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Volume 17
Issue 15
10.3390/nu17152573
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Article

Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI ≥ 50—A Prospective Cohort Study

by
Marta Herstowska
1,*,
Karolina Myśliwiec
1,
Marta Bandura
1,
Jędrzej Chrzanowski
2,
Jacek Burzyński
2,
Arkadiusz Michalak
2,
Agnieszka Lejk
1,
Izabela Karamon
3,
Wojciech Fendler
2 and
Łukasz Kaska
4
1
Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland
2
Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland
3
Department of Dermatology, Venereology and Allergology, Medical University of Gdansk, 80-210 Gdansk, Poland
4
Hospital of the Ministry of the Interior and Administration, 80-104 Gdansk, Poland
*
Author to whom correspondence should be addressed.
Nutrients 2025, 17(15), 2573; https://doi.org/10.3390/nu17152573 (registering DOI)
Submission received: 15 July 2025 / Revised: 4 August 2025 / Accepted: 6 August 2025 / Published: 7 August 2025
(This article belongs to the Section Nutrition and Metabolism)
Review Reports Versions Notes

Abstract

Background: Super morbid obesity (SMO), defined as a body mass index (BMI) ≥ 50 kg/m2, represents a distinct and increasingly prevalent subgroup of patients undergoing bariatric surgery. Compared to individuals with lower BMI, patients with BMI ≥ 50 kg/m2 often exhibit unique clinical, psychological, and social characteristics that may influence treatment outcomes. Objective: This study aimed to compare demographic, metabolic, and psychiatric profiles of patients with BMI ≥ 50 kg/m2 and non-super morbid obesity (NSMO; BMI < 50 kg/m2) who were evaluated prior to bariatric surgery. Methods: A total of 319 patients were recruited between December 2022 and December 2023 at a bariatric center in Gdansk, Poland. All participants underwent a comprehensive preoperative assessment, including laboratory testing, psychometric screening (BDI, PHQ-9), and psychiatric interviews. Patients were stratified into class IV obesity and NSMO groups for comparative analysis. Results: Patients with BMI ≥ 50 kg/m2 were significantly older and more likely to report a history of lifelong obesity, family history of obesity, and childhood trauma. They had higher rates of obesity-related health problems such as hypertension, obstructive sleep apnea, and chronic venous insufficiency, as well as worse liver function and lipid profiles. Although the overall psychiatric burden was high in both groups, patients with BMI ≥ 50 kg/m2 reported fewer prior diagnoses of depression and eating disorders, despite similar scores on screening tools. Conclusions: Patients with BMI ≥ 50 kg/m2 represent a clinically distinct population with elevated metabolic risk, complex psychosocial backgrounds, and possibly underrecognized psychiatric burden. These findings underscore the need for multidisciplinary preoperative assessment and individualized treatment strategies in this group of patients.
Keywords: obesity; bariatric surgery; psychiatric dimension obesity; bariatric surgery; psychiatric dimension

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MDPI and ACS Style

Herstowska, M.; Myśliwiec, K.; Bandura, M.; Chrzanowski, J.; Burzyński, J.; Michalak, A.; Lejk, A.; Karamon, I.; Fendler, W.; Kaska, Ł. Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI ≥ 50—A Prospective Cohort Study. Nutrients 2025, 17, 2573. https://doi.org/10.3390/nu17152573

AMA Style

Herstowska M, Myśliwiec K, Bandura M, Chrzanowski J, Burzyński J, Michalak A, Lejk A, Karamon I, Fendler W, Kaska Ł. Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI ≥ 50—A Prospective Cohort Study. Nutrients. 2025; 17(15):2573. https://doi.org/10.3390/nu17152573

Chicago/Turabian Style

Herstowska, Marta, Karolina Myśliwiec, Marta Bandura, Jędrzej Chrzanowski, Jacek Burzyński, Arkadiusz Michalak, Agnieszka Lejk, Izabela Karamon, Wojciech Fendler, and Łukasz Kaska. 2025. "Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI ≥ 50—A Prospective Cohort Study" Nutrients 17, no. 15: 2573. https://doi.org/10.3390/nu17152573

APA Style

Herstowska, M., Myśliwiec, K., Bandura, M., Chrzanowski, J., Burzyński, J., Michalak, A., Lejk, A., Karamon, I., Fendler, W., & Kaska, Ł. (2025). Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI ≥ 50—A Prospective Cohort Study. Nutrients, 17(15), 2573. https://doi.org/10.3390/nu17152573

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