"2026-04-11T13:55:08","date_gmt":"2026-04-11T11:55:08","guid":{"rendered":"https:\/\/www.smob.ch\/en\/?page_id=1635"},"modified":"2026-04-11T13:55:08","modified_gmt":"2026-04-11T11:55:08","slug":"mental-health","status":"publish","type":"page","link":"https:\/\/www.smob.ch\/en\/mental-health\/","title":{"rendered":"Mental Health"},"content":{"rendered":"\n<p>In the multidisciplinary team treating obesity, mental health is not just a side effect, but a central pillar for long-term success. Because obesity and mental health disorders are in a bidirectional relationship, unresolved psychological barriers can often sabotage physical progress <\/p>\n\n\n\n<p>(Ref: Dandgey S, Patten E. Psychological considerations for the holistic management of obesity. Clin Med (Lond). 2023 Jul;23(4):318-322; Jankowska, P. (2025). The Role of Stress and Mental Health in Obesity. Obesities, 5(2), 20).<\/p>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-f95c4fa8393a7fc7690554044201900c\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">Key Aspects of Mental Health<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Common Comorbidities: Up to 60% of patients in obesity cohorts show evidence of psychiatric diagnoses. Depression, anxiety disorders, ADHD and eating disorders such as binge eating disorders are particularly common.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Stigma &#038; Self-Esteem: Weight-related stigma and discrimination often lead to social withdrawal, low self-esteem, and chronic physiological stress, which further hinders weight loss.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Stress &#038; Emotion Regulation: Chronic stress increases cortisol levels, which increases cravings for high-calorie comfort foods and promotes fat storage. <br>(Ref: Psychological considerations for the holistic management of obesity, Clinical Medicine, Volume 23, Issue 4, 2023, Pages 318-322)<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-0373800d4942012483853de5ac04a190\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">The Role of Psychological Professionals on the Team<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Diagnostics: Identifying psychosocial factors and screening for trauma.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Cognitive Behavioral Therapy (CBT): Supporting patients in changing eating habits, managing emotional eating, and reducing negative thought patterns.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">If necessary, eating disorders treatment.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Pre-Surgery Preparation: Assessing psychological readiness and stability prior to bariatric surgery.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Interdisciplinary Consultation: Supporting other team members (e.g., dietitians, physicians) to ensure holistic and non-stigmatizing care.<br>(Ref: Psychological considerations for the holistic management of obesity, Clinical Medicine, Volume 23, Issue 4, 2023, Pages 318-322)<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">The inclusion of psychological support has been shown to correlate with better therapy adherence and sustainable weight loss results.<\/li>\n\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-6719c82362d7f03c6aea98d49aa7ee40\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">Additional psychiatric task:<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Management of Psychotropic Medications<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Many psychotropic drugs (e.g., for depression or schizophrenia) affect metabolism and can cause significant weight gain.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">High-Risk Medications: Certain antipsychotics, such as clozapine and olanzapine, as well as antidepressants like mirtazapine or amitriptyline, are particularly problematic.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-b62823e637e13dfc9f366fc13c4520c3\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">Management Strategies:<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Switching Medications: If possible, switch to weight-neutral alternatives such as aripiprazole, fluoxetine, bupropion or lamotrigine.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Combination with GLP-1 receptor agonists (such as semaglutide); methylphenidate with comorbid ADHD.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">After bariatric surgery (especially gastric bypass), the pharmacokinetics of psychotropic medications may change drastically. The risk: The medications may be less effective, have a shorter duration of action, or lead to sudden toxicities.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-70c1325b8dedaf52ea18d8009de0472d\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">Why do drug levels drop or fluctuate?<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Reduced absorption surface: The active ingredient has less time and space to be absorbed in the small intestine.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Altered pH: Many psychotropic medications require an acidic environment in the stomach to dissolve. Surgery increases the pH, which reduces solubility (e.g., of antidepressants).<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">First-pass effect: Due to the anatomical changes, metabolism in the liver can be accelerated, which lowers the drug level in the blood.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading marginBottm5px has-text-color has-link-color wp-elements-cf0b0caff10310d53f0db826d8c2c3c3\" style=\"color:#1b75bc;font-style:normal;font-weight:400\">Practical Recommendations:<\/h3>\n\n\n\n<ul style=\"margin-left: 20px !important;\">\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Switching to liquid or immediate-release tablets: In the initial period after surgery, drops or orally disintegrating tablets should be preferred, as these are absorbed more quickly.<\/li>\n<li style=\"border-bottom: 0px !important;background:none !important;list-style: square  !important;padding: 0px 0px 5px 0px  !important;\">Therapeutic Drug Monitoring (TDM): It is essential to measure the drug plasma concentrations before and several times after surgery in order to adjust the dose individually.<\/li>\n<\/ul>\n\n\n\n<p>(Ref: Pasi P, Kr\u00f6ll D, Siegfried A, Sykora M, Wildisen A, Milone C, Milos G, Horka L, Fischli S and Henzen C (2023) Plasma concentrations of SSRI\/SNRI after bariatric surgery and the effects on depressive symptoms. <em>Front. Psychiatry <\/em>14:1132112)<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the multidisciplinary team treating obesity, mental health is not just a side effect, but a central pillar for long-term success. Because obesity and mental health disorders are in a bidirectional relationship, unresolved psychological barriers can often sabotage physical progress (Ref: Dandgey S, Patten E. Psychological considerations for the holistic management of obesity. Clin Med [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":755,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-mit-sidebar-1-cs.php","meta":{"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","inline_featured_image":false,"footnotes":""},"class_list":["post-1635","page","type-page","status-publish","has-post-thumbnail","hentry","clearfix"],"_links":{"self":[{"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/pages\/1635","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/comments?post=1635"}],"version-history":[{"count":15,"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/pages\/1635\/revisions"}],"predecessor-version":[{"id":1650,"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/pages\/1635\/revisions\/1650"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/media\/755"}],"wp:attachment":[{"href":"https:\/\/www.smob.ch\/en\/wp-json\/wp\/v2\/media?parent=1635"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}