Background

Psychosocial disorders including anxiety, depression, and post-traumatic stress disorder (PTSD) are prevalent among patients with severe obesity. Bariatric surgery is an effective treatment for severely obese patients; however, past literature suggests psychiatric disorders may decrease expected weight loss. To evaluate the prevalence and impact of psychiatric diagnoses on bariatric surgery outcomes.

Methods

A retrospective chart review was performed identifying 232 patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass at our institution between 2015 and 2019. 215 (93%) patients had at least one lifetime psychiatric diagnosis including anxiety, depression, PTSD, sexual abuse, substance abuse, eating disorders, suicidal ideation, bipolar disorder, or schizophrenia. Excess body weight lost (EWL) was recorded at three months, six months, twelve months, two years, and three years post-surgery. EWL was compared between patients with one lifetime psychiatric diagnosis, more than one lifetime psychiatric diagnosis, and no past psychiatric diagnosis.

Results

At 12 months post-surgery, there was no significant difference in mean EWL for patients with no past psychiatric diagnosis (N = 10; 39.6% EWL) compared to those with one diagnosis (N = 33; 39.9% EWL; p = 0.949) and those with more than one diagnosis (N = 95; 42.6% EWL; p = 0.560). Similarly, there was no statistically significant difference in EWL between these groups at any other timepoint.

Conclusions

The prevalence of psychiatric illness in our study population was significantly higher than the general population. Comparable weight loss outcomes suggest exclusion from surgery should not be based on psychiatric illness alone.