Psychological aspects of bariatric surgery

Individuals who undergo bariatric surgery typically experience outcomes of marked weight loss and improvements in medical comorbidities and psychological functioning. Unfortunately, a significant minority of patients also experience problems, such as reoccurring or new psychiatric disorders, alcohol or substance abuse, or eating disorders. In the current manuscript, we explore empirical studies published in the past year that are relevant to this topic.

In the area of psychiatric disorders, we focus on depression and anxiety, with several studies showing initial improvement in depression and anxiety symptoms followed by deterioration in the following years. Research in alcohol use has revealed a trend in which alcohol consumption decreases or ceases immediately following surgery, but often increases over time. Some studies have recently compared alcohol use across different types of surgery, which may help clarify a potential biological component of these problems. Finally, some eating disordered behaviors, which have until now received relatively little attention, have been further studied, with subthreshold loss-of-control eating behaviors receiving increased empirical examination.

Stemming from these findings, we suggest several directions to take for future research. With respect to psychiatric disorders, a closer examination of the effect of weight regain on related psychiatric comorbidities would prove valuable in determining the risk of disorder development. The mechanism by which the rate of alcohol consumption is altered following surgery has been proven elusive, and focusing further scrutiny on the differences in consumption between surgical procedures could prove useful in deciphering it. And with regards to eating disorders, a closer examination of both full diagnostic and less common eating disorders following bariatric surgery would be prudent.