Top

Published in:

01-03-2016 | Obesity + Diet (G. Rao, Section Editor)

The Impact of Bariatric Surgery on Depression: a Review

Authors: Noah J. Switzer, Estifanos Debru, Neal Church, Philip Mitchell, Richdeep Gill

Published in: Current Cardiovascular Risk Reports | Issue 3/2016

Abstract

More than half of patients with obesity who present for medical or surgical management meet the criteria for a psychiatric illness, commonly a mood disorder. Bariatric surgery leads to significant improvement in depression symptomology and a reduction in the overall prevalence of depression. Studies generally report short-term overall reduction in depression rates between approximately 55 to 65 % within the first two years following surgery. It appears that there is a dose response relationship between weight loss and resolution of depression. There are some conflicting reports in the literature as to the maintenance of depression outcomes following bariatric surgery, with newer, long-term studies reporting the attenuation of depression symptomology improvements. While generally, bariatric surgery is beneficial for depression, there exists a cohort of patients who might actually worsen following surgery. A likely multifactorial consequence of weight regain, unrealistic expectations or other life stresses, this group needs to be monitored closely, as postoperative bariatric surgery patients surgery appear to be at an increased risk of suicide. Overall, a multidisciplinary team including psychiatrists, psychologists and other mental health professionals are vital to optimize patient care in the depressed, obese bariatric surgery patient.

1.•

Mitchell JE, King WC, Chen JY, Devlin MJ, Flum D, Garcia L, et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obesity. 2014;22(8):1799–806. doi:10.1002/oby.20738. This is an observational study on a large cohort of US patients, describing the pre-operative incidence of depression in the bariatric patient and the effect of bariatric surgery on this outcome, up to 3 years postoperatively. CrossRefPubMedPubMedCentral

Higgs ML, Wade T, Cescato M, Atchison M, Slavotinek A, Higgins B. Differences between treatment seekers in an obese population: medical intervention vs. dietary restriction. J Behav Med. 1997;20(4):391–405.CrossRefPubMed

Roberts RE, Kaplan GA, Shema SJ, Strawbridge WJ. Are the obese at greater risk for depression? Am J Epidemiol. 2000;152(2):163–70.CrossRefPubMed

Green DD, Engel SG, Mitchell JE. Psychological aspects of bariatric surgery. Curr Opin Psychiatry. 2014;27(6):448–52. doi:10.1097/YCO.0000000000000101.CrossRefPubMed

Ryden A, Torgerson JS. The Swedish Obese Subjects Study—what has been accomplished to date? Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2006;2(5):549–60. doi:10.1016/j.soard.2006.07.006.CrossRef

6.••

Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA : J Am Med Assoc. 2004;292(14):1724–37. doi:10.1001/jama.292.14.1724. This reference is of particular importance to any study in bariatric surgery since this is the most well cited review on the outcomes of bariatric surgery. CrossRef

7.•

Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9. doi:10.1001/archgenpsychiatry.2010.2. This reference is important as it establishes and explains the bidirectional relationship between obesity and depression. CrossRefPubMed

Mansur RB, Brietzke E, McIntyre RS. Is there a “metabolic-mood syndrome”? A review of the relationship between obesity and mood disorders. Neurosci Biobehav Rev. 2015;52:89–104. doi:10.1016/j.neubiorev.2014.12.017.CrossRefPubMed

Bjorntorp P. Do stress reactions cause abdominal obesity and comorbidities? Obesity reviews: an official journal of the International Association for the Study of Obesity. 2001;2(2):73–86.CrossRef

10.

Onyike CU, Crum RM, Lee HB, Lyketsos CG, Eaton WW. Is obesity associated with major depression? Results from the Third National Health and Nutrition Examination Survey. Am J Epidemiol. 2003;158(12):1139–47.CrossRefPubMed

11.

Jones-Corneille L, Wadden T, Sarwer D. Risk of depression and suicide in patients with extreme obesity who seek bariatric surgery. Obes Manag. 2007;3(6):255–60.CrossRef

12.

