How Can Hypnotherapy Help Prepare Overweight Patients for Surgery?

By Steve Cohen

We know that obesity and smoking are major burdens on the US healthcare system. Despite public health efforts, over two-thirds of US adults are considered overweight or obese.[1] This increases their risk of a number of medical conditions, including diabetes, heart disease, hypertension, and some types of cancer.[2] High BMI (Body Mass Index) also reduces the quality of life and life expectancy itself.[3]

What we are noticing is that some doctors and healthcare institutions are now starting to delay or deny routine surgery – such as hip and knee replacements – for patients who are overweight or clinically obese, or who smoke. Smoking and high BMI are both seen as important risk factors for the development of postoperative complications. Therefore, many physicians are inclined to consider them during the pre-op assessment.

 

Bodyweight – A Risk Factor for Postoperative Complications

Some people think that it is not justified to regard obesity as a major risk factor in general surgery. However, studies show that obesity can result in a longer operation time, more surgical blood loss and higher rates of surgical site infections.[4],[5],[6]

Several explanations have been given for poorer surgery outcomes in overweight and obese patients, including:

  • excessive subcutaneous fat tissue can impair the healing process;

 

  • a longer operation time is a significant predictor of wound infections;

 

  • elevated blood sugar levels and too much tension on the surgical incision can further contribute to poor wound healing.

 

Nonetheless, we also need to note the so-called “obesity paradox”. According to some studies, being overweight or obese can actually be associated with improved 30-days and long-term survival. This might suggest some potential ambiguity. However, it does not reduce the implications high BMI has on the pre-operative preparation and the surgery itself.

Surgery in overweight and obese patients has also been associated with several practical problems, e.g. problems with operation tables and instruments and increased use of analgesics. Furthermore, overweight and obese patients tend to be less active following a surgery, which can decrease their rehabilitation potential.

We should also consider that underweight patients are another at-risk group. This group often contains smokers. Smoking, too, has been associated with wound infection, weight loss and chronic diseases.

 

How Can Hypnotherapy Help?

Weight loss and/or smoking cessation are often indicated prior to a major surgery. 

Hypnotherapy can help patients address some of the subconscious reasons for not being able to lose weight and supports their behavioral modifications. Since stress is often an important factor behind weight gain, the intervention can focus on stress reduction. All in all, hypnotherapy is now considered as a viable, non-invasive method for treating obesity by using several techniques, including reinforcing a healthy diet, creating positive visualization and addressing underlying anxiety.[7]

Several studies also suggest that hypnosis could be an effective treatment modality for smoking cessation, both prior to and following a surgery. For example, one study showed that patients with pulmonary or cardiac illness were more likely to abstain at 26-weeks post discharge from the hospital compared to patients using nicotine replacement therapy.[8] Furthermore, a prospective pilot trial of intensive hypnotherapy for smoking cessation showed that after 8 individual sessions, 40% of participants stopped smoking (as confirmed by carbon-monoxide measurements) compared to 0% of those in the control group that received no intervention.[9]

Hypnosis can also encourage the feelings of autonomy and self-regulation, thus contributing to a psychological mindset that can support smoking cessation and weight loss in patients awaiting general surgery.

It’s important that hypnotherapy is performed by a qualified and experienced professional. Medvesta Hypnosis Healthcare provides high-quality hypnosis sessions to those facing various difficult health conditions. Please don’t hesitate to contact us if you have any questions.

 

 

[1] Alexopoulos, A., Fayfman, M., Zhao, L., Weaver, J., Buehler, L., Smiley, D., & … Umpierrez, G. E. (2016). Impact of obesity on hospital complications and mortality in hospitalized patients with hyperglycemia and diabetes. BMJ Open Diabetes Research & Care, 4(1). doi:10.1136/bmjdrc-2016-000200

[2] Haslam D.W., James W.P. (2005). Obesity. Lancet, 366(9492):1197–209. doi: 10.1016/S0140-6736(05)67483-1.

[3] de Gonzalez, A. B., Hartge, P., Cerhan, J. R., Flint, A. J., Hannan, L., MacInnis, R. J., & … Thun, M. J. (2010). Body-mass index and mortality among 1.46 million white adults. The New England Journal Of Medicine, 363(23), 2211-2219.

[4] Tjeertes, E. E. K. M., Hoeks, S. S. E., Beks, S. S. B. J. C., Valentijn, T. T. M., Hoofwijk, A. A. G. M., & Stolker, R. J. R. J. (2015). Obesity – a risk factor for postoperative complications in general surgery? BMC Anesthesiology, 15, 112. http://doi.org/10.1186/s12871-015-0096-7

[5] Kurmann, A., Vorburger, S., Candinas, D., & Beldi, G. (2011). Operation time and body mass index are significant risk factors for surgical site infection in laparoscopic sigmoid resection: A multicenter study. Surgical Endoscopy and Other Interventional Techniques, 25(11), 3531-3534. doi:10.1007/s00464-011-1753-7

[6] House, M., Fong, Y., Arnaoutakis, D, Sharma, R., Protic, M., Brennan, M., & … Olson, S. (2008). Preoperative predictors for complications after pancreaticoduodenectomy: Impact of BMI and body fat distribution. Journal of Gastrointestinal Surgery, 12(2), 270-278. doi:10.1007/s11605-007-0421-7

[7] Jureidini, K. (2017). Successful hypnosis for obesity. Internal Medicine Journal, (S3), 22. doi:10.1111/imj.3_13463

[8] Hasan, F. M., Zagarins, S. E., Pischke, K. M., Saiyed, S., Bettencourt, A. M., Beal, L., & … McCleary, N. (2014). Hypnotherapy is more effective than nicotine replacement therapy for smoking cessation: Results of a randomized controlled trial. Complementary Therapies in Medicine, 22(1), 1-8. doi:10.1016/j.ctim.2013.12.012

[9] Elkins, G., Marcus, J., Bates, J., Rajab, M., & Cook, T. (2006). Intensive hypnotherapy for smoking cessation: a prospective study. International Journal of Clinical & Experimental Hypnosis, 54(3), 303-315.

 

Posted in Diet, Medication, Obesity, Pain, Smoking, Uncategorized, Weight