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

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.

• Authors: Melissa A Kalarchian, Wendy C King, Michael J Devlin, Amanda Hinerman, Marsha D Marcus, Susan Z Yanovski, James E Mitchell
• Journal: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Surg Obes Relat Dis) Vol. 15 Issue 5 Pg. 739-748 (May 2019) ISSN: 1878-7533 [Electronic] United States
• PMID: 30826244 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2019. Published by Elsevier Inc.

Topics

• Academic Medical Centers
• Adult
• Bariatric Surgery
• Female
• Follow-Up Studies
• Humans
• Longitudinal Studies
• Male
• Mental Disorders (epidemiology)
• Middle Aged
• Obesity, Morbid (surgery)
• Prevalence
• Prospective Studies
• Quality of Life
• United States (epidemiology)
• Weight Loss