Valentin Mocanu1, Iran Tavakoli1, Jerry Dang1, Noah Switzer2, Daniel Birch1, Shahzeer Karmali1. 1University of Alberta, 2The Ohio State University
INTRODUCTION: The objective our study was to carry out a systematic review and meta-analysis to examine the impact of attention deficit and hyperactivity disorder (ADHD) on bariatric surgery outcomes.
Despite the effectiveness of bariatric surgery, about 10 to 20% of patients continue to regain weight after the procedure. New evidence supports that ADHD may be directly associated with obesity and may affect outcomes following bariatric surgery. However, certain psychiatric illnesses, such as ADHD are rarely screened for, leading to a continued lack of data on the interaction between ADHD and bariatric surgery.
METHODS AND PROCEDURES: A comprehensive literature search for both published and unpublished studies of ADHD and bariatric surgery from 1946 to August 2018 was performed. The search was conducted using the Medline, EMBASE, Scopus, the Cochrane Library, and Web of Science databases as well as conference abstracts. Our search strategy terms included “(ADHD OR attention deficit hyperactivity disorder) AND (bariatrics OR obesity surgery OR gastric bypass OR gastric sleeve OR Roux-en-Y OR RYGB OR sleeve gastrectomy)” and was limited to human studies in the English language. Preliminary database search of the literature yielded 104 articles after 70 duplicates were removed
RESULTS: A total of five studies with 492 patients were included. The overall ADHD rate was 20.9% with reported rates ranging from 7% to 38%. The weighted mean age was 44.0 +/- 10.2 years, the weighted sex was 83.6% female, and the weighted mean follow-up was 22.2 months. Preoperative weighted mean BMI was 43.7 versus a postoperative weighted mean BMI of 34.7. No statistical significance was observed for mean BMI difference between non-ADHD vs. ADHD patients undergoing bariatric surgery (Figure 1) (3 studies; MD -2.66; CI -7.54 to 2.13; p = 0.28). Statistical significance was, however, observed for postoperative follow-up between patients with ADHD vs. non-ADHD subjects (3 studies; MD -7.28; -13.83 to -0.73; p = 0.03).
CONCLUSION: Patients with ADHD do not have a statistically significant mean BMI difference following bariatric surgery but have a statistically significant reduction in postoperative follow-up versus non-ADHD patients. Targeted strategies aimed at improving clinic attendance for this at-risk ADHD population may improve bariatric outcomes and minimize recidivism rates.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95762
Program Number: P192
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster