Quality of Life Outcomes in Bariatric Surgery: Improvements in Anxiety and Depression Do not Correlate with Postoperative Weight Loss

Eliza A Conaty, BS¹, Sydney Gordon¹, Brittany Lapin, PhD¹, Woody Denham, MD¹, John G Linn, MD¹, Stephen P Haggerty, MD¹, Kristine Kuchta, MS¹, Zeeshan A Butt, PhD², Michael B Ujiki, MD¹. ¹NorthShore University HealthSystem, ²Northwestern University

INTRODUCTION: Improvements in depression and anxiety after bariatric surgery have been well documented to date, however, no studies exist which make use of a quality of life metric specific to surgical outcomes. We aimed to better assess patient quality of life after bariatric surgery, specifically as it relates to anxiety and depression, and elucidate potential predictors of improved or worsened symptoms.

METHODS AND PROCEDURES: We evaluated quality of life using Surgical Outcomes Measurement System (SOMS) questionnaires from patients of a prospective bariatric surgical database, excluding revisional procedures from our analysis. Quality of life was captured via questionnaires administered preoperatively and at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year postoperatively. Questionnaire domains were specific to anxiety and depression symptoms within the 7 days prior. Quality of life scores were analyzed with respect to prior diagnosis of anxiety or depression, anxiety or depression specific medication use, gender, age, and BMI.

RESULTS: From 2014 to 2016, 296 bariatric patients completed SOMS quality of life questionnaires specific to anxiety and depression. A statistical mixed effects model was used to analyze the data. Patients experienced significant improvement over time in both anxiety and depression quality of life scores following bariatric surgery (Table 1). 56 patients had a preoperative diagnosis of anxiety and 126 patients had a preoperative diagnosis of depression. 122 patients took medication for one or both of these conditions. Preoperative diagnoses of anxiety or depression were predictors of worse anxiety and depression quality of life scores over time. Postoperative weight loss did not correlate with postoperative improvements in SOMS scores relating to anxiety or depression.

CONCLUSIONS: Though improvement in both anxiety and depression after bariatric surgery can be expected, even for those patients with a preoperative diagnosis of one or both conditions, no expectation can be made that greater postoperative weight loss will result in greater improvement of related symptoms. Further clarity for treatment of anxiety and depression in postoperative bariatric patients is necessary.