Mental Health Does Not Improve in All Bariatric Surgery Patients

Although adolescents who receive Roux-en-Y gastric bypass (RYGB) experience a reduction in weight and an improvement in weight-related quality of life into adulthood, many of these patients still experience persistent mental health vulnerabilities post-surgery, according to a recent study.

It is well known that RYGB in adolescence provides a substantial reduction in bodyweight, as well as various cardiometabolic benefits into young adulthood. However, little is known about the impact of RYGB on psychosocial health.
__________________________________________________________________________________________________________________________________________

RELATED CONTENT
Bariatric Surgery Type Predicts Dyslipidemia Effect
Bariatric Surgery Reduces Depression, Night Eating in Patients with NES
__________________________________________________________________________________________________________________________________________

To further explore this relationship, the researchers assessed 14 adolescents in 2 sequential observational studies performed at a single medical center in the United States. Participants were a mean age of 16 years and had a mean body mass index (BMI) of 59.2 kg/m². A total of 64.3% of participants were female.

The researchers measured participants’ height and weight, and administered several measures of weight-related quality of life, mental health, and adaptive functioning to participants prior to surgery and at 6, 12, 18, 24, and 72 months and longer post-surgery. Additionally, substance use behaviors were evaluated at 72 months and longer.

Results showed a rapid improvement in BMI and weight-related quality of life throughout year 1 post-surgery. This was followed by stabilization, modest weight regain, and a decline in weight-related quality of life, with 50% of participants remaining severely obese.

Prior to surgery, 11 participants had demonstrated symptoms outside of the normal range for a mental health domain of 1 or higher. Post-surgery, 5 participants had demonstrated remittance in young adulthood, while 6 had demonstrated persistent symptomatology. Symptoms included anxiety, depression, being withdrawn, and having problems with thoughts. However, the researchers found no new incidence of mental health vulnerability that had not already been identified prior to surgery. Additionally, adaptive functioning and substance use were found to be within normal range.

“Although adolescent RYGB resulted in improvement in weight and [weight-related quality of life] into young adulthood, mental health trajectories were more variable, with some experiencing positive change while others experienced persistent mental health vulnerability,” the researchers concluded.

“Research focused on larger contemporary samples using a controlled design is critical to inform targets for prevention and intervention to optimize both physical and psychosocial health outcomes in this younger patient population.”

—Christina Vogt

Reference:

Zeller MH, Pendery EC, Reiter-Purtill J, et al. From adolescence to young adulthood: trajectories of psychosocial health following Roux-en-Y gastric bypass. Surg Obes Related Dis. 2017;13(7):1196-1203. doi:10.1016/j.soard.2017.03.008.