Abstract

Introduction: More understanding upon psychiatric disorders among bariatric surgery candidates is necessary since weight regain or surgery failure is frequently attributed to psychosocial and behavioral factors. Although most of the studies do not correlate preoperative psychiatric disorders to worse performance in the follow up, more studies are needed in order to better understand its real impact in terms of weight loss, obesity recurrence and global health. Methods: An observational study was conducted at a private clinic in the South of Brazil, where patients underwent psychiatric examination. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Binge Eating Scale (BES) were applied. Data upon weight loss in the follow-up was retrieved from medical chart records, at 6 months, 12 months and 18 months after surgery. Results: A total of 84 patients were included in the study, 72% were female. The great majority underwent bypass surgery (73%). In 57 patients (67.8%) at least one psychiatric disorder was detected and 66.3% were taking psychiatric medication. The applied scales detected almost 70% of the patients scored in the depression range, 55.1% in the anxiety disorder range and 42.9% scored in the moderate to severe binge eating disorder. Body mass index at base line was on average 41.06. In the follow up, the psychiatric disorder group lost less weight than the group without it 6 months after surgery (p<0.05). At 12 and 18 months, the two groups loss weight in the same trend and no statistical difference were detected. Psychiatric medication use also was not associated to worse performance after bariatric surgery. Discussion: In this small observational study, psychiatric disorders were detected in almost 70% of bariatric surgery candidates and worse weight loss performance 6 months after surgery was observed in the patients diagnosed with psychiatric disorders. There was no statistical difference in weight loss in the longer run, but results can be biased by missing data as patients tend to return to medical appointments less over time. The results are consistent with clinical observations and make it clearer that patients with psychiatric disorders need even closer attention from the multidisciplinary team. Larger studies are needed to validate the results and bring better quality information in longer follow ups.

Keywords

psychiatric disorders, bariatric surgery, depression