Obesity and mental health are closely linked. The UK’s National Obesity Observatory reports that that there is a bidirectional association between obesity and mental health. Obesity can lead to vulnerability to depression, low self-esteem, poor body image, unhealthy eating habits and exercise avoidance. Also, the other way around, mental health problems can lead to weight gain and obesity.
Depression is the most common mental health problem in obese patients having weight loss surgery. A recent meta-analytic study showed that depression is a problem for 19% of patients having weight loss surgery.(1) This number is in keeping with information from the UK’s National Bariatric Surgery Registry. The Registry has reported that 27% of women and 15% of men were on medication for depression.
After depression, binge eating is the second most common mental health problem in obese people having bariatric surgery. About 17% have a binge-eating problem. The third most common mental health problem is anxiety (12%). Other problems are suicidal ideation (9%), personality disorder (7%), substance abuse disorder (3%), post-traumatic stress disorder (1%) and psychosis (1%). All these mental health disorder are more common in people having weight loss surgery than in the general population.
The recently published meta-analytic study shows that depression improves after weight loss surgery.(1) Similarly, there is improvement in binge eating disorders and anxiety. These mental health problems may not be cured by weight loss surgery but the severity is reduced. Weight loss can improve body image, self-worth, empowerment and inter-personal relationships. The extent of weight loss after bariatric surgery in people in mental health problems does not seem to be any different from the general population. Having said that, some notes of caution are important. There can be some relapse of mental health disorders with time. Also, there is concern about increase in attempts at self-harm and suicide after weight loss surgery.(2)
In summary, mental health problems are common in obese people. The most common problem is depression, followed by binge eating and anxiety. There is good evidence weight loss surgery improves mental health in obese people.
- Dawes AJ, Maggard-Gibbons M, Maher AR et al. Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-Analysis. JAMA. 2016;315(2):150-63.
- Bhatti JA, Nathens AB, Thiruchelvam D et al. Self-harm emergencies after bariatric surgery: A population-based cohort study. JAMA Surgery. 2016;151(3):226-32.