Recent studies reveal that Bariatric Surgery has a positive impact on depressive symptoms in obese people.

There is a clear reciprocal relationship between obesity and depression. In numerous research studies it has been shown that obesity can lead to depression, and that people suffering depression also often become overweight or obese. However, it has also been shown in studies that bariatric surgery — and the improved quality of life that comes from weight loss and improved health associated with it — also reduces depression.

Bariatric Surgery and Depression Facts

Bariatric surgery is increasingly identified as the most effective treatment to achieve and maintain a substantial and sustained weight loss in adults with severe obesity. However, outcomes of bariatric surgery can be variable and research is needed to identify predictors of clinical outcomes.

Depressive symptoms are common among severely obese adults. Data from previous studies demonstrated that depressive symptomatology is elevated relative to population data among both obese sample electing for bariatric surgery and controls treated with conventional procedures. Other studies have also shown high depression symptoms in candidates for bariatric surgery.

The laparoscopic adjustable gastric band (LAGB) and the Roux-en-Y gastric bypass (RYGB) account for the majority of bariatric surgical procedures performed in the United States, with studies comparing pre- to postoperative rates of affective disorders and depressive symptoms following these procedures showing decreases in both the rate of mood disorder diagnoses and in the severity of the symptoms.

Studies on Bariatric Surgery and Depression

In a recent study published in the journal Obesity, a team of researchers determined that bariatric surgery has a positive impact on depressive symptoms. However, outcomes of bariatric surgery can be variable and research is needed to identify predictors of clinical outcomes.

To date, only a few studies have included follow-up beyond the first postoperative year. To address this research gap, in the study titled “Course of Depressive Symptoms and Treatment in the Longitudinal Assessment of Bariatric Surgery (LABS-2) Study,” James E. Mitchell from the Neuropsychiatric Research Institute and the University of North Dakota School of Medicine in Fargo, North Dakota, and colleagues, utilized data from the LABS-2 study to evaluate adults who have undergone a bariatric surgical procedure at 1 of 10 participating hospitals across the United States.

The study aimed to assess if baseline depressive symptoms and antidepressant medication use could predict short-term (30-day) major adverse clinical outcomes, to examine depressive symptoms changes and treatment for these symptoms during the first 3 years after surgery, to determine if changes differ by surgical procedure (RYGB versus LAGB), and to assess changes in depressive symptoms in parallel with body mass index (BMI). Patient recruitment was conducted between 2006 and 2009, resulting in a population of 2,458 severely obese patients.

What the Studies Show

Results showed that at baseline, 40.4% of the patients self-reported treatment for depression. At least mild depressive symptoms (BDI score 10) were reported by 28.3% of the patients; moderate (BDI score 19-29) and severe (BDI score 30) symptoms were uncommon (4.2 and 0.5%). The results also revealed that mild-to-severe depressive symptoms increased the likelihood of a major adverse event within 30 days following surgery.

In comparison to baseline, symptom severity was lower at all follow-up time points (e.g., mild-to-severe symptomatology was 8.9%, 6 months; 8.4%, 1year; 12.2%, 2 years; 15.6%, 3 years), however, it increased between 1 and 3 years after surgery. The researchers also found that a change in depressive symptoms was associated with a change in body mass index.

Based on these results, the researchers concluded that self-reported mild to severe depressive symptoms independently increases the odds of a major adverse event within 30 days of surgery, depressive symptomatology improves following bariatric surgery, but improvement deteriorates somewhat after the first postoperative year, and change in depressive symptoms is significantly related to change in BMI.

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