Psychosocial Consequences of Bariatric Surgery: Two Sides of a Coin: a Scoping Review

Abstract

This scoping review summarizes current evidence with regard to the impact of bariatric surgery on psychological health in adults with obesity. While a large body of evidence reports major metabolic benefit and improved quality of life, there is also ample evidence suggesting an increased incidence of self-harming behavior, a greater likelihood of developing an alcohol problem and higher rates of completed suicide among bariatric patients. Being able to identify the "at risk" patient population requires more longitudinal research into the risk factors for psychological complications after bariatric surgery. Bariatric surgery remains an extremely valuable long-term treatment option for managing obesity; however, there is a need to invest in mitigating psychological complications after the surgery, such as depression, alcohol consumption, and other self-harming behaviors.

Predicting satisfaction with outcome and follow‐up care 5 years after bariatric surgery: A prospective evaluation

“…Several studies report a reduction in the prevalence of depressive, and to some degree anxiety symptoms among many patients in the first few years after bariatric surgery. 23,24 This change, together with an improvement in body image, seems to correspond with changes in body weight. In the long-term, a relapse in psychological concerns, such as depressive symptoms and body image problems, has been documented, often in association with suboptimal weight loss.…”

“…Several studies report a reduction in the prevalence of depressive, and to some degree anxiety symptoms among many patients in the first few years after bariatric surgery 23,24 . This change, together with an improvement in body image, seems to correspond with changes in body weight.…”

“…This change, together with an improvement in body image, seems to correspond with changes in body weight. In the long‐term, a relapse in psychological concerns, such as depressive symptoms and body image problems, has been documented, often in association with suboptimal weight loss 23,24 . For example, depressive symptoms have been associated with less outcome satisfaction at 2 years 12 and 4 years after surgery, 6 and body dissatisfaction has generally been related to lower satisfaction when assessed at the same time 6,13 .…”

“…In the long‐term, a relapse in psychological concerns, such as depressive symptoms and body image problems, has been documented, often in association with suboptimal weight loss. 23 , 24 For example, depressive symptoms have been associated with less outcome satisfaction at 2 years 12 and 4 years after surgery, 6 and body dissatisfaction has generally been related to lower satisfaction when assessed at the same time. 6 , 13 As post‐surgical psychological factors are often interrelated with both weight loss and negative somatic symptoms, 25 , 26 it can be challenging to dissect the specific impact of mental health and body image on the degree of satisfaction with the outcome.…”

“…In addition to an association between excess body weight and poorer health‐related quality of life, findings from review studies indicate that bariatric surgery candidates have increased psychiatric symptoms and diagnoses. 23 , 24 Patients' mental health and body image before surgery may thus influence satisfaction through expectations and worries that affect the experience and interpretation of postsurgical outcomes. 27 , 28 For example, concerns about the procedure and possible side effects may increase the patient's awareness and duration of symptoms.…”