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

Abstract

Obesity is a leading global epidemic. Bariatric surgery is the only treatment demonstrating substantial long-term weight loss and medical benefits. However, there is limited research on the psychological outcomes following surgery.Therefore, the primary aim of this study was to systematically review depression, anxiety, and binge eating outcomes at different time points following bariatric surgery and identify whether bariatric surgery significantly reduces psychological symptoms over time. These outcomes were also examined among endoscopic bariatric procedures as a secondary aim. Forty-eight studies met inclusion criteria.

The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology

“…An association between depression and obesity has been long supported by clinical and epidemiological studies ( 40 , 41 ) with a recent meta-analyses providing further evidence of this relationship in bariatric surgery patients ( 42 ). A review on the psychological outcomes after bariatric surgery found that pre-surgery depression symptoms reduced at 6, 12, and 24 months after bariatric surgery; however, from 36 months onwards, depression symptoms increased and returned to pre-surgery levels ( 43 ). Similarly, a population-based study of 4,793 participants found that bariatric surgery patients had higher levels of depression than others with similar BMI and that initial reductions in depression were not maintained at the follow-up ( 44 ).…”

Feasibility and Clinical Usefulness of the Unified Protocol in Online Group Format for Bariatric Surgery Candidates: Study Protocol for a Multiple Baseline Experimental Design

“…Obesity and being overweight have become a serious public health problem due to their high prevalence and associated costs [ 2 , 9 ]. EDs are highly present in people with obesity [ 7 ], and this can interfere with a commitment to voluntary weight loss [ 82 ] and it is also associated with worse post-intervention outcomes [ 11 ]. An intervention based on emotion-regulation training could help those patients to achieve both aims, to lose weight before the BS to prevent surgery problems and the emergence of emotional symptoms after the BS, maintaining their emotional and physical achievements over time.…”

“…The causes of obesity are complex and multifactorial [ 1 ], and this condition is associated with different health problems, such as myocardial infarction, hypertension, stroke, dyslipidemia, diabetes mellitus, or obstructive sleep apnea [ 4 , 5 , 6 ]. All these alterations affect the quality of life and can disturb important areas of functioning (e.g., physical function, vitality, social functioning and emotional role) [ 7 , 8 ]. In addition to all of these complications, people with obesity experience significant psychological difficulties [ 7 ].…”

“…All these alterations affect the quality of life and can disturb important areas of functioning (e.g., physical function, vitality, social functioning and emotional role) [ 7 , 8 ]. In addition to all of these complications, people with obesity experience significant psychological difficulties [ 7 ]. Due to all of these health implications, obesity represents a challenge to the countries’ economies [ 9 ].…”

“…For all these reasons (high prevalence and associated costs), many efforts have been made to find treatments for obesity and weight loss, which include lifestyle interventions, pharmacological interventions, surgical interventions, and endoscopic bariatric procedures [ 7 ]. Bariatric surgery (BS) is the most commonly performed procedure worldwide [ 10 ] and the most effective intervention for individuals with severe obesity (BMI greater than 40 kg/m 2 ) [ 11 ], and includes a group of surgical procedures performed to facilitate weight loss, such as open or laparoscopic roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding.…”