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Psychiatric Disorder Common Among Patients Seeking Bariatric Surgery: Study

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Mental health conditions – such as depression and binge eating disorders – have been found common among individuals who seek and undergo bariatric surgery, according to a new study.

A new study led by researchers from UCLA discovered that these mental conditions may be twice as prevalent among bariatric surgery patients versus the general American population, with almost a quarter having a mood disorder and almost 20 percent diagnosed with a binge eating problem before the operation.

The findings were published Jan. 12 in the Journal of the American Medical Association.

The Lowdown On Bariatric Surgery

Bariatric surgery is a weight loss procedure performed in severely obese individuals.

According to the U.S. Centers for Disease Control and Prevention, obesity affects 78.6 million Americans or about 34.9 percent of the population. It puts sufferers at risk of health issues such as heart disease and stroke, type 2 diabetes and even some types of cancer – all of which are deemed as the leading causes of preventable death.

Screening helps doctors and surgeons determine if someone is medically and psychologically fit to undergo the procedure. Even weight gain during the screening process can affect whether or not the patient should undergo surgery.

Depression, Binge Eating In Bariatric Surgery Patients

The team investigated 68 journals published from January 1988 to November last year, looking at the rates of mental health conditions among candidates and actual recipients of the surgery, as well as the pre-operation and post-procedure results.

They discovered that 23 percent undergoing bariatric surgery reported having a current mood disorder. Of those, 19 percent reported depression while 17 percent said they had binge-eating disorder.

The researchers defined mental health conditions as including problems such as depression, post-traumatic stress disorder, anxiety, substance abuse problems, personality disorders, suicidal thoughts, and eating disorders, specifically binge eating.

Lead investigator and UCLA general surgery resident Dr. Aaron Dawes underscored the importance of screening for treating these conditions in all people considered for bariatric surgery. He expanded on their findings.

"[W]e found no evidence to suggest that patients with these conditions lose less weight after surgery and some evidence that certain conditions, particularly depression, may actually improve after surgery," he explained.

The authors then said that these patients may stand to gain certain mental health benefits apart from the much-heralded weight loss effects of bariatric surgery.

However, the higher rates of some mental conditions did not appear to affect the weight outcomes – there was no significant gap in weight loss between those with or without pre-surgery depression a year after the operation.

Did Surgery Help Patients Lighten Up?

Perhaps a surprising result: undergoing bariatric surgery seemed to lower post-surgical depression rates.

"We were pretty surprised to find a somewhat dramatic drop in both the incidence of depression and the severity of the depressive symptoms after the operation," Dr. Dawes said in an interview.

The study cannot determine precisely why this is so, although the authors noted that the surgery may lead to a lower incidence of depression due to weight loss, enhanced self-esteem, body image changes and even altered biochemistry of the body.

But the result potentially hints at how certain mental conditions might be addressed as part of physical health conditions, such that they are related to or driven by obesity, instead of being a separate confounder.

Photo: Tony Alter | Flickr

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