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BackgroundPreoperative anxiety, and to some extent depression, predict the perceived impact of somatic symptoms (such as dumping, pain, and fatigue) one year after Roux-en-Y gastric bypass (RYGB). Negative attention to and interpretation of somatic symptoms may thus be associated with post-operative changes in affect. ObjectivesThe aim of this study was to explore whether preoperative anxiety and depressive symptoms predicted the perceived impact of somatic symptoms three years after RYGB.Secondly, we aimed to examine the three-year trajectory of depressive and anxiety symptoms, and their interaction with perceived somatic symptoms postoperatively. SettingUniversity hospital. MethodsPre-surgery, 1-, and 3-years post-surgery data were collected from 169 participants (62.4% follow-up). A cross-lagged, autoregressive regression analysis was employed to examine the mutual interaction of trajectories over the follow-up period. ResultsFatigue (30.8%) and dumping (23.7%) were common high-impact symptoms three years postoperatively. Pre-surgery anxiety was associated with higher impact of fatigue (p<.001), pain (p<.001), and diarrhea (p<.001), while pre-surgery depressive mood was related to reporting higher impact of diarrhea (p<.01) at 3-year follow-up. Higher anxiety/depression symptoms were related to higher perceived total symptom impact at one and three years postoperatively, controlling for percent total weight loss. Higher impact of somatic symptoms at one-year post-surgery predicted a significant increase in depressive symptoms 3-years postsurgery. ConclusionHigher perceived total symptom burden (pain, fatigue, dumping, diarrhea, and vomiting) at one-year post-surgery predicted increase in depression over the next two years. The results underscore the importance of managing somatic symptoms after surgery to prevent patients' distress..

Purpose After bariatric surgery, body contouring surgery (BCS) is thought to improve body image, weight loss, and mental health. Many patients desire but do not undergo BCS after bariatric surgery. This patient subset has rarely been studied. The present study compares bariatric surgery patients that, at 5 years after surgery, desires, have undergone or have no desire for BCS regarding pre- and post-surgery body image and mental health, including within-group changes over time. Materials and Methods Data were collected from participants (N = 216) pre-bariatric surgery and at 1- and 5-year post-surgery. Health care providers measured body mass index (BMI). All other data were collected via self-report (questionnaires). Results At 5-year post-surgery, 30.6% had undergone BCS, 17.1% did not desire it, and 52.3% desired BCS. Patients who subsequently desired BCS scored lower on body satisfaction pre-surgery than the other groups. They also reported less resilience pre-surgery and more depressive symptoms at all times compared to participants with BCS. For five-year post-surgery, patients who desired BCS had lower body satisfaction levels than patients with BCS and were more bothered with excess skin relative to the two other groups. Body satisfaction improved in all three groups from baseline to five years and in most patients with BCS. Mental health improved only in patients with BCS. Conclusion This study emphasizes the relevance of identifying participants who desire but have not undergone BCS. The study suggests that BCS is associated with improved body image and mental health. Graphical abstract