Abstract

Abstract Aims The long-term effect of psychiatric medication on weight loss after bariatric surgery is unknown. The aim of this study was to compare the 1 year and 5 year percentage excess weight loss (%EWL) and BMI between those prescribed and not prescribed psychiatric medication who underwent laparoscopic bariatric surgery. Methods Consecutive patients, who received identical perioperative care were selected from a prospectively maintained database. Patients who had gastric bands and revisional procedures were excluded. Patients were defined as “prescribed psychiatric medication” if prescribed antidepressant, antipsychotic or mood stabilizer at baseline and subdivided into those taking a single agent and those on two or more agents. Results Of 119 patients (58 sleeve gastrectomy, 61 gastric bypass), 46 patients were prescribed psychiatric medication (40 one agent, 6 two or more agents). At 1 year, median %EWL did not differ significantly in those taking no agent, 1 agent and 2 or more agents respectively (66.8, 63.3, 57.4, p = 0.433). At 5 years this approached, but did not reach statistical significance (56.6, 54.4, 40.6, p = 0.099). The same pattern was observed for median BMI at 5 years (35.7, 39.2, 40.7, p = 0.086). Conclusion There is no significant difference in excess weight loss or BMI at 1 year post surgery between patients prescribed psychiatric medication and those not prescribed psychiatric medication but there is a difference at 5 years, which shows a trend towards statistical significance. Such patients should receive intensive specialist bariatric psychological support for a prolonged period after surgery.

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