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Pre-surgical depression does not affect weightloss post-surgery

Patients suffering from depression can experience health outcomes and quality of life improvements comparable to non-depressed patients
Doctors and patients still need to consider psychological issues prior to surgery
Jonathan Finks

According to a study of more than 25,000 patients entitled, ‘Prevalence of psychiatric disease among morbidly obese patients undergoing bariatric surgery: Results from the Michigan bariatric surgery collaborative’, depression and anxiety do not seem to interfere with the amount of weight loss or the improvement of obesity-related conditions after bariatric surgery. 

“Depression and anxiety are relatively common among those with chronic diseases like obesity and type 2 diabetes, and these conditions can sometimes interfere with treatment,” said Dr Jonathan F Finks, Assistant Professor of Surgery at the University of Michigan, and lead study author. “This study suggests bariatric patients suffering from depression can experience health outcomes and quality of life improvements comparable to non-depressed patients. However, doctors and patients still need to consider psychological issues, state of mind and commitment to lifestyle changes after surgery in assessing whether bariatric surgery is appropriate and indicated for any particular patient.”


University of Michigan researchers examined data from 25,469 patients across 29 hospitals in the Michigan Bariatric Surgery Collaborative (MBSC), a consortium of the state’s hospitals and surgeons that maintains a prospective registry of bariatric surgery patients. Between 2006 and 2010, researchers found 11,687 bariatric patients (46%) were being treated for at least one psychiatric disorder, with depression (41%) and anxiety (15%) among the most common. Follow-up surveys of these patients were conducted each year for three years after surgery.


Excess weight loss at one year was similar between patients suffering from a psychiatric disorder and those with no known disorder (57.2% vs 58.7%). All patients reported 28% to 32% improvement in quality of life measures including mobility, family life, social interactions, and independent living.


However, patients with clinically diagnosed depression had a higher rate of minor complications compared with non-depressed patients (4.0% vs 3.3%). There were no significant differences in major complications. Among patients with depression, use of antidepressant medications dropped from 72% to 60% one year after surgery and remained at that level after three years of follow-up.


“Depression and anxiety are relatively common among those with chronic diseases like obesity and type 2 diabetes, and these conditions can sometimes interfere with treatment,” said Finks. “This study suggests bariatric patients suffering from depression can experience health outcomes and quality of life improvements comparable with non-depressed patients.”


He added that physicians need to consider psychological issues, state of mind, and commitment to lifestyle changes after surgery when assessing whether bariatric surgery is appropriate for an individual patient.


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