Bariatric Surgery and Depression: What’s the Association?

Sarfaroj Khan 

Disclosures

February 15, 2021

Takeaway

  • In individuals with a history of depression, bariatric surgery was associated with a reduction in depression-related consultations.

  • In contrast, the risk of de novo depression-related consultations was increased following bariatric surgery.

Why this matters

  • The findings of this study, supported by the bi-directional association between obesity and depression, encourage a considered approach by medical professionals in evaluating the enhanced benefits that bariatric surgery may provide in those with pre-existing depression.

Study design

  • A retrospective nested-control study of 3534 patients with a body mass index ≥30 kg/m2 who had undergone bariatric surgery (57% had pre-existing depression) and 15,480 control participants from the UK Clinical Practice Research Datalink (CPRD).

  • Funding: None.

Key results

  • Cox regression analysis demonstrated that bariatric surgery was associated with an increased risk of developing de novo depression (HR, 1.50; 95% CI, 1.32-1.71; P<.005).

  • For those with pre-existing depression, a higher proportion of post-surgical patients had no further consultations related to depression at each yearly interval after the index date (P<.005).

  • Kaplan-Meier analysis revealed that by 5 years, just over 20% of surgical patients had no further consultations related to depression vs 17% of control participants.

Limitations

  • Retrospective design.

  • Risk of confounding.

 

Arhi CS, Dudley R, Moussa O, Ardissino M, Scholtz S, Purkayastha S. The Complex Association Between Bariatric Surgery and Depression: a National Nested-Control Study. Obes Surg. 2021 Feb 3 [Epub ahead of print]. doi: 10.1007/s11695-020-05201-z. PMID: 33537948 View full text  

This clinical summary originally appeared on Univadis, part of the Medscape Professional Network.

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