Bariatric Surgery Tied To Increased Rates of Depression and Binge Eating Disorder

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A new study from UCLA suggests that people who undergo bariatric surgery may be twice as likely to experience depression and binge eating disorder, compared to the general U.S. population. However, the report says these conditions often improve following the surgery.

Bariatric surgery is widely accepted as a method for promoting weight loss in severely obese individuals, but the prevalence of mental health problems among individuals seeking the procedure and whether they are associated with postoperative outcomes has not been thoroughly researched until now.

For the study, published in the Journal of the American Medical Association, researchers from UCLA analyzed 68 journals published between January 1988 and November 2015 to determine the prevalence of mental health conditions among candidates for bariatric surgery, as well as the association between preoperative mental illness and postoperative outcomes.

In this study, the authors specifically defined mental health conditions as depression, anxiety, post-traumatic stress disorder, personality disorders, substance abuse disorders, suicidality or suicidal ideation, and eating disorders – particularly binge eating disorder.

The findings show that 23 percent of people undergoing bariatric surgery reported a preoperative mood disorder, with 19 percent reporting depression. The researchers also found that 17 percent of those undergoing surgery were diagnosed with an eating disorder.

“Given these rates, it is important for physicians to screen for and treat these conditions in all patients being considered for bariatric surgery,” said lead investigator Dr. Aaron Dawes, a general surgery resident at the David Geffen School of Medicine at UCLA and a Robert Wood Johnson Foundation Clinical Scholar. “At the same time, we found no evidence to suggest that patients with these conditions lose less weight after surgery and some evidence that certain conditions, particularly depression, may actually improve after surgery.

“Although we certainly do not think that surgery should be considered as a treatment for depression, our results suggest that severely obese patients undergoing bariatric surgery may stand to gain mental health benefits in addition to the more-talked-about physical health benefits of the operation,” added Dawes, who is also affiliated with the UCLA Fielding School of Public Health and the Veterans Affairs Greater Los Angeles Healthcare System.

While neither depression nor binge eating disorder were consistently linked with differences in weight outcomes, the researchers did note bariatric surgery was consistently associated with a decreased in the prevalence of depression and severity of depression symptoms following the procedure.

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