The role of attachment in body weight gain and weight loss in bariatric patients

Purpose: To explore the role of attachment styles in obesity. Material and methods: The present study explored differences in insecure attachment styles between an obese sample waiting for bariatric surgery (n=195) and an age, sex and height matched normal weight control group (n=195). It then explored the role of attachment styles in predicting change in BMI one year post bariatric surgery (n=143). Results: The bariatric group reported significantly higher levels of anxious attachment and lower levels of avoidant attachment than the control non obese group. Baseline attachment styles did not, however, predict change in BMI post-surgery. Conclusion: Attachment style is different in those that are already obese from those who are not. Attachment was not related to weight loss post-surgery

Integration with Community Resources

In the United States, emergency departments (EDs) have become primary sites for emergent psychiatric evaluations and crisis intervention. These types of ED visits have been steadily increasing per year and have been found to have significantly longer lengths of stay than for non-mental-health-related visits. Recent data demonstrate a discrepancy in disposition options for mental-health-related complaints as compared to nonmental illness presentations in the ED, with presentations due to mental illness having disproportionately higher rates of hospital admission (Figs. 40.1 and 40.2). ED staff treat acute medical emergencies (e.g., cardiac arrest, stroke, and pulmonary embolism), diagnose and manage new-onset illnesses, and evaluate exacerbations for chronic diseases (congestive heart failure, diabetes, and chronic obstructive pulmonary disorder), understanding that not all sickness requires inpatient medical admission. As the number of mental health presentations continues to increase, ED staff need an understanding of and access to alternative community resources to avoid the exclusive use of hospitalization as the disposition choice for mental health crises. Lack of safe, nonhospital interventions leaves ED staff to over-rely on inpatient levels of care. This, in turn, contributes to the decreased availability of inpatient beds for significant crises, subsequently increasing psychiatric boarding