Bariatric Surgery and Gender Differences in Depressive Symptoms-A 5-Year Prospective Study of Preoperative Predictors

Candidates for metabolic bariatric surgery (MBS) often exhibit a higher prevalence of depressive symptoms compared with the general population. Studies have shown improvements in depressive symptoms and a reduction in depression prevalence during the initial years following MBS. However, reports on the long-term maintenance of these improvements are conflicting, and factors such as preoperative predictors and gender differences remain poorly understood.

Data were collected from 210 subjects pre-MBS and at 1- and 5-years post-MBS. Health care providers measured Body Mass Index (BMI). All other data were collected via self-report (questionnaires). Pre-MBS factors assumed associated with depressive symptoms at 5 years included BMI, body dissatisfaction, appearance orientation, resilience, and outcome expectancies.

The sample comprised 77.6% women. Pre-MBS there were no significant gender differences in depressive symptomatology or the likelihood of being depressed. At both one and 5 years post-MBS, a higher proportion of men were categorized as probably depressed. From baseline to 5 years post-MBS, depressive symptoms declined among women, whereas there was no change among men. Regardless of gender, preoperative depressive symptoms and resilience predicted postoperative depression. Among women, preoperative body dissatisfaction and expectations regarding weight change and appearance were initially associated with postoperative levels of depression.

Contrasting common findings, this study identified higher rates of post-surgery depression in men than in women. Furthermore, the results indicate that post-surgery depression may be bivariately associated with different factors depending on gender, although resilience predicted depressive symptoms irrespective of gender.