Melissa A Kalarchian1, Wendy C King2, Michael J Devlin3, Amanda Hinerman2, Marsha D Marcus4, Susan Z Yanovski5, James E Mitchell6. 1. School of Nursing, Duquesne University, Pittsburgh, Pennsylvania. Electronic address: kalarchianm@duq.edu. 2. Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania. 3. Columbia University Vagelos College of Physicians and Surgeons/New York State Psychiatric Institute, New York, New York. 4. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. 5. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland. 6. Neuropsychiatric Research Institute, Fargo, North Dakota.
Abstract
BACKGROUND: Long-term, longitudinal data are limited on mental disorders after bariatric surgery. OBJECTIVE: To report mental disorders through 7 years postsurgery and examine their relationship with changes in weight and health-related quality of life. SETTING: Three U.S. academic medical centers. METHOD: As a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 199 adults completed the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition prior to Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric band. Participants who completed ≥1 follow-up through 7 years postsurgery are included (n = 173; 86.9%). Mixed models were used to examine mental disorders over time, and among the RYGB subgroup (n = 104), their relationship with long-term (≥4 yr) pre- to postsurgery changes in weight and health-related quality of life, measured with the Short Form-36 Health Survey, and with weight regain from nadir. RESULTS: Compared with presurgery (34.7%), the prevalence of having any mental disorder was significantly lower 4 years (21.3%; P < .01) and 5 years (19.2%; P = .01), but not 7 years (29.1%; P = .27) after RYGB. The most common disorders were not related to long-term weight loss postRYGB. However, independent of weight change, mood and anxiety disorders, both pre- and postRYGB, were significantly related to less improvement in mental (but not physical) health-related quality of life. Having a concurrent mood disorder appeared to be associated with greater weight regain (6.4% of maximum weight lost, 95% confidence interval, -.3 to 13.1), but this was not statistically significant (P = .06). CONCLUSIONS: Bariatric surgery does not result in consistent long-term reductions in mental disorders. Mood disorders may impact long-term outcomes of bariatric surgery.
BACKGROUND: Long-term, longitudinal data are limited on mental disorders after bariatric surgery. OBJECTIVE: To report mental disorders through 7 years postsurgery and examine their relationship with changes in weight and health-related quality of life. SETTING: Three U.S. academic medical centers. METHOD: As a substudy of the Longitudinal Assessment of Bariatric Surgery Consortium, 199 adults completed the structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, 4th Edition prior to Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric band. Participants who completed ≥1 follow-up through 7 years postsurgery are included (n = 173; 86.9%). Mixed models were used to examine mental disorders over time, and among the RYGB subgroup (n = 104), their relationship with long-term (≥4 yr) pre- to postsurgery changes in weight and health-related quality of life, measured with the Short Form-36 Health Survey, and with weight regain from nadir. RESULTS: Compared with presurgery (34.7%), the prevalence of having any mental disorder was significantly lower 4 years (21.3%; P < .01) and 5 years (19.2%; P = .01), but not 7 years (29.1%; P = .27) after RYGB. The most common disorders were not related to long-term weight loss postRYGB. However, independent of weight change, mood and anxiety disorders, both pre- and postRYGB, were significantly related to less improvement in mental (but not physical) health-related quality of life. Having a concurrent mood disorder appeared to be associated with greater weight regain (6.4% of maximum weight lost, 95% confidence interval, -.3 to 13.1), but this was not statistically significant (P = .06). CONCLUSIONS: Bariatric surgery does not result in consistent long-term reductions in mental disorders. Mood disorders may impact long-term outcomes of bariatric surgery.
Authors: Marney A White; Melissa A Kalarchian; Michele D Levine; Robin M Masheb; Marsha D Marcus; Carlos M Grilo Journal: Obes Surg Date: 2015-10 Impact factor: 4.129
Authors: Melissa A Kalarchian; Marsha D Marcus; Michele D Levine; Anita P Courcoulas; Paul A Pilkonis; Rebecca M Ringham; Julia N Soulakova; Lisa A Weissfeld; Dana L Rofey Journal: Am J Psychiatry Date: 2007-02 Impact factor: 18.112
Authors: Melissa A Kalarchian; Marsha D Marcus; Michele D Levine; Julia N Soulakova; Anita P Courcoulas; Meghan S C Wisinski Journal: Surg Obes Relat Dis Date: 2008-06-02 Impact factor: 4.734
Authors: Michael J Devlin; Wendy C King; Melissa A Kalarchian; Gretchen E White; Marsha D Marcus; Luis Garcia; Susan Z Yanovski; James E Mitchell Journal: Int J Eat Disord Date: 2016-07-18 Impact factor: 4.861
Authors: Melissa A Kalarchian; Wendy C King; Michael J Devlin; Marsha D Marcus; Luis Garcia; Jia-Yuh Chen; Susan Z Yanovski; James E Mitchell Journal: Psychosom Med Date: 2016-04 Impact factor: 4.312
Authors: Anita P Courcoulas; Nicholas J Christian; Steven H Belle; Paul D Berk; David R Flum; Luis Garcia; Mary Horlick; Melissa A Kalarchian; Wendy C King; James E Mitchell; Emma J Patterson; John R Pender; Alfons Pomp; Walter J Pories; Richard C Thirlby; Susan Z Yanovski; Bruce M Wolfe Journal: JAMA Date: 2013-12-11 Impact factor: 56.272
Authors: J Picot; J Jones; J L Colquitt; E Gospodarevskaya; E Loveman; L Baxter; A J Clegg Journal: Health Technol Assess Date: 2009-09 Impact factor: 4.014
Authors: Wendy C King; Amanda Hinerman; Melissa A Kalarchian; Michael J Devlin; Marsha D Marcus; James E Mitchell Journal: Surg Obes Relat Dis Date: 2019-04-17 Impact factor: 4.734
Authors: Valentina Ivezaj; Janet A Lydecker; Ashley A Wiedemann; Andrew J Duffy; Carlos M Grilo Journal: Obesity (Silver Spring) Date: 2020-07-29 Impact factor: 5.002
Authors: Valentina Ivezaj; Melissa A Kalarchian; Wendy C King; Michael J Devlin; James E Mitchell; Ross D Crosby Journal: Surg Obes Relat Dis Date: 2022-04-22 Impact factor: 3.709
Authors: Jeane Lorena Dias Kikuchi; Manuela Maria de Lima Carvalhal; Ana Paula da Silva Costa; Jairisson Augusto Santa Brígida Vasconcelos; Carla Cristina Paiva Paracampo; Daniela Lopes Gomes Journal: Int J Environ Res Public Health Date: 2022-06-09 Impact factor: 4.614
Authors: Kathryn E Smith; Tyler B Mason; Li Cao; Ross D Crosby; Kristine J Steffen; Luis Garcia; Wendy C King; James E Mitchell Journal: Obes Res Clin Pract Date: 2020-09-12 Impact factor: 2.288
Authors: Robyn M Brown; Eva Guerrero-Hreins; Wendy A Brown; Carel W le Roux; Priya Sumithran Journal: Nat Rev Endocrinol Date: 2021-07-14 Impact factor: 43.330
Authors: Caitlin E Smith; Misty A W Hawkins; Gail A Williams-Kerver; Jennifer Duncan Journal: Surg Obes Relat Dis Date: 2019-12-24 Impact factor: 3.709