The effect of mental health on weight loss after bariatric surgery.

INTRODUCTION: Psychosocial assessment of pre-bariatric patients is an internationally recommended practice. However, the applicability of the assessments remains unaccounted for. This study investigated if the allocation of bariatric surgery candidates to a high-risk category on the basis of a psychosocial assessment correlates with attenuated weight loss and reduced mental health improvements.

METHODS: The assessment procedure consisted of standardised psychometric questionnaires, structured diagnostic interviews and semi-structured interviews. Outcome measures were BMI and psychiatric symptom load measured by the Symptom Checklist 90 at baseline and 18 months after surgery. All patients received either the gastric bypass or sleeve gastrectomy procedure.

RESULTS: Forty pre-bariatric patients participated in the study. The findings point towards an enhanced weight loss but reduced mental health improvement in the high-risk category.

CONCLUSIONS: Eating disorder symptomology might explain the efficient weight loss results in the high-risk category. The high-risk category may have more mental health issues that are unrelated to obesity, which explains the proportionally reduced mental health improvement. The study calls for further research involving a larger study population and a longer follow-up period.

FUNDING: The work was carried out as a part of the research programme Governing Obesity, funded by the University of Copenhagen Excellence Programme for Interdisciplinary Research.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02070081.