Does preoperative weight loss in a specialist medical weight management centre influence postoperative weight loss after bariatric surgery?

Summary: Weight loss of 5%–10% is advised in medical weight management (MWM) programmes prior to bariatric surgery but it remains to be established whether it influences postoperative weight loss outcomes. We studied postoperative percent total weight loss (%TWL) in 168 patients categorized by preoperative referral weight loss <5% or ≥5% in a UK NHS bariatric centre. Eighty‐six (51.2%) patients achieved sustained referral weight loss <5% (Group A) and 82 (48.8%) ≥5% (Group B). Overall postoperative %TWL in Group A compared with Group B was 30.0% versus 28.3% (p = .30) at 12 months and 32.5% versus 29.6% (p = .20) at 24 months. There were no significant differences in postoperative %TWL at 12 and 24 months when categorized by procedure (gastric bypass, n = 106; or sleeve gastrectomy, n = 62), age or sex. Preoperative weight loss during intensive specialist MWM did not influence postoperative weight loss up to 24 months with gastric bypass or sleeve gastrectomy

Mental Health Treatment Seeking and Perceived Stigma Among International Students

Background. Mori (2000) put forward evidence that international students were at greater risk for psychological problems. He also said that mental health concerns of international students on American campuses were often overlooked. Stigma associated with mental illness and seeking treatment is the reason most often cited that people do not seek counseling and other mental health services (Corrigan, 2004). No studies have focused on international students’ beliefs about service seeking or stigma around health treatment seeking. Objective. The basic aims of this study are to examine international students’ beliefs about mental health services and relationships between stigma and mental health treatment seeking. Method. Participants are 35 international students who were invited to fill out an online questionnaire. The measures included in the questionnaire were designed to collect demographic information (i.e. sex, age, country of birth, etc.), students’ perceived stigma regarding help seeking (i.e. social stigma), students’ overall distress level, students’ prior treatment seeking and willingness to seek treatment from various people (i.e. family/friends, psychologists, teachers, doctors, etc.), and students’ willingness to seek treatment from a psychologist in various settings (i.e. Community clinic, private practice, primary care, etc.). Results. International students at ETSU generally reported feeling moderate levels of stigma regarding mental health treatment [M=2.02, SD=.466, N=36 (1= little/no experienced stigma and 4 = extremely high levels of experienced stigma). Additionally, they reported being equally as likely to seek help from others as to deal with their troubles on their own (M=2.47, SD=.416, N=34). Among the students who hadn’t talked with family members/close friends, doctors, or psychologists about their problems, the more stigma that they felt, the less willing that they were to talk with family members/close friends, doctors, or psychologists in the future (r=-.474, p\u3c.05, N=19; r=-.503, p\u3c.01, N=27; r=-.689, p\u3c.001, N=27). Among all international students, the more stigma they felt, the less willing that they were to seek treatment from a psychologist (counselor or therapist) working at their school or community behavior and health center (r=-.39, p\u3c.05, N=30; r=-.415, p\u3c.05, N=31). However, stigma was not found to be significantly correlated with treatment seeking from a psychologist working in any other setting (ie. private practice or doctors’ office). Implications. Even though the results show that international students generally only feel a moderate amount of stigma, the stigma that they do experience significantly influences their willingness to seek mental health treatment. Future research should focus on identifying new ways addressing this major barrier to mental health treatment seeking to hopefully increase mental health service utilization by international student on college campuses

Nutrition in Pregnancy Following Bariatric Surgery

The widespread use of bariatric surgery for the treatment of morbid obesity has led to a dramatic increase in the numbers of women who become pregnant post-surgery. This can present new challenges, including a higher risk of protein and calorie malnutrition and micronutrient deficiencies in pregnancy due to increased maternal and fetal demand. We undertook a focused, narrative review of the literature and present pragmatic recommendations. It is advisable to delay pregnancy for at least 12 months following bariatric surgery. Comprehensive pre-conception and antenatal care is essential to achieving the best outcomes. Nutrition in pregnancy following bariatric surgery requires specialist monitoring and management. A multidisciplinary approach to care is desirable with close monitoring for deficiencies at each trimester