Benefits and risks of bariatric surgery in patients with bipolar disorders |
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| Affiliation: | 1. Endocrinology, Diabetology, Nutrition, University Hospital Grenoble Alpes, Grenoble, France;2. Digestive Surgery, University Hospital Grenoble Alpes, Grenoble, France;3. Hypoxia Physiopathology (HP2) Laboratory, INSERM U1042, Grenoble Alpes University, Grenoble, France;1. Unité bariatrique CHU de Montpellier, Montpellier, France;2. Université Montpellier 1, Montpellier, France;3. Département Information Médicale, Unité de Recherche Clinique et Epidémiologie, INSERM, Centre d’Investigation Clinique 1411, Montpellier, France;4. CHU Nimes, Nimes, France;5. CHU Hôpital Nord, Marseille, France;6. ELSAN, Clinique Saint Michel, Toulon, France;7. ELSAN, Clinique Bouchard, Marseille, France;1. Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California;2. Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel;1. Department of General Surgery, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal;2. Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine, University of Porto, Porto, Portugal;3. Department of Anatomy, Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal;1. Department of Metabolic and Investigative Medicine, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom;2. Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom;3. National Heart and Lung Institute, Imperial College London, London, United Kingdom;4. Department of Upper Gastrointestinal and Bariatric Surgery, St George’s Hospital, London, United Kingdom;5. Department of Upper GI and Bariatrics, Hebei Medical University, Shijiazhuang, China;6. Population Health Research Institute, St George’s, University of London, London, United Kingdom |
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| Abstract: | The prevalence of bipolar disorders in patients requesting bariatric surgery is estimated to be 1.5% to 3.4%. There are currently no specific recommendations regarding the way bariatric surgery should be managed in the context of bipolar disorder. The aim was to document the benefit-risk of bariatric surgery in patients with bipolar disorders. A systematic literature review was carried out. In addition, results were reported from a survey of current clinical practice in French referent centers for obesity care. Finally, 3 clinical cases from the “Severe Obesity Outcome Network” cohort are described. This systematic review shows there are few studies in the literature regarding the outcomes of bariatric surgery in patients with bipolar disorders and no randomized, controlled trials. Weight loss appeared similar in all patients, but psychiatric complications were sometimes reported in those with bipolar disorders. Almost all 11 referent centers for obesity care that responded had carried out bariatric surgery in patients with stable bipolar disorders. Postsurgical psychiatric destabilization occurred and included, at least, a need to reinforce treatment and follow-up. In the 3 case studies, postsurgical manic or hypomanic decompensation occurred. Thus, although effective in terms of weight loss, bariatric surgery could be a destabilizing factor for those with bipolar disorders. Current practice is to contraindicate surgery in patients with unstable disorders. There are insufficient data to conclude on the benefits and safety of bariatric surgery in patients with stable bipolar disease. Further studies are required to fully determine the benefits and risks. |
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| Keywords: | Bariatric surgery Bipolar disorder Benefit Risk Systematic review |
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