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S72 Abstracts: 2009 Behavioral Health Session / Surgery for Obesity and Related Diseases 5 (2009) S71–S76

ass index (BMI) decreases at six-month follow-up than patientsithout these diagnoses (Kalarchian et al., 2008). This study aimed

o determine if psychiatric comorbidities affected early weight lossor patients undergoing laparoscopic sleeve gastrectomy (LSG).

ethods: 114 patients with a median BMI of 61.29 kg/m2 (range1.37-129.14 kg/m2) underwent LSG at the Cleveland Clinic fromuly 2005-May 2008. Patients were prospectively followed at,3,6,9, and 12 months. Participants were primarily Caucasian79.6%), female (71.9%), high school educated (49.1%) and un-mployed (69.3%). Semi-structured psychiatric evaluations dem-nstrated that 48% had a current and 58.2% had a lifetime diag-osis of a mood or anxiety disorder. Further, 64% were currentlyaking psychotropic medications.esults: No significant differences in excess body weight lostere found between patients with and without lifetime mood or

nxiety disorders. Patients with a current mood or anxiety disorderost significantly less excess body weight than patients with nosychiatric diagnoses at one-month follow-up (14.5% and 12.2%s. 19.6% respectively) but significant differences were not foundt 3, 6, 9, or 12 month follow-ups. Similarly, patients on psycho-ropic medications lost significantly less excess body weight at-month (15.5% vs. 19.2%), but not at subsequent visits.onclusion: Contrary to RYGB findings, psychiatric comorbidi-

ies do not appear to significantly influence weight loss in LSGatients after one-month follow-up. LSG may be a more appro-riate procedure for patients with psychiatric conditions, althoughhe effect of these disorders on longer-term follow-up should bexamined.

H-104.

ETERMINING CANDIDACY FOR BARIATRICURGERY: MOVING BEYOND DICHOTOMOUSSYCHOLOGICAL EVALUATIONeslie Heinberg, PhD; Laura E. Simonelli, PhD;athleen R. Ashton, PhD; Kathleen M. Alcorn, MSSA;my K. Windover, PhD; Bariatric & Metabolic Institute, Cleve-

and Clinic Foundation, Cleveland, OH, USA.

ackground: Most Bariatric programs and insurers require are-surgical psychological evaluation (Walfish et al., 2007)rior to surgery. The criteria for such decision-making andcceptance rates have been well described in the literatureWadden & Sarwer, 2006). However, most programs makeichotomous distinctions or include a “waiting” category. Theurpose of this study was to explore the feasibility of a multi-imensional psychological determination process.ethods: Bariatric surgery candidates [n�464; 77.6% female;

4.3% Caucasian; Mean Body Mass Index (BMI) �49.9 kg/m2;D�11.39] were evaluated across eight domains drawn from thesychosocial bariatric literature: 1) capacity to consent; 2) expec-ations; 3) mental health; 4) eating behaviors/disorders; 5) sub-tance use/abuse/dependence; 6) social support; 7) adherence; and) coping and stressors. Each domain was graded on a 5 point scaleanging from poor to excellent. A summary assessment of poor,uarded, fair, good or excellent was also given.esults: Most candidates were deemed acceptable but 25.7%ere initially considered guarded or poor candidates. Only.6% of the sample was unable to achieve goals to improve their

andidacy and have surgery. Hierarchical regression analyses c

n summary assessments were conducted that initially includedemographic variables, BMI in the second step, alcohol/sub-tance/tobacco in the third and psychiatric history in the fourth.ll steps were significant at p�.01 and the entire model pre-icted 30% (R�.55; p�.001) of the variance.onclusion: Variables most strongly associated with lower assess-ents were: unemployment, less education, higher BMI, current

moking and number of psychiatric medications. Such variableshould be further evaluated for predictive validity and may bemportant in screening candidates.

H-105.

RACTICAL UTILIZATION OF A BRIEF SCREENINGOOL TO ASSESS, TRIAGE AND TREATREOPERATIVE EATING BEHAVIOR IN BARIATRICURGERY PATIENTSisa West-Smith, PhD; LCSW, Georgetown Briatrics, George-

own Community Hospital, Georgetown, KY, USA

ackground: Clearly an important debate on the overall valid-ty, reliability and value of the preoperative psychological eval-ation of the bariatric surgery patient ensues in the literaturend among bariatric healthcare professionals worldwide. Al-hough recent estimates indicate that at least 80% of weight lossurgery (WLS) centers, accrediting and professional organiza-ions and third party payers in the US require or recommend thereoperative assessment, they are conducted in the absence ofny uniform set of guidelines for what constitutes appropriateontent, process and outcome. Although rigorously pursued,mpirical evidence is inconclusive for an overall psychologicalrofile(s) or specific factor to predict poor postoperative out-ome in WLS patients. For the clinician researcher charged withariatric behavioral health programming, evidence based prac-ice with the current literature presents interesting challenges.lthough fully addressing the broader debate on the preopera-

ive psychological evaluation is beyond the scope of this pre-entation, attendees of this workshop will obtain a practicalverview of a brief screening tool utilized in a communityased hospital surgical weight loss center. This brief screeningool is used to assess, triage and treat preoperative eatingehaviors reasonably believed to contribute to less than favor-ble program compliance and WLS outcomes, including bingeating, grazing, emotionally triggered eating and externallyriggered eating. Background on the development and utiliza-ion of the tool and preliminary results from a preoperativereatment group will be presented in this workshop via interac-ive lecture and discussion.

ethods: N/A.esults: N/A.onclusion: N/A.

H-106.

ESPONSE TO BINGE EATING INTERVENTIONFFECTS ON POSTSURGICAL ADHERENCE ANDEIGHT LOSS

athleen R. Ashton, PhD; Leslie Heinberg, PhD;my K. Windover, PhD; Bariatric and Metabolic Institute/Psy-

hiatry and Psychology, Cleveland Clinic, Cleveland, OH, USA.