Weight Loss Surgery and Depression: Understanding the Link
Obesity and depression often go hand-in-hand. People struggling with obesity have a 55% increased risk of developing depression compared to the general population.[1] While the exact reasons for this link are still being studied, research suggests that factors like inflammation, altered brain function, and social stigma may play a role.[2]
For many, weight loss surgery provides an effective treatment for severe obesity. However, it's important to be aware that surgery may impact mental health in both positive and negative ways.
Pre-Existing Depression
Individuals considering weight loss surgery should be screened for pre-existing mental health conditions like depression. Studies show that up to 50% of bariatric surgery candidates have a history of depression.[3] Untreated depression prior to surgery can negatively impact outcomes.
It's critical that candidates receive appropriate treatment to manage depression before undergoing surgery. This may involve therapy and/or antidepressant medication. Getting depression under control beforehand allows patients to be in the best mindset to handle the challenges of surgery and make the lifestyle changes needed for success.
Risk of Depressive Symptoms After Surgery
While weight loss surgery can positively impact self-esteem and quality of life for most patients, some may experience depressive symptoms after surgery. Reported rates vary widely, from 5% to over 50%.[4]
Potential factors include:
- Difficulty coping with rapid change in body image and eating habits
- Nutritional deficiencies like iron, folate, and B12
- Neurochemical changes due to calorie restriction
- Unmet expectations regarding amount of weight lost
- Struggles with maintaining lifestyle changes for weight maintenance
Careful screening and follow-up monitoring for depression should occur for all patients during the first 1-2 years after surgery.[5] Any emerging symptoms should be promptly addressed through support groups, therapy, medication, or nutritional counseling as needed.
Long-Term Mental Health Outcomes
For most patients who undergo weight loss surgery, long-term mental health outcomes are positive. A meta-analysis looking at 65 studies found:[6]
- Depression resolved in the majority of patients with pre-existing depression (72%)
- Remission rates increased over time, up to 5 years after surgery
- Only 13.5% of patients had new-onset depressive symptoms
- Post-surgery depression incidence was lower than the general obese population
While a subgroup of patients do experience depression after surgery, overall quality of life and functioning improve for most patients along with weight loss. Sustained weight loss has been linked to lasting positive effects on mood, self-esteem, and depression.
Getting Support
It's normal to experience emotional ups and downs before and after weight loss surgery. Having a strong support system is key - this can include friends, family, support groups, and mental health professionals. Patients should be proactive and speak up if they experience symptoms of depression at any point so appropriate treatment can begin right away.
With proper mental health care and self-care, most bariatric patients can successfully manage depression symptoms and experience significant improvements in emotional well-being. Please consider a consultation with Dr. Babak Moein to begin you personal journy.
References:
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4551126/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5669931/
[3] https://asmbs.org/resources/mental-health-and-weight-loss-surgery
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3996125/
[5] https://asmbs.org/resources/postoperative-depressive-symptoms-after-bariatric-surgery
[6] https://jamanetwork.com/journals/jamasurgery/fullarticle/2774542
