Researchers found that patients who undergo — or show interest in undergoing — bariatric surgery often also suffer from depression and binge eating disorders, and these mental health conditions might be helped by the surgery. The study, titled “Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery A Meta-analysis,” was published in JAMA.
Bariatric surgery is known to aid in sustained weight loss and to improve physical health in patients with severe obesity, a worldwide and increasingly prevalent health burden. Patients seeking and undergoing bariatric surgery may also have comorbid illnesses, including mental health disorders. To date, however, no study has evaluated the prevalence of depression or other mental health difficulties in this group of patients, and their association with bariatric surgery outcomes.
Aaron J. Dawes, MD, of the David Geffen School of Medicine at UCLA, Los Angeles, and colleagues performed a systematic search for relevant published literature to investigate the prevalence of mental health disorders among patients seeking and undergoing bariatric surgery, and possible pre- and postoperative links.
In total, 68 studies were included in the meta-analysis. Of these, 59 reported findings of preoperative mental health conditions involving 65,363 patients, and 27 studies — comprising 50,182 patients — reported associations between preoperative mental health and postoperative outcomes.
Findings revealed that among patients seeking and undergoing bariatric surgery, the most common mental health issues were depression (19%), and binge eating disorder (17%). “Both estimates are higher than published rates for the general U.S. population, suggesting that special attention should be paid to these conditions among bariatric patients,” the research team wrote, according to a news release.
The evidence regarding the association between preoperative mental health conditions and postoperative weight loss was conflicting. Neither depression nor binge eating disorder was found to be associated with differences in weight outcomes. However, the results showed that bariatric surgery was associated with a postoperative decrease in the prevalence of depression, as well as in the severity of depressive symptoms.
“Previous reviews have suggested that self-esteem, mental image, cognitive function, temperament, support networks, and socioeconomic stability play major roles in determining outcomes after bariatric surgery,” the authors wrote. “Future studies would benefit from including these characteristics as well as having clear eligibility criteria, standardized instruments, regular measurement intervals, and transparency with respect to time-specific follow-up rates.
“By addressing these methodological issues, future work can help to identify the optimal strategy for evaluating patients’ mental health prior to bariatric surgery.”