Abstract

PurposeMetabolic and bariatric surgery (MBS) is increasingly used in adolescents. The aim was to explore symptoms of depression and anxiety in young adults over 5 years’ follow-up after undergoing MBS.MethodsBeck Depression Inventory-2 and the Beck Anxiety Inventory were used to assess symptoms of depression and anxiety in 62 patients 1, 2, and 5 years after having Roux-en-Y gastric bypass at 13–18 years of age. Mental health, eating-related problems, and weight outcomes were tested for association with suicidal ideation at the 5-year follow-up.ResultsAt the 5-year follow-up, the mean score for depression was 11.4 (± 12.4), indicating minimal symptoms of depression. The mean score for anxiety was 12.82 (± 11.50), indicating mild anxiety symptoms. Still, several participants reported moderate or severe symptoms of depression (26%) and anxiety (32%). Women reported more symptoms than men (P = 0.03 and 0.04). No significant changes were found in self-reported symptoms of depression and anxiety between the 1-year and the 5-year follow-up (P = 0.367 and 0.934). Suicidal ideation was reported by 16% at the 5-year follow-up. Participants reporting suicidal ideation had lost significantly less excess weight than participants without suicidal ideation (P = 0.009).ConclusionFive years after adolescent MBS, a substantial minority still struggles with mental health issues, and women are more burdened than men. Our results indicate an association between less optimal weight loss and suicidal ideation 5 years after MBS. The findings emphasize the importance of offering long-term follow-up and mental health treatment several years after MBS.Level of evidenceLevel III, cohort study.Clinical trial registrationThe study is registered with ClinicalTrials.gov (NCT00289705). First posted February 10, 2006.

Highlights

  • Obesity is associated with an increased risk of depression and suicidal ideation, especially in women [1, 2]

  • metabolic and bariatric surgery (MBS) is a standard treatment for severe obesity in adults, and studies focusing on safety, weight loss, and the resolution of comorbidities after MBS have found similar favourable outcomes in adolescents and adults [6, 7]

  • There were no significant differences at baseline or at the 5-year follow-up in body mass index (BMI), age, sex, or any other variable included in the present study (P > 0.05; Table 2) between the adolescents (n = 62) who completed the Beck Depression Inventory-2 (BDI-2) and Beck Anxiety Inventory (BAI) at 5 years and those who did not (n = 19)

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Summary

Introduction

Obesity is associated with an increased risk of depression and suicidal ideation, especially in women [1, 2]. Patients seeking metabolic and bariatric surgery (MBS) may hope for improved mental health following a massive weight loss [5]. MBS is a standard treatment for severe obesity in adults, and studies focusing on safety, weight loss, and the resolution of comorbidities after MBS have found similar favourable outcomes in adolescents and adults [6, 7]. Many patients, including adolescents, report reduced symptoms of depression and improved health-related quality of life (HRQoL) during the first year after MBS [8,9,10,11]. Studies of mental health outcomes after adolescent MBS in young adulthood are limited, but previous studies from our Swedish group and US cohorts indicate that adolescents and young adults undergoing MBS are more psychologically vulnerable than middle-aged patients [14,15,16,17]

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