Anxiety affects obesity surgery success
Extremely obese people suffering from depression or anxiety tend to lose less weight after obesity surgery than mentally healthy people, researchers reported in a study that suggests such patients could benefit from treatment beforehand.
People diagnosed with mood or anxiety disorders on average lost 81 pounds six months after gastric bypass surgery compared to their counterparts who shed 86 pounds. Although both groups lost significant weight after surgery, people without mental health problems did slightly better. Researchers plan to follow patients for up to two years to determine if there’s a weight difference over time.
Many hospitals and insurers require surgery candidates to go through a psychological evaluation before obesity surgery to make sure they are mentally fit for the operation and the lifestyle change afterward. Depressed people aren’t automatically disqualified for surgery, but those who are suicidal or abusing drugs and alcohol are usually ruled out.
How depression and other mental health disorders are handled before obesity surgery vary widely by medical center.
Those with serious problems are usually treated before surgery. That could include antidepressants, psychotherapy or more family involvement, said the center’s director William Perry.
In the new study, Pittsburgh researchers interviewed 207 surgery candidates and found two-thirds had a history of depression, bipolar disorder, post-traumatic stress syndrome or panic attacks. The vast majority were women with an average body-mass index of 51. A person with a BMI of over 40 is considered morbidly obese.
After adjusting for age, gender and race, researchers compared weight loss six months after surgery. Patients with a history of depression on average weighed 322 pounds before surgery and 241 afterward. Those with no mental health problems weighed 303 pounds before the operation and 217 pounds afterward.
Having a history of mental health problems should not prevent people from getting obesity surgery, even though they may not lose quite as much weight as mentally healthy people, said Dr Philip Schauer, president of the American Society for Bariatric Surgery.
