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Five-Year Changes in Psychiatric Treatment Status and Weight-Related Comorbidities Following Bariatric Surgery in a Veteran Population

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Abstract

Background

Although bariatric surgery is an established treatment for obesity, less is known regarding the long-term effects of surgery on psychiatric function. This paper reports changes in psychiatric treatment status, weight, and weight-related comorbidities over 5 years of follow-up among a population of veterans completing bariatric surgery.

Methods

We assessed 55 veterans undergoing bariatric surgery at a single Veteran Affairs medical center for 5 years post-surgery. Patients completed a pre-surgery clinical interview with a licensed psychologist. Using computerized medical records, we tracked pre- to post-surgery involvement with antidepressants, anxiolytics, psychotherapies, and overall psychiatric treatment visits along with changes in weight and metabolic function.

Results

Rates of antidepressant use and/or involvement with psychotherapy for depression declined from 56.4 % at pre-surgery to 34.6 % at 5 years post-surgery, p = 0.01. Anxiolytic use and/or involvement with psychotherapy for anxiety, however, increased from 23.6 to 32.7 % pre- to 5 years post-surgery. Average psychiatric treatment volume remained similar to pre-surgery status across follow-up. These mixed indicators of psychiatric improvement occurred despite marked metabolic improvements from surgery. Mean percent excess weight loss = 51.7 and 41.3 (1 and 5 years post-surgery, respectively), systolic blood pressure (−6.8 mmHg (14.3)/−6.1 mmHg (12.8), respectively), glucose levels (−18.6 mg/dL (30.2)/−10.0 mg/dL (25.9), respectively), triglycerides (−78.2 mg/dL (96.7)/−69.1 mg/dL (102.2), respectively) and high-density lipoproteins (+7.1 (9.9)/+11.3 (11.3), respectively) levels each improved.

Conclusions

We report evidence of decreased antidepressant use and depression therapies following bariatric surgery, but no improvements on rates of anxiolytic use and anxiety therapies or on overall psychiatric treatment involvement. Despite metabolic improvements, bariatric patients with psychiatric histories may warrant ongoing attention to mental health.

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Conflict of Interest

No grant support was employed in the completion of this study.

Author information

Authors and Affiliations

  1. VA San Diego Healthcare System, Medical Center, 3350 La Jolla Village Drive, San Diego, CA, 92161, USA

    Thomas Rutledge, Gina Woods & Karen L. Herbst

  2. Department of Psychiatry, UC San Diego, San Diego, USA

    Thomas Rutledge

  3. Department of Psychology, Case Western Reserve University, Cleveland, USA

    Abby L. Braden

  4. Department of Medicine, UC San Diego, San Diego, USA

    Gina Woods & Karen L. Herbst

  5. Department of Psychology, Stanford University, Stanford, USA

    Lisa M. Groesz

  6. Department of Surgery, University of Texas Science Center, San Antonio, USA

    Michelle Savu

Authors
  1. Thomas Rutledge
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  2. Abby L. Braden
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  3. Gina Woods
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  4. Karen L. Herbst
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  5. Lisa M. Groesz
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  6. Michelle Savu
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Correspondence to Thomas Rutledge.

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Rutledge, T., Braden, A.L., Woods, G. et al. Five-Year Changes in Psychiatric Treatment Status and Weight-Related Comorbidities Following Bariatric Surgery in a Veteran Population. OBES SURG 22, 1734–1741 (2012). https://doi.org/10.1007/s11695-012-0722-0

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  • DOI: https://doi.org/10.1007/s11695-012-0722-0

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