Hubbard VS, Hall WH. Gastrointestinal surgery for severe obesity. Obes Surg. 1991;1(3):257–65.CrossRefPubMed

13.

Bauchowitz AU, Gonder-Frederick LA, Olbrisch ME, Azarbad L, Ryee MY, Woodson M, et al. Psychosocial evaluation of bariatric surgery candidates: a survey of present practices. Psychosom Med. 2005;67(5):825–32. doi:10.1097/01.psy.0000174173.32271.01.CrossRefPubMed

14.

Herpertz S, Kielmann R, Wolf AM, Hebebrand J, Senf W. Do psychosocial variables predict weight loss or mental health after obesity surgery? A systematic review. Obes Res. 2004;12(10):1554–69. doi:10.1038/oby.2004.195.CrossRefPubMed

15.

Cassin S, Sockalingam S, Hawa R, Wnuk S, Royal S, Taube-Schiff M, et al. Psychometric properties of the Patient Health Questionnaire (PHQ-9) as a depression screening tool for bariatric surgery candidates. Psychosomatics. 2013;54(4):352–8. doi:10.1016/j.psym.2012.08.010.CrossRefPubMed

16.

Kalarchian MA, Marcus MD, Levine MD, Soulakova JN, Courcoulas AP, Wisinski MS. Relationship of psychiatric disorders to 6-month outcomes after gastric bypass. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2008;4(4):544–9. doi:10.1016/j.soard.2008.03.003.CrossRef

17.

Powers PS, Rosemurgy A, Boyd F, Perez A. Outcome of gastric restriction procedures: weight, psychiatric diagnoses, and satisfaction. Obes Surg. 1997;7(6):471–7. doi:10.1381/096089297765555197.CrossRefPubMed

18.

Semanscin-Doerr DA, Windover A, Ashton K, Heinberg LJ. Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss? Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2010;6(2):191–6. doi:10.1016/j.soard.2009.11.017.CrossRef

19.

Fuchs HF, Laughter V, Harnsberger CR, Broderick RC, Berducci M, DuCoin C, et al. Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success. Surg Endosc. 2015. doi:10.1007/s00464-015-4196-8.

20.

Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Preoperative predictors of weight loss following bariatric surgery: systematic review. Obes Surg. 2012;22(1):70–89. doi:10.1007/s11695-011-0472-4.CrossRefPubMed

21.

Sheets CS, Peat CM, Berg KC, White EK, Bocchieri-Ricciardi L, Chen EY, et al. Post-operative psychosocial predictors of outcome in bariatric surgery. Obes Surg. 2015;25(2):330–45. doi:10.1007/s11695-014-1490-9.CrossRefPubMedPubMedCentral

22.

Fabricatore AN, Sarwer DB, Wadden TA, Combs CJ, Krasucki JL. Impression management or real change? Reports of depressive symptoms before and after the preoperative psychological evaluation for bariatric surgery. Obes Surg. 2007;17(9):1213–9.CrossRefPubMed

23.

Da Silva VB, Da Silva RB, Azorin JM, Belzeaux R. Mood disorders are highly prevalent but underdiagnosed among patients seeking bariatric surgery. Obes Surg. 2015;25(3):543–4. doi:10.1007/s11695-014-1557-7.CrossRefPubMed

24.

Duarte-Guerra LS, Coelho BM, Santo MA, Wang YP. Psychiatric disorders among obese patients seeking bariatric surgery: results of structured clinical interviews. Obes Surg. 2015;25(5):830–7. doi:10.1007/s11695-014-1464-y.CrossRefPubMed

25.

Ambwani S, Boeka AG, Brown JD, Byrne TK, Budak AR, Sarwer DB, et al. Socially desirable responding by bariatric surgery candidates during psychological assessment. Surg Obes Relat Dis : Off J Am Soc Bariatric Surg. 2013;9(2):300–5. doi:10.1016/j.soard.2011.06.019.CrossRef

26.

