Abstract
Background
Long-term, longitudinal data are limited on mental disorders after bariatric surgery.
Objective
To report mental disorders through 7 years postsurgery and examine their relationship
with changes in weight and health-related quality of life.
Setting
Three U.S. academic medical centers.
Method
As a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 199
adults completed the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition prior to Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric
band. Participants who completed ≥1 follow-up through 7 years postsurgery are included
(n = 173; 86.9%). Mixed models were used to examine mental disorders over time, and
among the RYGB subgroup (n = 104), their relationship with long-term (≥4 yr) pre-
to postsurgery changes in weight and health-related quality of life, measured with
the Short Form-36 Health Survey, and with weight regain from nadir.
Results
Compared with presurgery (34.7%), the prevalence of having any mental disorder was
significantly lower 4 years (21.3%; P < .01) and 5 years (19.2%; P = .01), but not 7 years (29.1%; P = .27) after RYGB. The most common disorders were not related to long-term weight
loss postRYGB. However, independent of weight change, mood and anxiety disorders,
both pre- and postRYGB, were significantly related to less improvement in mental (but
not physical) health-related quality of life. Having a concurrent mood disorder appeared
to be associated with greater weight regain (6.4% of maximum weight lost, 95% confidence
interval, −.3 to 13.1), but this was not statistically significant (P = .06).
Conclusions
Bariatric surgery does not result in consistent long-term reductions in mental disorders.
Mood disorders may impact long-term outcomes of bariatric surgery.
Key words
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References
- Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding.Surg Obes Relat Dis. 2008; 4: S47-S55
- Bariatric surgery: a systematic review and meta-analysis.JAMA. 2004; 292: 1724-1737
- The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation.Health Technol Assess. 2009; 13 (215–357, iii–iv): 1-190
- Meta-analysis: surgical treatment of obesity.Ann Intern Med. 2005; 142: 547-559
- Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study.JAMA Surg. 2018; 153: 427-434
- Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies.Surg Obes Relat Dis. 2015; 11: 466-473
- The impact of bariatric surgery on quality of life: a systematic review and meta-analysis.Obes Res. 2015; 16: 639-651
- Quality of life and bariatric surgery: a systematic review of short- and long-term results and comparison with community norms.Eur J Clin Nutr. 2017; 71: 441-449
- Weight recidivism post-bariatric surgery: a systematic review.Obes Surg. 2013; 23: 1922-1933
- Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.JAMA. 2013; 310: 2416-2425
- Psychopathology before surgery in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study.Surg Obes Relat Dis. 2012; 8: 533-541
- Axis I and II disorders and quality of life in bariatric surgery candidates.J Clin Psychiatry. 2008; 69: 295-301
- Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status.Am J Psychiatry. 2007; 164: 328-334
- Relationship of psychiatric disorders to 6-month outcomes after gastric bypass.Surg Obes Relat Dis. 2008; 4: 544-549
- Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews.J Affect Disord. 2011; 133: 61-68
- Psychiatric disorders and weight change in a prospective study of bariatric surgery patients: a 3-year follow-up.Psychosom Med. 2015; 11: S47
- The safety and efficacy of bariatric surgery: the Longitudinal Assessment of Bariatric Surgery (LABS).Surg Obes Relat Dis. 2007; 3: 116-126
- Validity of self-reported weights following bariatric surgery.JAMA. 2013; 310: 2454-2456
- Comparison of the performance of common measures of weight regain after bariatric surgery for association with clinical outcomes.JAMA. 2018; 320: 1560-1569
- Structured clinical interview for DSM-IV axis I disorders—patient edition.Biometrics Research Department, New York1995 (SCID-I/P, Version 2)
- Patient-reported functional health and well-being outcomes with drug therapy: a systematic review of randomized trials using the SF-36 health survey.Med Care. 2014; 52: 439-445
- A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life.Clin Obes. 2017; 7: 273-289
- SF-36® physical and mental health summary scales: a user's manual.The Health Institute, Boston1994
- Prognostic significance of depressive symptoms on weight loss and psychosocial outcomes following gastric bypass surgery: a prospective 24-month follow-up study.Obes Surg. 2015; 25: 1909-1916
- Post-operative psychosocial predictors of outcome in bariatric surgery.Obes Surg. 2015; 25: 330-345
- Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery.Eur Eat Disord Rev. 2014; 22: 87-91
- Eating pathology and experience and weight loss in a prospective study of bariatric surgery patients: 3-year follow-up.Int J Eat Disord. 2016; 49: 1058-1067
- Eating pathology and associations with long-term changes in weight and quality of life in the Longitudinal Assessment of Bariatric Surgery (LABS) Study.Int J Eat Disord. 2018; 51: 1322-1330
- The gut in the brain: the effects of bariatric surgery on alcohol consumption.Addict Biol. 2017; 22: 1540-1553
- Alcohol and other addictive disorders following bariatric surgery: prevalence, risk factors and possible etiologies.Eur Eat Disord Rev. 2015; 23: 442-450
Article info
Publication history
Published online: February 01, 2019
Accepted:
January 11,
2019
Received in revised form:
January 2,
2019
Received:
September 20,
2018
Footnotes
This clinical study was a cooperative agreement funded by the National Institute of Diabetes and Digestive and Kidney Diseases (Grant DSS-U01DK066557; Columbia, U01-DK66667 [in collaboration with Cornell University Medical Center CTSC, Grant UL1-RR024996]; Neuropsychiatric Research Institute, Grant U01-DK66471; University of Pittsburgh Medical Center, Grant U01-DK66585 [in collaboration with CTRC, grant UL1-RR0241531]). Also funded by the National Institute of Diabetes and Digestive and Kidney Diseases Grant R01 DK084979.
Identification
Copyright
© 2019 Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery.
