Term Paper on "Psychosomatic Conditions in Post Operative Bariatric Patients Versus Non-Obese Population"

Term Paper 12 pages (3158 words) Sources: 0

[EXCERPT] . . . .

obese patients have more psychosomatic illnesses following surgery than non-obese patients have. The writer explores research about psychosomatic conditions and obesity and then proposes a study including the methodology. The psychological aspect of psychosomatic illness will be studied using a case study method. The study will include participants who are obese as well as participants who are not obese. There were five sources used to complete this paper.

Obesity has been reported as an American epidemic. The most recent research on obesity statistics indicates that 65% of Americans are overweight. A large percentage of those are considered obese with a BMI of more than 30(Dahm, 2005).

Many diseases and health issues have been linked to obesity over the years. Heart problems, knee and other joint issues, diabetes and cancer have all shown proven correlations to obesity in the American population. The health issues that are related to obesity can also create the need for surgery. Whether it is surgery for cancer or a gastric by-pass, surgery on obese patients is performed daily throughout the nation.

One of the most important aspects of recovery from surgery is the mental attitude of the patient. Patients that are upbeat, willing to follow post-op instructions and eager to get back on their feet generally fare better than those who are stressed and feeling poorly. Psychosomatic illness and disorder can occur during the post-op phase of recovery. When a recovering surgical patient believes that he or she is ill, whether it is a real or imagined illness their recovery can become obstructed. Psychosomatic issues are common among the obese pre-op patients according to research.

While little research has been conducted that directly address the question of post operative psychosomatic issues among obese people, there have been many studies conducted with regards to obese people, obese patients, psychosomatic illness and disorder and obesity and psychosomatic illness.

The literature concludes there are overwhelmingly seeming ties between the issues which does not conclusively answer the question about obesity and post op psychosomatic illness, but points in the direction of a need for further study about the issue.

One study found that eating disorders among the obese is common. The binging and purging are symptoms of the disorder in which the participant believes that they can control their lives by controlling the food that goes into and come out of their body.

The study used 75 subjects that were drawn from a pool of volunteers that were advertised for through local newspapers and college student notification. All subjects were female and were between the ages of 20 and 69 years old (Boulton, 2005).

The group of volunteers was divided into eating disordered and non-eating disordered. While the study itself was focused on researching the eating disorders themselves the study noted a significant number of those reporting eating disorders were overweight or obese (Boulton, 2005).

Another study examined the impact of rapid weight loss by previously obese patients on their marital satisfaction.

The resulting data provided conflicting results as to the incidence of psychosomatic illness in obese patients (Wampler, 2000).

A third study worked to identify psychosomatic family traits in the families of obese patients.

Harkaway and her associates (Doherty & Harkaway, 1990; Harkaway, 1983, 1986, 1987, 1989; Harkaway & Madsen, 1989) have conceptualized the problems of weight gain, loss, and maintenance systemically. This conceptualization is consistent with earlier research on psychosomatic families (Minuchin, 1977), demonstrating that family dynamics play a critical role in both brittle diabetes and anorexia in adolescents (Health, 2000)."

The research team came to believe that obesity may be based in the desire to control the family. According to the researchers the desire for control translates into telling family members what to eat and using food as a way to control intimacy. This is done through the use of psychosomatic illness in which the obese person feels and believes that he or she or various family members suffer from unproven disorders or diseases that can be assisted by eating (Health, 2000).

The basis for these study results is based in an exhaustive literature review conducted by the research team.

Psychosomatic illness and disorder has been shown to be responsible for many conditions including chronic pain (Merrick, 2005).

One study found a strong correlation of past abuse and the psychosomatic incidence of chronic pain. In other studies it has been shown that there are significant correlations between past abuse and adult obesity. While it does not show a direct link there can be a summation that the prevalence of past abuse among the obese might also create an environment that can create psychosomatic illness and disorder (Merrick, 2005).

The most likely reason for this connection between abuse and chronic pain is the notion that strong negative emotions are repressed by the person in the emotionally painful moment of abuse. In holistic therapy, where the focus is on integrating body, feelings, and mind, we often find such feelings "hidden in the tissues and organs of the body," causing not only pain but also actual disease. In a multidisciplinary treatment of a patient with chronic pain, it is therefore necessary to remain open to the possibility that the root cause may not be visible initially and that it may indeed be quite ugly (Merrick, 2005). "

Given the possibility that psychosomatic and emotional elements contribute to and are present in many diseases it is important to distinguish between primary pain, (organic) and secondary pain (which can be psychosomatic) (Merrick, 2005).

Another study examined the use of coronary medications in patients with heart disease and depression. The study found that patients who had illness that was psychological by nature were not taking their beta blockers and other heart medications as prescribed, which increased the possibility of their having a future incident related to their heart issues. The study included men and women who had been diagnosed with and were being treated for heart problems (Tucker, 2005). The study further divided the group into those who had been diagnosed with depression and those that had not been diagnosed with depression. Those who were not taking depression medication but had a diagnosis of depression proved to be less diligent about taking their prescribed heart medication as well.

While this study was primarily for the purpose of researching depression and medication compliance the results can be extrapolated to understand that those with disorders that are psychological in nature are more likely to place themselves at risk for physiological issues as well. (Tucker, 2005)

It is important to be able to determine when a patient has a psychosomatic illness or disorder as compared to a biological and physiological disorder. The purity of the study will depend on being able to define between the two.

One recent study detailed the differences and provided a list of elements that are commonly associated with psychosomatic behaviors and disorders.

If the patient demands excessive attention, it could indicate a psychosomatic situation. The patient or the patient's family members calling the physicians office many times over a short time or showing up without a scheduled appointment may indicate there is a psychosomatic background for the patients' complaints.

In addition "the patient may go to the emergency room unnecessarily. The patient is seeking validation of physical suffering. Usually the patient is also trying to convince the clinician that the symptoms are severe enough to warrant more tests and/or more medication. "

Another indicator that the problems are more mind-based than body-based is if the patient refuses to comply with a carefully planned treatment. In this case the physician will have discussed the symptoms, the preferred treatment and any medication or therapy needs the patient has. Together they will create a plan of action to treat the patient but the patient not only ignores the agreed upon treatment plan but also continues to seek out other opinions from other clinicians or Emergency Room physicians.

The patient may begin to accuse the doctor of mistreating him or her as the doctor continues to point out that there is no biological bases for the symptoms.

The patient may insist on having prescriptions written for narcotics or muscle relaxants. This can also happen in a drug addict situation but in a psychosomatic situation the patient believes that the pain or problem is real and is demanding the medications not out of an addictive need for the drug but because they believe they need them to take care of the psychosomatic illness.

Finally the psychosomatic patient will insist that tests be ordered which are unnecessary.

The symptoms of psychosomatic illness are clearly defined and will play an important role in the study of obesity in post op patients and the incidence of psychosomatic disorders.

Post operative patients are often given many directions to follow. They are asked to comply with diet restrictions, exercise steps and follow up visit schedules to follow. Several past research studies have shown that people who are obese may be more likely to suffer from psychosomatic illness and that… READ MORE

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