Five years after undergoing bariatric surgery and substantial weight loss as adolescents, young adults showed small gains in self-esteem and moderate improvements in binge eating, yet their mental health problems persisted, researchers reported in The Lancet Child & Adolescent Health.
“Although bariatric surgery can improve many aspects of health, alleviation of mental health problems should not be expected, and a multidisciplinary bariatric team should offer long-term mental health support after surgery,” concluded the study authors.
The study looked at mental health outcomes for 81 adolescents in Sweden 5 years after undergoing Roux-en-Y gastric bypass surgery and 80 matched control subjects who received conventional obesity management treatment. Researchers used national register data on psychiatric drugs dispensed and specialist treatment for mental disorders for each participant, and also collected self-reported data from participants who underwent bariatric surgery.
At baseline, the average body mass index (BMI) was 45 for the surgical group and 42 for the control group. Five years later, both groups had increases in the proportion of participants prescribed psychiatric drugs and the proportion receiving specialist mental health care, the study found.
Participants who had bariatric surgery, however, received significantly more specialized psychiatric treatment in the 5 years after intervention, compared with control subjects, the study found.
While self-esteem scores rose from an average 19 to 22 out of a possible 30 over the 5 years among participants who received surgery, overall mood scores did not, according to self-reported data. Nearly three-quarters of participants scored below average for people their age in the general population.
Meanwhile, participants who underwent bariatric surgery did report declines in binge eating, emotional eating, and uncontrolled eating.
“The transition from adolescence to young adulthood is a vulnerable time, not least in adolescents with severe obesity,” said researcher Kajsa Järvholm, PhD, Skåne University Hospital, Sweden. “Our results provide a complex picture, but what's safe to say is that weight-loss surgery does not seem to improve general mental health.”
Järvholm K, Bruze G, Peltonen M, et al. 5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: a prospective cohort study. The Lancet Child & Adolescent Health. 2020 January 21;[Epub ahead of print].
The Lancet Child & Adolescent Health: Mental health problems persist in adolescents five years after bariatric surgery despite substantial weight loss [press release]. Washington, DC: EurekAlert!; January 21, 2020.