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

Abstract

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.

Obesity in children and adolescents: epidemiology, causes, assessment, and management

“… 181 , 182 However, incidence and remission of mental health problems are highly variable following metabolic and bariatric surgery; a proportion of youth will continue to experience mental health concerns post-surgery that can persist long-term, with a subset experiencing suicidal ideations and behaviours. 183 , 184 , 185 , 186 Pre-surgical and post-surgical psychological support is recommended 187 and is associated with improved psychosocial health and weight loss maintenance. 188 Mortality rates 5 years following metabolic and bariatric surgery in adolescents (1·9%) appear to be similar to that of adults (1·8%) but adolescents tend to require abdominal reoperations more frequently than adults and have a higher incidence of low levels of ferritin, 177 requiring monitoring of nutritional status.…”

Prevalence of depression in post-bariatric surgery among Saudi females in Riyadh

“…Pharmacological treatments, diets, and lifestyle changes appear to be ineffective in morbidly obese patients (Brandao et al, 2015). The standard treatment for severe obesity in adults is metabolic and bariatric surgery (MBS), studies focusing on safety, weight loss, and the resolution of comorbidities after MBS have found similar favorable outcomes in adolescents and adults (Järvholm et al, 2021).…”

“…Obesity is a major health issue that can lead to a variety of comorbidities, including cardiovascular disease, metabolic syndrome, and a higher mortality rate. Obese people are more likely to experience psychological distress, depression, anxiety, sadness, suicidal ideation and a reduction in their health-related quality of life (HRQoL) particularly women (Sait et al, 2019;Järvholm et al, 2021). Patients with obesity-related comorbidities like cardiovascular diseases and diabetes mellitus type 2 tend to increase the risk of developing depression (Sait et al, 2019).…”

Pediatric obesity—Long‐term consequences and effect of weight loss

“…However, long term follow‐up of adolescents after bariatric surgery indicates that, despite good short‐term effects [194], the positive effects of weight loss on depression and anxiety are very limited. These results indicate that depression and anxiety, at least among adolescents with severe obesity, are associated with but not caused by obesity [195–197].…”