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

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Emergency Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland

    Martin Müller

  2. Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland

    Philipp C. Nett, Yves Michael Borbély, Caroline Buri, Guido Stirnimann, Kurt Laederach & Dino Kröll

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  1. Martin Müller
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  2. Philipp C. Nett
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Correspondence to Dino Kröll.

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Electronic Supplementary Material

Figure S1

Flow diagram (PPTX 36 kb)

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)

High resolution image (EPS 194 kb)

Fig S2b

(PNG 9 kb)

High resolution image (EPS 195 kb)

Table S1

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Müller, M., Nett, P.C., Borbély, Y.M. et al. Mental Illness Has a Negative Impact on Weight Loss in Bariatric Patients: a 4-Year Follow-up. J Gastrointest Surg 23, 232–238 (2019). https://doi.org/10.1007/s11605-018-3903-x

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  • DOI: https://doi.org/10.1007/s11605-018-3903-x

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