5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: a prospective cohort study

Järvholm, Kajsa; Bruze, Gustaf; Peltonen, Markku; Marcus, Claude; Flodmark, Carl Erik; Henfridsson, Pia; Beamish, Andrew J.; Gronowitz, Eva; Dahlgren, Jovanna; Karlsson, Jan; Olbers, Torsten

doi:10.1016/s2352-4642(20)30024-9

Cited by 47 publications

(64 citation statements)

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“…When adolescents in the present study were assessed at baseline using the adolescent questionnaire BYI, 24% reported highly elevated symptoms of depression and 19% reported highly elevated symptoms of anxiety [11]. Even if a direct comparison is not possible due to the differences in assessment, the findings in the present study support the main conclusion of our previous study using register data: adolescent MBS should not be expected to alleviate mental health problems [14].…”

Section: Discussionsupporting

confidence: 73%

“…Some US studies indicate equal or better mental health in adolescents undergoing MBS compared with age-matched peers with severe obesity undergoing lifestyle treatment [21,38]. Other US studies and our previous findings from Sweden, however, show equal or worse mental health in the MBS group compared with a control group of conventionally treated adolescents with severe obesity [14,39]. Therefore, regardless of the type of treatment, it is important to address mental health issues when treating adolescents and young adults for severe obesity.…”

Section: Discussionmentioning

confidence: 62%

“…Many patients, including adolescents, report reduced symptoms of depression and improved health-related quality of life (HRQoL) during the first year after MBS [8][9][10][11]. However, weight loss does not appear to improve long-term mental health in an unambiguous way [12][13][14]. Studies of mental health outcomes after adolescent MBS in young adulthood are limited, but previous studies from our Swedish group and US cohorts indicate that adolescents and young adults undergoing MBS are more psychologically vulnerable than middle-aged patients [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Depression, anxiety, and suicidal ideation in young adults 5 years after undergoing bariatric surgery as adolescents

et al. 2020

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Purpose Metabolic and bariatric surgery (MBS) is increasingly used in adolescents. The aim was to explore symptoms of depression and anxiety in young adults over 5 years’ follow-up after undergoing MBS. Methods Beck Depression Inventory-2 and the Beck Anxiety Inventory were used to assess symptoms of depression and anxiety in 62 patients 1, 2, and 5 years after having Roux-en-Y gastric bypass at 13–18 years of age. Mental health, eating-related problems, and weight outcomes were tested for association with suicidal ideation at the 5-year follow-up. Results At the 5-year follow-up, the mean score for depression was 11.4 (± 12.4), indicating minimal symptoms of depression. The mean score for anxiety was 12.82 (± 11.50), indicating mild anxiety symptoms. Still, several participants reported moderate or severe symptoms of depression (26%) and anxiety (32%). Women reported more symptoms than men (P = 0.03 and 0.04). No significant changes were found in self-reported symptoms of depression and anxiety between the 1-year and the 5-year follow-up (P = 0.367 and 0.934). Suicidal ideation was reported by 16% at the 5-year follow-up. Participants reporting suicidal ideation had lost significantly less excess weight than participants without suicidal ideation (P = 0.009). Conclusion Five years after adolescent MBS, a substantial minority still struggles with mental health issues, and women are more burdened than men. Our results indicate an association between less optimal weight loss and suicidal ideation 5 years after MBS. The findings emphasize the importance of offering long-term follow-up and mental health treatment several years after MBS. Level of evidence Level III, cohort study. Clinical trial registration The study is registered with ClinicalTrials.gov (NCT00289705). First posted February 10, 2006.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

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Depression, anxiety, and suicidal ideation in young adults 5 years after undergoing bariatric surgery as adolescents

et al. 2020

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“…47 However, a 5-year follow-up study in adolescents with morbid obesity who underwent bariatric surgery demonstrated no significant improvement in self-esteem. 48 Potentially, a small proportion of participants may be at risk of developing worsening pathology, which clinicians should monitor, while treatment of weight concerns should be considered within treatment plans for young people with depression and obesity. 46 Identification of these young people and provision of additional support may improve treatment outcomes while benefits to psychological well-being following treatment should be considered when assessing treatment success.…”

Section: Systematic Reviews On Interventionsmentioning

confidence: 99%

Psychotherapy versus treatment as usual and other control interventions in children and adolescents with overweight and obesity: a protocol for systematic review with meta-analysis and Trial Sequential Analysis

et al. 2020

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IntroductionThe prevalence of children with overweight and obesity is increasing worldwide. Multicomponent interventions incorporating diet, physical activity and behavioural change have shown limited improvement to body mass index (BMI). However, the impact of psychotherapy is poorly explored. This systematic review aims to assess the effects of psychotherapeutic approaches for children with all degrees of overweight.Methods and analysisWe will include randomised clinical trials involving children and adolescents between 0 and 18 years with overweight and obesity, irrespective of publication type, year, status or language up to April 2020. Psychotherapy will be compared with no intervention; wait list control; treatment as usual; sham psychotherapy or pharmaceutical placebo. The following databases will be searched: Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE, Embase, PsycINFO, PubMed, Web of Science, CINAHL and LILACS. Primary outcomes will be BMI z-score, quality of life measured by a validated scale and proportion of patients with serious adverse events. Secondary outcomes will be body weight, self-esteem, anxiety, depression and proportion of patients with non-serious adverse events. Exploratory outcomes will be body fat, muscle mass and serious adverse events. Study inclusion, data extraction and bias risk assessments will be conducted independently by at least two authors. We will assess risk of bias according to Cochrane guidelines and the Cochrane Effective Practice and Organisation of Care guidance. We will use meta-analysis and control risks of random errors with Trial Sequential Analysis. The quality of the evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation Tool. The systematic review will be reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Cochrane guidelines.Ethics and disseminationAs individual patient data will not be included, we do not require ethics approval. This review will be published in a peer review journal.PROSPERO registration numberCRD42018086458.

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“…Adolescents who have bariatric surgery continue to experience mental health problems five years after surgery despite substantial weight loss, a study has found 1…”

mentioning

confidence: 99%

Obesity surgery does not lead to long term alleviation of mental health problems in teens, study finds

Iacobucci¹

2020

BMJ

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5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: a prospective cohort study

Cited by 47 publications

References 26 publications

Depression, anxiety, and suicidal ideation in young adults 5 years after undergoing bariatric surgery as adolescents

Depression, anxiety, and suicidal ideation in young adults 5 years after undergoing bariatric surgery as adolescents

Psychotherapy versus treatment as usual and other control interventions in children and adolescents with overweight and obesity: a protocol for systematic review with meta-analysis and Trial Sequential Analysis

Obesity surgery does not lead to long term alleviation of mental health problems in teens, study finds

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