News

Depression Before Surgery Does Not Interfere with Weight Loss After Surgery

Depression and anxiety do not seem to interfere with the amount of weight loss or the improvement of obesity-related conditions after bariatric surgery, according to a new study of more than 25,000 patients presented at the 28th Annual Meeting of the American Society for Metabolic & Bariatric Surgery.

Whether depressed or not, patients with morbid obesity lost about 60% of their excess weight within one year and reported an average 30% improvement in quality of life. Patients with clinically diagnosed depression, however, had a higher rate of minor complications (4.0% vs. 3.3%) than nondepressed patients. There were no significant differences in major complications. Among patients with depression, use of antidepressant medication dropped by about 20% (72% to 60%) one year after surgery and remained at that level after three years of follow-up.

“Depression and anxiety are relatively common among those with chronic diseases like obesity and type 2 diabetes, and these conditions can sometimes interfere with treatment,” said Jonathan F. Finks, MD, an assistant professor of surgery at the University of Michigan, and lead study author. “This study suggests bariatric patients suffering from depression can experience health outcomes and quality of life improvements comparable to non-depressed patients. However, doctors and patients still need to consider psychological issues, state of mind, and commitment to lifestyle changes after surgery in assessing whether bariatric surgery is appropriate and indicated for any particular patient.”

University of Michigan researchers examined data from 25,469 patients across 29 hospitals in the Michigan Bariatric Surgery Collaborative, a consortium of the state's hospitals and surgeons that maintains a prospective registry of bariatric surgery patients. Between 2006 and 2010, researchers found 11,687 bariatric patients (46%) were being treated for at least one psychiatric disorder, with depression (41%) and anxiety (15%) among the most common. Follow-up surveys of these patients were conducted each year for three years after surgery.

Excess weight loss at one year was similar between patients suffering from a psychiatric disorder and those with no known disorder (57.2% vs. 58.7%). All patients reported 28% to 32% improvement in quality of life measures including increased mobility, family life, social interactions, and independent living.

“The relationship between obesity and psychiatric disorders has been established,” said James E. Mitchell, MD, Professor and Chair, Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences. “But often obesity isn't the only reason for psychological issues. Further study is needed to determine what else health professionals and patients can do before and after an obesity intervention to further enhance mental health and health status, particularly as people go from high BMIs to low ones and vice versa over time.”

— Source: American Society for Metabolic & Bariatric Surgery