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

Pedro, Jorge; Neves, João Sérgio; Ferreira, Maria João; Guerreiro, Vanessa; Salazar, Daniela; Viana, Sara; Mendonça, Fernando; Silva, Maria Manuel; Brandão, Isabel; Belo, Sandra; Freitas, Paula; Varela, Ana; Carvalho, Davide

doi:10.1159/000506404

Cited by 9 publications

(18 citation statements)

References 28 publications

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“…Surgery has a more positive impact on the depressive disorders than anxiety disorders (de Zwaan et al, 2011), but preoperative symptoms also likely affect the results of the surgical methods. Preoperative depression is also associated with lower postoperative weight loss (Pedro et al, 2020). Although MOR availability is associated with depressive and anxious symptoms (Nummenmaa et al, 2020), we observed no association between depressive and anxiety symptoms and weight loss.…”

Section: Discussioncontrasting

confidence: 61%

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Karlsson

Tuominen

Helin

et al. 2021

Preprint

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BackgroundBariatric surgery is the most effective method for weight loss in morbid obesity. There is significant individual variability in the weight loss outcomes, yet factors leading to postoperative weight loss or weight regain remain elusive. Alterations in the µ-opioid receptor (MOR) and dopamine D2 receptor (D2R) systems are associated with obesity, appetite control, and reward processing. The magnitude of initial brain receptor system perturbation is a plausible predictor of long-term surgical weight loss outcomes. The aim was to test this hypothesis by measuring obese subjects’ MOR and D2R availability with positron emission tomography (PET) preoperatively before bariatric surgery and then assessing their weight development association with regional MOR and D2R availabilities at 2-year follow-up.MethodsWe studied 19 morbidly obese women (mean BMI 40, mean age 43) scheduled to undergo bariatric surgery, i.e. Roux-en-Y gastric bypass or sleeve gastrectomy, according to their standard clinical treatment. Preoperative MOR and D2R availabilities were measured using PET with [11C]carfentanil and [11C]raclopride, respectively. Subject weight was recorded at 3, 6, 12, and 24 months after surgery. Radiotracer binding potentials (BPND) were extracted and correlated with patient weight at different time points. ROIs were delineated in the striatum and in limbic and paralimbic components of the emotion and reward networks.ResultsMOR availabilities were not correlated with preoperative weight. MOR availabilities in the amygdala (r = −0.54), insula (r = −0.46), ventral striatum (r = −0.48) and putamen (r = −0.49) were associated with subject weight at 3 months. Significant association was found in the amygdala at 6 months (r = −0.53), 12 (r = −0.49), and 24 months (r = −0.50). D2R availabilities were associated with neither preoperative weight nor weight loss at any follow-up time point.ConclusionsTo our knowledge, this is the first study to demonstrate that neuroreceptor markers prior to bariatric surgery in patients with morbid obesity are associated with the postoperative weight loss. Preoperative MOR availability in the amygdala was associated with long-term postoperative weight development after surgery suggesting that postoperative weight regain may derive from dysfunction in the opioid system. Postoperative weight loss outcomes after bariatric surgery may be partially predicted based on preoperative receptor availability opening up new potential for treatment possibilities.Clinical Trials RegistrationSleevePET2, NCT01373892, http://www.clinicaltrials.gov

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Section: Discussioncontrasting

confidence: 61%

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Karlsson

Tuominen

Helin

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Surgery has a more positive impact on the depressive disorders than anxiety disorders ( 34 ), but preoperative symptoms also likely affect the results of the surgical methods. Preoperative depression is also associated with lower postoperative weight loss ( 35 ). Although MOR availability is associated with depressive and anxious symptoms ( 36 ), we observed no association between depressive and anxiety symptoms and weight loss.…”

Section: Discussionmentioning

confidence: 99%

Preoperative brain μ-opioid receptor availability predicts weight development following bariatric surgery in women

Karlsson¹,

Tuominen²,

Helin³

et al. 2021

JCI Insight

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Bariatric surgery is the most effective method for weight loss in morbid obesity. There is significant individual variability in the weight loss outcomes, yet factors leading to postoperative weight loss or weight regain remain elusive. Alterations in the µ-opioid receptor (MOR) and dopamine D2 receptor (D2R) systems are associated with obesity and appetite control, and the magnitude of initial brain receptor system perturbation may predict long-term surgical weight loss outcomes. We tested this hypothesis by studying 19 morbidly obese women (mean BMI 40) scheduled to undergo bariatric surgery. We measured their preoperative MOR and D2R availabilities using positron emission tomography (PET) with [ 11 C]carfentanil and [ 11 C]raclopride, respectively, and then assessed their weight development association with regional MOR and D2R availabilities at 24-month follow-up. MOR availability in the amygdala consistently predicted weight development throughout the followup period, but no associations were found for D2R. This is the first study to demonstrate that neuroreceptor markers prior to bariatric surgery are associated with the postoperative weight development. Postoperative weight regain may derive from dysfunction in the opioid system, and weight loss outcomes after bariatric surgery may be partially predicted based on preoperative brain receptor availability opening up new potential for treatment possibilities.

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“…The BES is a 16-item self-report questionnaire assessing the severity of binge eating behavior. Total scores range from 0 to 46 with cut-off scores of possible (18)(19)(20)(21)(22)(23)(24)(25)(26) and probable (≥ 27) BED (31). Cronbach's alpha in the present sample was 0.91.…”

Section: Psychometric Instrumentsmentioning

confidence: 80%

“…the period of rapid and drastic weight loss that begins immediately after surgery and continues for six to 12 months), differences in patients' weight loss trajectories became apparent (14,15). More precisely, it was reported that either binge eating disorders (BED) or major depression consistently exhibited their negative effect on body mass index (BMI) evolution at least two years after surgery (16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive and Psychopathological Predictors of Weight Loss After Bariatric Surgery: A 4-Year Follow-Up Study

et al. 2021

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Twenty to thirty percent of patients experience weight regain at mid and long-term follow-up. Impaired cognitive functions are prevalent in people suffering from obesity and in those with binge eating disorder, thereby, affecting the weight-loss outcomes. The aim of our study was to investigate neurocognitive and psychopathological predictors of surgical efficacy in terms of percentage of excess weight loss (%EWL) at follow-up intervals of one year and 4-year. Psychosocial evaluation was completed in a sample of 78 bariatric surgery candidates and included psychometric instruments and a cognitive battery of neuropsychological tests. A schedule of 1-year and 4-year follow-ups was implemented. Wisconsin Sorting Card Test total correct responses, scores on the Raven’s Progressive Matrices Test, and age predicted %EWL at, both, early and long-term periods after surgery while the severity of pre-operative binge eating (BED) symptoms were associated with lower %EWL only four years after the operation. Due to the role of pre-operative BED in weight loss maintenance, the affected patients are at risk of suboptimal response requiring ongoing clinical monitoring, and psychological and pharmacological interventions when needed. As a result of our findings and in keeping with the latest guidelines we encourage neuropsychological assessment of bariatric surgery candidates. This data substantiated the rationale of providing rehabilitative interventions tailored to cognitive domains and time specific to the goal of supporting patients in their post-surgical course.

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

Cited by 9 publications

References 28 publications

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Preoperative brain μ-opioid receptor availability predicts weight development following bariatric surgery in women

Neurocognitive and Psychopathological Predictors of Weight Loss After Bariatric Surgery: A 4-Year Follow-Up Study

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