Psychological characteristics of Iranian patients undergoing bariatric surgery during the COVID‑19 pandemic and lockdown

Abstract

Introduction: Pandemics are the most well-known to cause mental distress. This study examines the psychological characteristics of Iranian patients undergoing bariatric surgery during the COVID‑19 pandemic and lockdown. Method: Patients were consecutively recruited during the quarantine among those waiting for bariatric surgery or attending a post-bariatric follow-up phase and were asked to complete the Depression-Anxiety-Stress Scales-21 and a self-assessment questionnaire of 22 items assessing the resilience, change in eating behavior, and emotional responses referring to the current epidemic. Results: 59% of the 434 recruited participants reported of being worried about the epidemic, and 63% particularly reported of being worried about their or their relatives’ health. 37% and 56% felt lonelier and more bored, respectively. 66% was hungrier with an increased frequency of snacking (55%) and 39% reported more impulse to eat. Remarkably, 49% felt unable to follow a recommended diet. Logistic regression analysis on post-bariatric patients revealed an association between snacking, hunger, eating impulsivity, and anxiety, stress, and/or depression symptoms. Conclusion: Epidemics led to incremented psychological distress in patients with a history of current or past obesity, decreased quality of life, and impacting dietary compliance. Targeted psychological support is warranted in times of increased stress for susceptible participants such as pre-and post-bariatric patients.