Background

Bariatric surgery outcomes in patients with bipolar or schizoaffective disorders are not well elucidated. Our study aims to explore the impact of these psychiatric conditions on percent Total Weight Loss (%TWL) and the early and late postoperative complication rates.

Methods

We conducted a retrospective chart review analysis of the bariatric surgical procedures in patients with bipolar or schizoaffective disorders between 2008-2021. We used specific ICD 9 & 10 codes to identify patients from our prospectively maintained database. Patient data were analyzed at 3-, 6-, 12-, and 24-month follow-up intervals. Data were summarized using frequencies and percentages for categorical and means and standard deviations for continuous variables.

Results

Our study included 74 patients with a Mean+-SD age of 51.8+-12.7. Concomitant psychiatric comorbidities were abstracted (10.8% Eating Disorders, 27% PTSD, and 13.5% ADHD). 93.2% had bipolar disorder, 2.7% had schizoaffective and 4.1% had both. 67.6% underwent Roux-en-Y gastric bypass, 27% had sleeve gastrectomy and 5.4% had duodenal switch. %TWL and Δ BMI (kg/m²) at 24 months from baseline were 31.3+-11.7% and -14.8+-8.8 kg/m² respectively. The remission rate for diabetes mellitus, hypertension, dyslipidemia, and sleep apnea were 69%, 34%, 43%, and 51% respectively (Figure 1). The early and late postoperative complications are listed in (Table 1).

Conclusions

Bariatric surgery in patients with bipolar or schizoaffective disorders can lead to acceptable long-term weight loss and comorbidity amelioration. Alcohol abuse among these patients requires the need for screening and psychological support long term.