Metabolic and Bariatric Surgery

Background: High incidence of depression in obese populations is well-reported. While several studies examined the impact of weight loss outcomes after bariatric surgery on post-operative psychological well-being and vice-versa, fewer have analyzed influence of preoperative depression on post-operative weight loss outcomes. Furthermore, this question has been limitedly applied to Laparoscopic Sleeve Gastrectomy (LSG) versus other bariatric procedures.

 

Aim: Given the increasing utilization of LSG, we aim to evaluate the relationship between pre-operative Beck’s Depression Index (BDI) scores and post-operative weight outcomes.

 

Method: 117 patients underwent LSG. BDI, a validated tool for assessing psychometric properties was completed pre-operatively. Additional psychological history and medications were obtained during patient interview. Pre and post-operative BMI, percent Total Weight Loss (%TWL) and percent Excess Weight Loss (%EWL) were recorded.

 

Results: Among the 88 females and 29 males, the mean pre-operative weight and BMI is 123 kg and 42.7 kg/m2, respectively. Mean reduction in BMI post operatively at one year is 14 kg/m2. This equates to a median %TWL of 32%. The median BDI score is 14 (Range 0-52), correlating to ‘mild’ depression. Females reported a higher average BDI score. 39.6% and 33.3% of patients reported minimal and mild depression, respectively. Patients classified with severe BDI score, were less likely to lose more than the median TWL of 35.4 kg found in our cohort (OR: 0.32 95% CI 0.06-1.66).

 

Conclusion: In our cohort, an important association was found between pre-operative BDI scores and weight loss post LSG.

This highlights the significance of pre-operative assessment for depression and makes implications for the involvement of early

psychological services to improve both bariatric-specific and psychosocial outcomes.