Journal of Gastrointestinal Surgery

, Volume 23, Issue 2, pp 232–238 | Cite as

Mental Illness Has a Negative Impact on Weight Loss in Bariatric Patients: a 4-Year Follow-up

  • Martin Müller
  • Philipp C. Nett
  • Yves Michael Borbély
  • Caroline Buri
  • Guido Stirnimann
  • Kurt Laederach
  • Dino KröllEmail author
Original Article



Mental health disorders are highly prevalent among bariatric surgery patients. Bariatric surgery induces weight loss with continuous health improvements. However, long-term follow-up data on weight loss and quality of life data of patients who have a mental illness after bariatric surgery are scarce, and it is not clear whether mental illness is associated with more pronounced weight regain. The aim was to investigate the impact of preoperative mental illness on the course of long-term weight changes after bariatric surgery.


Patients with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass surgery (RYGB) between 2005 and 2013 with a follow-up of at least 3 years were included. The study population was divided into two groups: patients with mental illness (MI) and patients without (No-MI). Weight loss outcomes over time were compared using mixed models up to 4 years after surgery.


In total, 254 patients (RYGB 61.0%, SG 39%) were included. The distribution of baseline characteristics was similar between the MI (n = 108) and No-MI groups (n = 146). The most prevalent mental illness was depressive disorder (63.9%). In the MI group, the percent of total weight loss (%TWL) was significantly smaller over the study period. After 36 months, the predicted mean group-difference of %TWL was 4.6% (95% CI 1.9, 7.2; p = 0.001), and the predicted odds ratio for weight regain was 4.9 (95% CI 1.6, 15.1) for patients in the MI group.


Preoperative mental illness leads to lower long-term weight loss and an increased risk of weight regain after bariatric surgery.


Mental illness Bariatric surgery Depression Weight loss outcomes Weight change Long-term 



The authors would like to acknowledge Clyde Schechter and Andrew Atkinson for their helpful comments and critical reading of the manuscript.

Author Contribution

Each author has participated significantly in the work and takes public responsibility for it.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

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Figure S1 Flow diagram (PPTX 36 kb)
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Figure S2

Time course after surgery of mean a) BMI and b)%EBMIL of patients with mental illness (black) and without mental illness (gray) with 95% confidence interval. (PNG 9 kb)

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High resolution image (EPS 194 kb)
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Fig S2b

(PNG 9 kb)

11605_2018_3903_MOESM3_ESM.eps (195 kb)
High resolution image (EPS 195 kb)
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Table S1 (DOCX 26 kb)
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Table S2 (DOCX 25 kb)
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Table S3 (DOCX 24 kb)
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Table S4 (DOCX 16 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Martin Müller
    • 1
  • Philipp C. Nett
    • 2
  • Yves Michael Borbély
    • 2
  • Caroline Buri
    • 2
  • Guido Stirnimann
    • 2
  • Kurt Laederach
    • 2
  • Dino Kröll
    • 2
    Email author
  1. 1.Department of Emergency Medicine, InselspitalBern University Hospital and University of BernBernSwitzerland
  2. 2.Department of Visceral Surgery and Medicine, InselspitalBern University Hospital and University of BernBernSwitzerland

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