Depression, Anxiety, and Binge Eating Before and After Bariatric Surgery: Problems That Remain

Abstract

Background: As the number of surgeries increases and the elapsed time of the realization increases as well, the postoperative evaluations would become increasingly necessary. Aim: To assess the psychological profile before and after surgery. Methods: Were evaluated 281 patients from the public service of bariatric surgery. In this study, 109 patients completed the evaluations before surgery (T0) and up to 23 months after surgery (T1); 128 completed the evaluations in T0 and between 24 months and 59 months after surgery (T2); and 44 completed the evaluations in T0 and 60 months after surgery (T3). A semi-structured interview, the Beck Depression Inventory (BDI), Beck Anxiety (BAI), and the Binge Eating Scale (BES) were used. Results: There was a higher prevalence of female (83%), patients with less than 12 years of education (83%), and patients who have a partner (64%). Analyzing all times of evaluation, regarding anxiety, depression, and binge eating, there was a reduction in all symptoms in T1, pointing to significant improvements in the first 23 months after surgery. Already, in T2 and T3, there was an increase in all indicators of anxiety, depression, and binge eating pointing to the transient impact of weight loss or bariatric surgery on these symptoms. Conclusions: This study shows the importance of the continuous psychological evaluation and needs for the appropriate interventions for these patients who have undergone bariatric surgery, even after weight loss.

Psychological outcomes following surgical and endoscopic bariatric procedures: A systematic review

“…There were nine studies that collected their follow‐up data at around 24 months post‐surgery. Eight out of these nine studies reported a reduction in depression symptoms from pre‐surgery, but one study found that pre‐surgery depression symptoms remained the same at 24‐month follow‐up . Two of these studies used clinical assessments and found an overall reduction of people with depression, whereas one did not …”

“…Six studies conducted RYGB or GBY, and six used LAGB . Other studies used SG, BPD/DS, VG, and GB, but these were not very commonly used, and they found similar outcomes to other surgery options.…”

“…There were six studies that collected their follow‐up data at around 48 months post‐surgery. Five out of these six studies reported a reduction in depression symptoms from pre‐surgery, but one study found that depression symptoms returned to pre‐surgery levels, after having reduced at earlier time points . One study used a clinical diagnosis and structured clinical assessment instead of questionnaires, and this was the only study to find depression symptoms return to pre‐surgery levels .…”

“…One study found that those who undertook surgery (GB group) had a greater reduction in depression symptoms compared with those who received non‐surgical intervention . Furthermore, one study measured outcomes from 24 to 59 months post‐surgery and found a reduction in depression symptoms from pre‐surgery …”

Impact of Depression on Weight Variation after Bariatric Surgery: A Three-Year Observational Study

“…In most current literature, improved long-term depression outcomes among BS patients have been shown, although some studies have not demonstrated improvement and others have revealed worsening [9][10][11]. However, little is known about the impact that the diagnosis of depression before bariatric surgery (DDBS) may have on weight loss.…”