Aims: We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity.
Materials and methods: We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery.
Results: There was a significant reduction in body mass index (BMI) post-operatively (pooled d+: -13.3 kg/m2 [95% confidence interval [CI] 15.19, -11.47], p < 0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre-operatively to 16.9% post-operatively, with an odds ratio (OR) of 0.58 (95% CI 0.51, 0.67, p < 0.001). The reduction remained significant in women aged ≥40 years and irrespective of post-operative BMI. There were significant reductions in Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: -0.64 [95% CI -1.06, -0.22], p = 0.003) and Generalized Anxiety Disorder Assessment-7 score by 0.54 (pooled d+: -0.54 [95% CI -0.64, -0.44], p < 0.001). The pooled proportion of depressive symptoms reduced from 34.7% pre-operatively to 20.4% post-operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p < 0.001). The reduction remained significant irrespective of patient's age and post-operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: -1.34 [95% CI -1.93, -0.76], p < 0.001), Beck's Depression Inventory score (pooled d+: -1.04 [95% CI -1.46, -0.63], p < 0.001) and Patient Health Questionnaire-9 score (pooled d+: -1.11 [95% CI -1.21, -1.01], p < 0.001).
Conclusion: Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.
Keywords: anxiety symptoms; depressive symptoms; mental health; metabolic surgery; obesity.
© 2021 The Authors. Diabetes/Metabolism Research and Reviews published by John Wiley & Sons Ltd.