This study aims to review the obesity literature in order to assess the impact of bariatric surgery on quality of life and the between-study variation by examining the standardized mean magnitude of effect in change in the levels of quality of life. The following databases EMBASE, PubMed, PsycINFO, CINAHL, the Cochrane Library and Web of Science were systematically searched for studies examining change in quality of life in adults receiving bariatric surgery for obesity. Seventy-two studies were included with a total of 9,433 participants treated for obesity with bariatric surgery. The average impact of bariatric surgery on quality of life corresponded to an effect size of 0.88 (95% CI: 0.80-0.96), indicating that bariatric surgery has a significant positive influence on quality of life in general. The impact varied considerably across studies with bariatric surgery showing a significantly greater positive influence on physical quality of life compared to mental quality of life. Bariatric surgery is effective in improving quality of life, especially when looking at physical well-being. Greater focus on the psychological well-being of the person undergoing surgery for obesity may lead to a better post-surgery prognosis for more people.

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Psychiatric disorders as risk factors for type 2 diabetes: an umbrella review of systematic reviews with and without meta-analyses,

Aims/hypothesis Estimates of the global prevalence of type 2 diabetes vary between 6% and 9%. The prevalence of type 2 diabetes has also been investigated in psychiatric populations, but a critical appraisal of the existing evidence is lacking, and an overview is needed. This umbrella review summarizes existing systematic reviews of observational studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder. MethodsWe searched PubMed, EMBASE, PsycINFO and Cochrane Database of Systematic Reviews from inception to January 17, 2021, and screened reference lists of included systematic reviews. Based on prespecified criteria we included systematic reviews investigating prevalence of type 2 diabetes in adults (≥18years) with a psychiatric disorder. Title and abstracts of 5,155 identified records and full text of 431 selected studies were screened by two independent reviewers, based on predefined eligibility criteria and an a priori developed extraction form, following the PRISMA and MOOSE guidelines. Risk of bias was assessed with the ROBIS instrument. Data extracted from primary studies were synthesized using random-effects metaanalyses.Results A total of 32 systematic reviews with 245 unique primary studies were identified and met inclusion criteria. Of them, 12 had low risk of bias. They reported type 2 diabetes prevalence estimates ranging from 5% to 22% depending on the specific psychiatric disorder. We meta-analyzed data for ten categories of psychiatric disorders and found prevalence estimates of type 2 diabetes varying between 8% to 40%: 40% among people with sleep disorders, 21% in binge eating disorders, 16% in substance use disorders, 14% in anxiety disorders, 11% in bipolar disorders, 11% in psychosis, 10% in schizophrenia, 10% in a mixed group of psychiatric disorders, 9% in depression, and 8% in intellectual disabilities. All meta-analyses revealed high levels of heterogeneity. Conclusions/interpretationType 2 diabetes is a common comorbidity in people with a psychiatric disorder.Future research should investigate whether routine screening for type 2 diabetes and subsequent prevention initiatives for these people are warranted. PROSPERO registration no: CRD42020159870How might this impact on clinical practice in the foreseeable future?• Type 2 diabetes is a common comorbidity in individuals with psychiatric disorders. Future research should evaluate whether diabetes screening is warranted and whether diabetes treatment targets are currently met in this group.

Individuals with a binge/purge-type of eating disorder may be particularly vulnerable to interpersonal issues and these issues may lead to poorer treatment recovery by reducing the individual's ability to engage in the treatment process on a functional level. The clinical and research implications are discussed.