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Mental disorders and weight change in a prospective study of bariatric surgery patients: 7 years of follow-up

Published:February 01, 2019DOI:https://doi.org/10.1016/j.soard.2019.01.008

      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

        • Cunneen S.A.
        Review of meta-analytic comparisons of bariatric surgery with a focus on laparoscopic adjustable gastric banding.
        Surg Obes Relat Dis. 2008; 4: S47-S55
        • Buchwald H.
        • Avidor Y.
        • Braunwald E.
        • et al.
        Bariatric surgery: a systematic review and meta-analysis.
        JAMA. 2004; 292: 1724-1737
        • Picot J.
        • Jones J.
        • Colquitt J.L.
        • Gospodarevskaya E.
        • Loveman E.
        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
        • Maggard M.A.
        • Shugarman L.R.
        • Suttorp M.
        • et al.
        Meta-analysis: surgical treatment of obesity.
        Ann Intern Med. 2005; 142: 547-559
        • Courcoulas A.P.
        • King W.C.
        • Belle S.H.
        • et al.
        Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study.
        JAMA Surg. 2018; 153: 427-434
        • Andersen J.R.
        • Aasprang A.
        • Karlsen T.-I.
        • Karin Natvig G.
        • Våge V.
        • Kolotkin R.L.
        Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies.
        Surg Obes Relat Dis. 2015; 11: 466-473
        • Lindekilde N.
        • Gladstone B.P.
        • Lübeck M.
        • et al.
        The impact of bariatric surgery on quality of life: a systematic review and meta-analysis.
        Obes Res. 2015; 16: 639-651
        • Raaijmakers L.C.
        • Pouwels S.
        • Thomassen S.E.
        • Nienhuijs S.W.
        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
        • Karmali S.
        • Brar B.
        • Shi X.
        • Sharma A.M.
        • de Gara C.
        • Birch D.W.
        Weight recidivism post-bariatric surgery: a systematic review.
        Obes Surg. 2013; 23: 1922-1933
        • Courcoulas A.P.
        • Christian N.J.
        • Belle S.H.
        • et al.
        Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity.
        JAMA. 2013; 310: 2416-2425
        • Mitchell J.E.
        • Selzer F.
        • Kalarchian M.A.
        • et al.
        Psychopathology before surgery in the Longitudinal Assessment of Bariatric Surgery-3 (LABS-3) psychosocial study.
        Surg Obes Relat Dis. 2012; 8: 533-541
        • Mauri M.
        • Ruccic P.
        • Calderone A.
        • et al.
        Axis I and II disorders and quality of life in bariatric surgery candidates.
        J Clin Psychiatry. 2008; 69: 295-301
        • Kalarchian M.A.
        • Marcus M.D.
        • Levine M.D.
        • et al.
        Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status.
        Am J Psychiatry. 2007; 164: 328-334
        • Kalarchian M.A.
        • Marcus M.D.
        • Levine M.D.
        • Soulakova J.N.
        • Courcoulas A.P.
        • Wisinski M.S.
        Relationship of psychiatric disorders to 6-month outcomes after gastric bypass.
        Surg Obes Relat Dis. 2008; 4: 544-549
        • de Zwaan M.
        • Enderle J.
        • Wagner S.
        • et al.
        Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews.
        J Affect Disord. 2011; 133: 61-68
        • Kalarchian M.A.
        • King W.C.
        • Devlin M.J.
        • et al.
        Psychiatric disorders and weight change in a prospective study of bariatric surgery patients: a 3-year follow-up.
        Psychosom Med. 2015; 11: S47
        • Belle S.H.
        • Berk P.D.
        • Courcoulas A.P.
        • et al.
        The safety and efficacy of bariatric surgery: the Longitudinal Assessment of Bariatric Surgery (LABS).
        Surg Obes Relat Dis. 2007; 3: 116-126
        • Christian N.J.
        • King W.C.
        • Yanovski S.Z.
        • Courcoulas A.P.
        • Belle S.H.
        Validity of self-reported weights following bariatric surgery.
        JAMA. 2013; 310: 2454-2456
        • King W.C.
        • Hinerman A.S.
        • Belle S.H.
        • Wahed A.S.
        • Courcoulas A.P.
        Comparison of the performance of common measures of weight regain after bariatric surgery for association with clinical outcomes.
        JAMA. 2018; 320: 1560-1569
        • First M.G.
        • Spitzer R.L.
        • Gibbon M.
        • Williams J.B.
        Structured clinical interview for DSM-IV axis I disorders—patient edition.
        Biometrics Research Department, New York1995 (SCID-I/P, Version 2)
        • Frendl D.M.
        • Ware Jr., J.E.
        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
        • Kolotkin R.L.
        • Andersen J.R.
        A systematic review of reviews: exploring the relationship between obesity, weight loss and health-related quality of life.
        Clin Obes. 2017; 7: 273-289
        • Ware J.
        • Kosinski M.
        • Keller S.K.
        SF-36® physical and mental health summary scales: a user's manual.
        The Health Institute, Boston1994
        • White M.A.
        • Kalarchian M.A.
        • Levine M.D.
        • Masheb R.M.
        • Marcus M.D.
        • Grilo C.M.
        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
        • Sheets C.S.
        • Peat C.M.
        • Berg K.C.
        • et al.
        Post-operative psychosocial predictors of outcome in bariatric surgery.
        Obes Surg. 2015; 25: 330-345
        • Meany G.
        • Conceição E.
        • Mitchell J.E.
        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
        • Delvin M.J.
        • King W.C.
        • Kalarchian M.A.
        • et al.
        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
        • Delvin M.J.
        • King W.C.
        • Marcus M.D.
        • Kalarchian M.A.
        • Yanovski S.Z.
        • Mitchell J.
        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
        • Blackburn A.N.
        • Hajnal A.
        • Leggio L.
        The gut in the brain: the effects of bariatric surgery on alcohol consumption.
        Addict Biol. 2017; 22: 1540-1553
        • Steffen K.J.
        • Engel S.G.
        • Wonderlich J.A.
        • Pollert G.A.
        • Sondag C.
        Alcohol and other addictive disorders following bariatric surgery: prevalence, risk factors and possible etiologies.
        Eur Eat Disord Rev. 2015; 23: 442-450