Kellie Martens1, Aaron Hamann2, Lisa R Miller-Matero3, Chazlyn Miller4, Aaron J Bonham5, Amir A Ghaferi5, Arthur M Carlin4. 1. Department of Surgery, Henry Ford Health System, Detroit, Michigan; Behavioral Health, Henry Ford Health System, Detroit, Michigan. Electronic address: kmarten2@hfhs.org. 2. Department of Surgery, Henry Ford Health System, Detroit, Michigan; Behavioral Health, Henry Ford Health System, Detroit, Michigan. 3. Behavioral Health, Henry Ford Health System, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, Michigan. 4. Department of Surgery, Henry Ford Health System, Detroit, Michigan. 5. Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Abstract
BACKGROUND: Findings regarding longer term symptoms of depression and the impact of depression on outcomes such as weight loss and patient satisfaction, are mixed or lacking. OBJECTIVES: This study sought to understand the relationship between depression, weight loss, and patient satisfaction in the two years after bariatric surgery. SETTING: This study used data from a multi-institutional, statewide quality improvement collaborative of 45 different bariatric surgery sites. METHODS: Participants included patients (N = 1991) who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2015-2018. Participants self-reported symptoms of depression (Patient Health Questionnaire-8 [PHQ-8]), satisfaction with surgery, and weight presurgery and 1 year and 2 years postsurgery. RESULTS: Compared to presurgery, fewer patients' PHQ-8 scores indicated clinically significant depression (PHQ-8≥10) at 1 year (P < .001; 14.3% versus 5.1%) and 2 years postsurgery (P < .0001; 8.7%). There was a significant increase in the prevalence of clinical depression from the first to second year postsurgery (P < .0001; 5.1% versus 8.7%). Higher PHQ-8 at baseline was related to less weight loss (%Total Weight Loss [%TWL] and %Excess Weight Loss [%EWL]) at 1 year postsurgery (P < .001), with a trend toward statistical significance at 2 years (P = .06). Postoperative depression was related to lower %TWL and %EWL, and less reduction in body mass index (BMI) at 1 year (P < .001) and 2 years (P < .0001). Baseline and postoperative depression were associated with lower patient satisfaction at both postoperative time points. CONCLUSIONS: This study suggests improvements in depression up to 2 years postbariatric surgery, although it appears that the prevalence of depression increases after the first year. Depression, both pre- and postbariatric surgery, may impact weight loss and patient satisfaction.
BACKGROUND: Findings regarding longer term symptoms of depression and the impact of depression on outcomes such as weight loss and patient satisfaction, are mixed or lacking. OBJECTIVES: This study sought to understand the relationship between depression, weight loss, and patient satisfaction in the two years after bariatric surgery. SETTING: This study used data from a multi-institutional, statewide quality improvement collaborative of 45 different bariatric surgery sites. METHODS:Participants included patients (N = 1991) who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2015-2018. Participants self-reported symptoms of depression (Patient Health Questionnaire-8 [PHQ-8]), satisfaction with surgery, and weight presurgery and 1 year and 2 years postsurgery. RESULTS: Compared to presurgery, fewer patients' PHQ-8 scores indicated clinically significant depression (PHQ-8≥10) at 1 year (P < .001; 14.3% versus 5.1%) and 2 years postsurgery (P < .0001; 8.7%). There was a significant increase in the prevalence of clinical depression from the first to second year postsurgery (P < .0001; 5.1% versus 8.7%). Higher PHQ-8 at baseline was related to less weight loss (%Total Weight Loss [%TWL] and %Excess Weight Loss [%EWL]) at 1 year postsurgery (P < .001), with a trend toward statistical significance at 2 years (P = .06). Postoperative depression was related to lower %TWL and %EWL, and less reduction in body mass index (BMI) at 1 year (P < .001) and 2 years (P < .0001). Baseline and postoperative depression were associated with lower patient satisfaction at both postoperative time points. CONCLUSIONS: This study suggests improvements in depression up to 2 years postbariatric surgery, although it appears that the prevalence of depression increases after the first year. Depression, both pre- and postbariatric surgery, may impact weight loss and patient satisfaction.
Authors: Jeannette Widmer; Daniel Gero; Barbara Sommerhalder; Daniela Alceste; Ivana Raguz; Michele Serra; René Vonlanthen; Marco Bueter; Andreas Thalheimer Journal: Clin Obes Date: 2021-12-08