Bariatric surgery not a magic wand to curb depression

Most severely obese people experience much better spirits once they shed weight through a diet, lifestyle changes or medical intervention. This is unfortunately not true for everyone, says Valentina Ivezaj and Carlos Grilo of the Yale University School of Medicine in the US. In an article in Springer’s journal Obesity Surgery, the researchers advise that the levels of depression in patients be measured six to 12 months after they have had such bariatric surgery. This will ensure that the necessary help can be provided when needed.

Ivezaj and Grilo set out to investigate how prone bariatric patients are to still experiencing depressive symptoms, and especially if such symptoms increase markedly or not at all, after post-surgery. Their study is the first to examine patients with discernible worsening depressive symptoms six and 12 months following gastric bypass surgery.

Self-reported questionnaires were completed by 107 patients with extreme obesity before they underwent gastric bypass surgery, and then again six and 12 months after the procedure. They were asked to reflect on their levels of depression, possible eating disorders, their self-esteem and general social functioning. Of the 107 participants, 94 were women and 13 were men, 73 were white and 24 had completed college.

Consistent with previous research, Ivezaj and Grilo observed that most people who had undergone this procedure were in much better spirits. In fact, most patients reported experiencing a normal and improved mood at six and 12 months after surgery. However, in some cases negative mood changes started to creep in between six and 12 months after the operation, with 3.7 percent of patients reporting that they felt discernibly more depressed 12 months post-surgery. Between six and 12 months after the operation, however, even more patients (13.1 percent) reported increases in depressive symptoms. These changes went hand-in-hand with significantly lower levels of self-esteem and social functioning.

“The majority of patients whose mood had worsened discernibly experienced these mood changes between six and 12 months post-surgery, suggesting this may be a critical period for early detection and intervention, as needed,” explains Ivezaj.

“The increases in symptoms of depression are also notable given that they were associated with other difficulties including lower self-esteem and social functioning,” adds Grilo.

Depression after Bariatric Surgery: Triggers, Identification, Treatment, and Prevention

A recent study in the Archives of Surgery has caught the attention of the bariatric community. It found the suicide rate after bariatric surgery to be at least five times that of the general population.1 This study may be thought of as important preliminary information, but it does not yet adequately explain the relationship between suicide and bariatric surgery. Nevertheless, this new information does highlight a need for bariatric professionals to educate their patients as to the possibility of depression postoperatively.