Improvement in mood symptoms ​after post‐bariatric surgery among people with obesity: A systematic review and meta‐analysis

Abstract

Aims We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity. Materials and Methods We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre‐ and post‐surgery. Results There was a significant reduction in body mass index (BMI) post‐operatively (pooled d+: −13.3 kg/m2 [95% confidence interval [CI] 15.19, −11.47], p < 0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre‐operatively to 16.9% post‐operatively, with an odds ratio (OR) of 0.58 (95% CI 0.51, 0.67, p < 0.001). The reduction remained significant in women aged ≥40 years and irrespective of post‐operative BMI. There were significant reductions in Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: −0.64 [95% CI −1.06, −0.22], p = 0.003) and Generalized Anxiety Disorder Assessment‐7 score by 0.54 (pooled d+: −0.54 [95% CI −0.64, −0.44], p < 0.001). The pooled proportion of depressive symptoms reduced from 34.7% pre‐operatively to 20.4% post‐operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p < 0.001). The reduction remained significant irrespective of patient's age and post‐operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: −1.34 [95% CI −1.93, −0.76], p < 0.001), Beck’s Depression Inventory score (pooled d+: −1.04 [95% CI −1.46, −0.63], p < 0.001) and Patient Health Questionnaire‐9 score (pooled d+: −1.11 [95% CI −1.21, −1.01], p < 0.001). Conclusion Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.

Long-Term Trajectories in Weight and Health Outcomes Following Multidisciplinary Publicly Funded Bariatric Surgery in Patients with Clinically Severe Obesity (≥ 3 Associated Comorbidities): A Nine-Year Prospective Cohort Study in Australia

“…Although this improvement may hold true, depression severity did increase after 2–3 years post-surgery, as shown in a meta-analysis of 58 studies [ 69 ]. Our longitudinal design provided confirmatory data that bariatric surgery offers short-term but not long-term improvements in depression and anxiety, supporting the proposed notion of a ‘psychological honeymoon‘ period of 3 years post-surgery, followed by rebounds in anxiety, depressive symptoms and binge eating disorder, as reported in other studies [ 22 ]. We recommend that all bariatric surgical candidates receive preoperative education and psychiatric evaluation as to the possibility of mental illness.…”

“…Many previous studies have not reported progressive and combined measures (both medication use and blood tests) of obesity-related comorbidities over a long-term period [ 3 , 20 , 21 ]. A recent systematic review showed that the effects of bariatric surgery on mental health conditions are contradictory [ 22 ]. High rates of mental health conditions are relatively common in patients with extreme obesity—as high as 30–40% in bariatric surgery candidates [ 23 , 24 ]—yet long-term data, particularly beyond 3 years post-surgery, are also limited on mental illness after bariatric surgery [ 22 ].…”

“…A recent systematic review showed that the effects of bariatric surgery on mental health conditions are contradictory [ 22 ]. High rates of mental health conditions are relatively common in patients with extreme obesity—as high as 30–40% in bariatric surgery candidates [ 23 , 24 ]—yet long-term data, particularly beyond 3 years post-surgery, are also limited on mental illness after bariatric surgery [ 22 ]. The data on these health outcomes in highly complex populations undergoing bariatric procedures is needed in real-world clinical settings.…”

Changes in Marital Status Following Roux-en-Y Gastric Bypass and Sleeve Gastrectomy: A US Multicenter Prospective Cohort Study

“…Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most effective treatments for severe obesity and generally lead to sustainable improvements in weight, glycemic control, and other aspects of physical health. 1 – 4 Bariatric surgical procedures are also associated with improvements in mental health, 5 , 6 self-esteem, 7 , 8 body image, 9 , 10 sexual desire, 11 and comfort with physical intimacy. 7 …”

The Metabolic Efficacy of a Cannabidiolic Acid (CBDA) Derivative in Treating Diet- and Genetic-Induced Obesity

“…Interestingly, EPM301 has shown impressive results in treating neuro-behavioral conditions such as anxiety and nausea, demonstrating efficacy at lower doses compared to CBDA [ 28 ], and major depression [ 29 ]. Accordingly, depression was linked to obesity in different studies [ 30 , 31 , 32 , 33 ]. Hence, an intriguing question is whether EPM301 can be used to treat DIO and GIO.…”