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Psychiatric and Cognitive Functioning After Metabolic and Bariatric Surgery: A Systematic Review and Meta-Analysis
Emma A van Reekum1,2,3, Michael Darcy4, Jaslyn Drage1
1Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
Summary
Metabolic and bariatric surgery (MBS) may improve depression, anxiety, and eating behaviors, but carries a slight risk of increased suicide and substance use disorders. More high-quality research is needed to confirm these findings.
Area of Science:
- Medical Science
- Psychiatry
- Bariatric Surgery
Background:
- Obesity is a complex chronic disease requiring effective management strategies.
- Metabolic and bariatric surgery (MBS) is a significant intervention for severe obesity.
- The impact of MBS on psychiatric and cognitive functioning requires thorough investigation.
Purpose of the Study:
- To systematically review and meta-analyze psychiatric and cognitive outcomes following MBS.
- To evaluate changes in depression, anxiety, eating behaviors, and cognitive performance post-MBS.
Main Methods:
- A systematic review and meta-analysis of randomized controlled trials (RCTs) and nonrandomized studies (NRS).
- Inclusion criteria: studies comparing MBS with nonsurgical interventions in individuals with obesity.
- Outcomes assessed: depression, anxiety, eating behaviors, substance use disorders, suicide, and cognitive functions (attention, memory, executive function).
Main Results:
- Evidence certainty was low to very low for most outcomes.
- MBS showed potential improvements in depressive symptoms, anxiety, and non-normative eating behaviors.
- Cognitive improvements were noted in attention, but not in executive function or memory.
- A slight increase in suicide deaths and substance use disorders was observed beyond 2 years post-surgery.
Conclusions:
- MBS may offer benefits for psychiatric and cognitive health, including reduced depression, anxiety, and improved attention.
- However, a potential increase in suicide deaths and substance use disorders warrants careful consideration.
- High-quality research is crucial to strengthen the evidence base and inform clinical practice.
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