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Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study

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Abstract

Background

This study examined the prognostic significance of depressive symptoms in bariatric surgery patients over 24 months of follow-ups.

Methods

Three hundred fifty-seven patients completed a battery of assessments before and at 6, 12, and 24 months following gastric bypass surgery. In addition to weight loss and depressive symptoms, the assessments targeted eating disorder psychopathology and quality of life.

Results

Clinically significant depressive symptoms, defined as a score of 15 or greater on the Beck Depression Inventory, characterized 45 % of patients prior to surgery, and 12 % at 6-month follow-up, 13 % at 12-month follow-up, and 18 % at 24-month follow-up. Preoperative depressive symptoms did not predict postoperative weight outcomes. In contrast, postsurgery depressive symptoms were predictive of weight loss outcomes. Higher postsurgery depressive symptoms at each time point predicted a greater degree of concurrent and subsequent eating disorder psychopathology and lower quality of life.

Conclusions

The frequency of elevated depressive symptoms decreases substantially following gastric bypass surgery but increases gradually over 24 months. Postoperative depressive symptoms are significantly associated with poorer weight outcomes at 6 and 12 months following surgery but do not predict longer-term weight outcomes at 24 months. Postoperative depressive symptoms prospectively predict greater eating disorder psychopathology and poorer quality of life through 24 months. Elevated depressive symptoms, readily assessed by self-report, may signal a need for clinical attention after surgery.

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Acknowledgments

This research was supported in part by grants K24 DK062291, K23 DK071646, R01 DK098492, and K24 DK070052 from the NIH/NIDDK.

Conflict of Interest

Dr. Kalarchian reports a grant from the National Institute of Health, during the conduct of the study and grants from TOS/Nutrisystem, grants from NIH/NIDDK, and grants from ASMBS Foundation, outside the submitted work. Dr. Grilo reports grants from National Institutes of Health, during the conduct of the study; grants from the National Institutes of Health and Medical research Foundations, personal fees from Shire, honoraria from the American Psychological Association, various scientific conferences and universities for delivering research lectures and grand rounds, and various CME-related educational talks, book royalties from Guilford Press; Taylor Francis Publishers, outside the submitted work.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Correspondence to Marney A. White.

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White, M.A., Kalarchian, M.A., Levine, M.D. et al. Prognostic Significance of Depressive Symptoms on Weight Loss and Psychosocial Outcomes Following Gastric Bypass Surgery: A Prospective 24-Month Follow-Up Study. OBES SURG 25, 1909–1916 (2015). https://doi.org/10.1007/s11695-015-1631-9

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  • DOI: https://doi.org/10.1007/s11695-015-1631-9

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