In a recent study published in the journal Obesity, a team of researchers found that after bariatric surgery, the majority of teens with severe obesity experience improved mental health. Nevertheless, according to the study results, one in five teens continue to experience depressive symptoms.
“Most young people felt significantly better 2 years after surgery,” Kajsa Järvholm, a PhD student at Lund University in Sweden, said in a press release. “On average, they felt like most other adolescents, so their mental health had been normalized.”
Treatment options for adolescents with severe obesity are urgently needed. While lifestyle interventions initiated in younger ages seem effective, in adolescents they are less successful. Studies of bariatric surgery for adolescents with severe obesity have shown results in both weight loss and resolution of comorbidities in line with those of adults. Because it is conducted during a time characterized by intense psychosocial development, the effects of surgery on adolescents’ quality of life (QoL) and mental health are of particular interest. Adolescents with severe obesity are a vulnerable group living with a highly stigmatized disease, and those presenting for obesity surgery are more heavily burdened with mental health problems than other teenagers.
With the aim of evaluating changes in mental health over 2 years in adolescents undergoing gastric bypass, in the study titled “Two-year trends in psychological outcomes after gastric bypass in adolescents with severe obesity,” Kajsa Järvholm from the Department of Psychology, Lund University in Lund, Sweden and colleagues evaluated 88 adolescents aged 13 to 18 years (mean BMI, 45.6 kg/m2). There was a significant decrease in BMI from baseline to 2 years after surgery with 50% of participants no longer in the obese range (BMI, < 30 kg/m2).
Results revealed that 2 years following bariatric surgery there was a reduction in symptoms of anxiety, depression, anger and disruptive behavior. The results also showed an improvement in obesity-related problems, self-esteem, self-concept, and overall mood. These improvements occurred in the first year following bariatric surgery.
The second year was characterized by stabilization. Symptoms of anxiety, depression, anger, disruptive behavior, and self-concept were at normative levels after surgery. However, 19% of the adolescents had depressive symptoms in the clinical range.
“There is also a big difference in how weight affected them in various social situations,” Järvholm said. “Two years after the operation they experienced far fewer limitations than before. Another important discovery was that some did not feel better. Just under 20% of patients said they still did not feel well after having surgery, and their self-assessments showed symptoms of moderate to severe depression. Thirteen percent showed symptoms of severe depression.”
According to the authors, the results from this study highlight that psychosocial support is necessary for patients undergoing bariatric surgery. However, the research also reveals that bariatric surgery and the weight loss achieved from it leads to improved mental health in obese teens.
“In summary, we found broad improvements in mental health, self-esteem, mood and obesity-related problems in adolescents 2 years after treatment for severe obesity by gastric bypass … indicating a mental health in the normative range,” the researchers wrote. “However, mood was still remarkably lower than that of age-matched norms, and 19% showed depressive symptoms at a clinical level 2 years after surgery.”