Psychiatric Comorbidities and Weight Loss Recommendations in Bariatric Surgery Patients

Metabolic and bariatric surgery is increasingly utilized as a treatment for obesity worldwide. Despite significant weight loss, weight regain can occur long-term with bariatric surgery, with factors related to weight regain including the presence of comorbid psychiatric conditions. Psychiatric comorbidity in bariatric surgery candidates is common; although these comorbidities sometimes improve in the short-term, they may worsen in the long-term or new problems may emerge post-surgically. Many patients may continue to take psychotropic medications after surgery to maintain behavioral health, yet some medications are associated with weight gain or may pose certain risks due to changes in pharmacokinetics following surgery. The research on psychiatric comorbidity in bariatric surgery patients is presented, along with a review of psychotropic medications that may pose risks of weight gain post-surgically. Clinical recommendations are provided based on existing evidence with respect to managing psychiatric comorbidity in patients in ways that can optimize behavioral health outcomes while also ensuring positive outcomes with bariatric surgery.