Mental disorders and weight change in a prospective study of bariatric surgery patients: 7 years of follow-up |
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Authors: | Melissa A. Kalarchian Wendy C. King Michael J. Devlin Amanda Hinerman Marsha D. Marcus Susan Z. Yanovski James E. Mitchell |
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Affiliation: | 1. School of Nursing, Duquesne University, Pittsburgh, Pennsylvania;2. Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania;3. Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York;4. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania;5. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland;6. Neuropsychiatric Research Institute, Fargo, North Dakota |
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Abstract: | BackgroundLong-term, longitudinal data are limited on mental disorders after bariatric surgery.ObjectiveTo report mental disorders through 7 years postsurgery and examine their relationship with changes in weight and health-related quality of life.SettingThree U.S. academic medical centers.MethodAs a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 199 adults completed the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition prior to Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric band. Participants who completed ≥1 follow-up through 7 years postsurgery are included (n = 173; 86.9%). Mixed models were used to examine mental disorders over time, and among the RYGB subgroup (n = 104), their relationship with long-term (≥4 yr) pre- to postsurgery changes in weight and health-related quality of life, measured with the Short Form-36 Health Survey, and with weight regain from nadir.ResultsCompared with presurgery (34.7%), the prevalence of having any mental disorder was significantly lower 4 years (21.3%; P < .01) and 5 years (19.2%; P = .01), but not 7 years (29.1%; P = .27) after RYGB. The most common disorders were not related to long-term weight loss postRYGB. However, independent of weight change, mood and anxiety disorders, both pre- and postRYGB, were significantly related to less improvement in mental (but not physical) health-related quality of life. Having a concurrent mood disorder appeared to be associated with greater weight regain (6.4% of maximum weight lost, 95% confidence interval, ?.3 to 13.1), but this was not statistically significant (P = .06).ConclusionsBariatric surgery does not result in consistent long-term reductions in mental disorders. Mood disorders may impact long-term outcomes of bariatric surgery. |
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Keywords: | Correspondence: Melissa A. Kalarchian, Ph.D., Duquesne University School of Nursing, 600 Forbes Avenue, Pittsburgh, PA 15282. Bariatric surgery Gastric bypass Laparoscopic adjustable gastric banding Mental disorders Weight change Quality of life Mood disorders |
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