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Does Long-Term Post-Bariatric Weight Change Differ Across Antidepressants?

David E Arterburn^1,2, Matthew L Maciejewski^3,4,5, Theodore S Z Berkowitz³

¹Kaiser Permanente Washington Health Research Institute, Seattle, WA.

Annals of Surgery Open : Perspectives of Surgical History, Education, and Clinical Approaches

|March 20, 2023

Summary

This summary is machine-generated.

Bupropion use before bariatric surgery may enhance initial weight loss compared to SSRIs, though differences may diminish over time. This suggests bupropion could be a preferred antidepressant for patients undergoing obesity surgery.

Keywords:

antidepressants bariatric bupropion gastric bypass matching sleeve gastrectomy veterans weight

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Area of Science:

Bariatric surgery outcomes
Pharmacological impact on weight management

Background:

Bariatric surgery leads to variable weight loss.
Antidepressant class may influence long-term weight loss after surgery.

Purpose of the Study:

To evaluate if weight change up to 5 years post-bariatric surgery differs by pre-surgery antidepressant class.
To compare the 5-year weight loss outcomes based on antidepressant monotherapy (bupropion, SSRIs, SNRIs).

Main Methods:

Retrospective cohort study of 556 Veterans undergoing bariatric surgery (sleeve gastrectomy or Roux-en-Y gastric bypass) from 2000-2016.
Compared weight loss in patients taking bupropion, SSRIs, or SNRIs before surgery against matched nonsurgical controls.
Analyzed 5-year weight change data.

Main Results:

Patients on bupropion showed greater differential weight loss versus controls than SSRI users at 1 and 2 years post-sleeve gastrectomy.
Similar trends observed for gastric bypass patients on bupropion versus SSRIs at 1 and 2 years.
No significant differences in weight loss were found when comparing SNRI users to SSRI users, or at the 5-year mark for bupropion vs. SSRI groups.

Conclusions:

Bupropion may be associated with greater initial weight loss compared to SSRIs after bariatric surgery.
The differential weight loss benefits of bupropion may decrease over the 5-year follow-up period.
Bupropion could be considered a first-line antidepressant for individuals with severe obesity planning bariatric surgery.