A lot of the people we see in clinic report a history of mental health problems. Most commonly, this will include depression. Some also report a history of treatment for anxiety, eating disorders and other mental health illnesses.
On this page, we address the relationship between depression and weight loss surgery, and the improvement in quality of life that patients might expect. Let me stress however that when we meet you for consultation, we will review your complete health history, including mental health.
Depression is a consistently reported psychological problem in obese patients. Looking specifically at weight loss surgery patients, one study found the prevalence of depression to be 36%. Furthermore, depression has a greater prevalence among female patients (1). This is broadly in keeping with our experience at Healthier Weight.
The use of food as a method of mood regulation is common. This involves eating being used to regulate emotions in place of other coping strategies (2). This phenomenon is described as people eating more when they feel depressed as a way of attempting to alleviate or block the negative emotions they feel (3).
The Impact of Depression on Weight Loss Outcomes After Weight Loss Surgery
It is often debated whether a history of depression leads to poorer weight loss outcomes after weight loss surgery. Although some will argue that it does, there is little compelling evidence to support this view. On the contrary, the more compelling data is that there is no association between the two. A review of multiple studies of differing types found no relationship between current depression pre-operatively and weight loss post-operatively.
Does Weight Loss Surgery Improve Quality of Life?
We know that weight loss surgery helps patients achieve a significant improvement in the quality of life. This is one of the main reasons that people choose to have a weight loss procedure and we see the benefit in our aftercare clinics. In addition to our own experience, there are published studies that demonstrate an improvement in the quality of life after surgery. One such study (4) specifically measured the quality of life after bariatric (weight loss) surgery.
In this study, a group of gastric sleeve and gastric bypass patients (with an average starting BMI of 50.4) completed questionnaires to assess their quality of life before surgery. During the process, several aspects of quality of life were measured including general self-esteem, physical activity, social contacts, work, sexual activity and eating behaviour.
For all parameters measured, quality of life was improved after surgery. This applied both to the gastric sleeve and gastric bypass groups.
At 12 months after surgery, the average excess weight loss across both groups was 58.8%, this equated to an average BMI of 33.4 compared to 50.4 before surgery.
"I have had the privilege of seeing the dramatic impact weight loss surgery can have on a person’s self-esteem, confidence, mental health and wellbeing. Those individuals who recognise that surgery is a tool and work with their procedure seem to do the best. They adapt and accept the restriction the procedure provides which results in a good amount of weight loss and correlates positively with improvements in their physical and mental health. To get the full benefits from your surgery, before going ahead, it is important to consider what type of relationship you have with food. In a small number of patient,s mental health can deteriorate after surgery if their expectations from weight loss surgery do not meet the reality post-surgery. My advice is to seek help early and to use the materials and support that is provided from your bariatric team. In the case of Healthier Weight, I have helped them prepare a simple guide on this that is designed to help people prepare mentally for weight loss surgery and life afterwards"
The Impact of Depression on Weight Loss Outcomes After Weight Loss Surgery
It is often debated whether a history of depression leads to poorer weight loss outcomes after weight loss surgery. Although some will argue that it does, there is little compelling evidence to support this view. On the contrary, the more compelling data is that there is no association between the two. A review of multiple studies of differing types found no relationship between current depression pre-operatively and weight loss post-operatively.
Psychological Pre-screening
At Healthier Weight we psychologically screen all patients for their suitability for weight loss surgery. We do so using a series of questions developed in cooperation with Counselling Psychologist Dr Claire Parkes. This screening is designed to identify patients for whom further psychological assessment would be of benefit before they proceed.
For the majority of patients, no further intervention is required but for a small proportion, we may seek a letter of recommendation from your GP, or other medical professionals whose treatment you are under, or a consultation with our Counselling Psychologist. In most cases, this would be Dr Parkes.
The outcome of the screening process and any follow-up actions would then be reviewed at the multi-disciplinary team through which all cases are reviewed.
Your Free Surgeon Consultation
When we meet you for consultation, we will discuss all aspects of your health, weight history and the health and weight loss benefits you are hoping to achieve with surgery. To get the best from your consultation and, if you decide to proceed to ensure you get the best results possible, it is important that you fully disclose all aspects of your health history to our team, including any treatment you have had in respect of your mental health. This is important because it will impact on both your eligibility and on what procedures would best suit you.
For example, for those patients who are taking medication associated with their mental health, we need to consider whether the surgery recommended would impact on the absorption of that medication. This might apply in the case of gastric bypass but less so in the case of gastric band or sleeve.
Weight Loss Surgery Success Stories
Many of our patients have decided to undergo weight loss surgery due to a history of depression or low mood that they relate, all or in part, to their weight. Many of these patients have gone on to achieve weight loss success after surgery and report a very dramatic improvement in their quality of life and mental health. You can read some of their stories here.
These people had a mixture of weight loss procedures, including gastric sleeve, gastric band and gastric bypass, all of which are proven in multiple studies to be safe and effective forms of treatment for obesity. Read more
Reference:
- Ali, Rasmussen, Monash and Fuller, 2009
- Geliebter & Aversa, 2003
- Hallings-Port, Waller, Watson & Scragg, 2006
- Major et al, Quality of Life After Bariatric Surgery. Obesity Surg. 2015; 25(9):1703-171
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