Burgmer R, Legenbauer T, Muller A, de Zwaan M, Fischer C, Herpertz S. Psychological outcome 4 years after restrictive bariatric surgery. Obes Surg. 2014;24(10):1670–8. doi:10.1007/s11695-014-1226-x.CrossRefPubMed

27.

Hayes S, Stoeckel N, Napolitano MA, Collins C, Wood GC, Seiler J, et al. Examination of the Beck Depression inventory-II factor structure among bariatric surgery candidates. Obes Surg. 2015;25(7):1155–60. doi:10.1007/s11695-014-1506-5.CrossRefPubMed

28.

Emery CF, Fondow MD, Schneider CM, Christofi FL, Hunt C, Busby AK, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg. 2007;17(6):759–63.CrossRefPubMed

29.

Burgmer R, Petersen I, Burgmer M, de Zwaan M, Wolf AM, Herpertz S. Psychological outcome two years after restrictive bariatric surgery. Obes Surg. 2007;17(6):785–91.CrossRefPubMed

30.

de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011;133(1–2):61–8. doi:10.1016/j.jad.2011.03.025.CrossRefPubMed

31.

Hayden MJ, Dixon JB, Dixon ME, Shea TL, O'Brien PE. Characterization of the improvement in depressive symptoms following bariatric surgery. Obes Surg. 2011;21(3):328–35. doi:10.1007/s11695-010-0215-y.CrossRefPubMed

32.

Sears D, Fillmore G, Bui M, Rodriguez J. Evaluation of gastric bypass patients 1 year after surgery: changes in quality of life and obesity-related conditions. Obes Surg. 2008;18(12):1522–5. doi:10.1007/s11695-008-9604-x.CrossRefPubMed

33.

Nijamkin MP, Campa A, Sosa J, Baum M, Himburg S, Johnson P. Comprehensive nutrition and lifestyle education improves weight loss and physical activity in Hispanic Americans following gastric bypass surgery: a randomized controlled trial. J Acad Nutr Diet. 2012;112(3):382–90. doi:10.1016/j.jada.2011.10.023.CrossRefPubMed

34.

McGuire MT, Wing RR, Klem ML, Lang W, Hill JO. What predicts weight regain in a group of successful weight losers? J Consult Clin Psychol. 1999;67(2):177–85.CrossRefPubMed

35.

Orth WS, Madan AK, Taddeucci RJ, Coday M, Tichansky DS. Support group meeting attendance is associated with better weight loss. Obes Surg. 2008;18(4):391–4. doi:10.1007/s11695-008-9444-8.CrossRefPubMed

36.

Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, et al. Long-term follow-up of patients’ status after gastric bypass. Obes Surg. 2001;11(4):464–8. doi:10.1381/096089201321209341.CrossRefPubMed

37.

Odom J, Zalesin KC, Washington TL, Miller WW, Hakmeh B, Zaremba DL, et al. Behavioral predictors of weight regain after bariatric surgery. Obes Surg. 2010;20(3):349–56. doi:10.1007/s11695-009-9895-6.CrossRefPubMed

38.

Ivezaj V, Grilo CM. When mood worsens after gastric bypass surgery: characterization of bariatric patients with increases in depressive symptoms following surgery. Obes Surg. 2015;25(3):423–9. doi:10.1007/s11695-014-1402-z.CrossRefPubMedPubMedCentral

39.

Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after long-term follow-up from bariatric surgery. Am J Med. 2010;123(11):1036–42. doi:10.1016/j.amjmed.2010.06.016.CrossRefPubMedPubMedCentral

Title: The Impact of Bariatric Surgery on Depression: a Review
Authors: Noah J. Switzer
Estifanos Debru
Neal Church
Philip Mitchell
Richdeep Gill
Publication date: 01-03-2016
Publisher: Springer US
Published in: Current Cardiovascular Risk Reports / Issue 3/2016
Print ISSN: 1932-9520
Electronic ISSN: 1932-9563
DOI: https://doi.org/10.1007/s12170-016-0492-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Impact of Bariatric Surgery on Depression: a Review

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content