From the Guidelines
Gastric bypass surgery is associated with psychiatric issues, and patients should undergo comprehensive pre-surgical psychiatric evaluation and post-surgical mental health monitoring. Patients who undergo gastric bypass may experience changes in mental health, including both improvements and new or worsening psychiatric conditions. Depression and anxiety often improve after surgery due to weight loss and enhanced quality of life, but some patients develop new mood disorders, substance use problems, or eating disorders 1. The surgery alters how the body absorbs medications, potentially affecting psychiatric medication effectiveness, and may require dosage adjustments. Additionally, the rapid weight loss can trigger body image issues and relationship changes. The surgery also impacts hormone levels and neurotransmitters, which can influence mood and behavior. Alcohol absorption changes significantly after gastric bypass, making patients more vulnerable to alcohol use disorders 1.
Some of the key psychiatric issues associated with gastric bypass surgery include:
- Depression and anxiety
- Substance use problems
- Eating disorders
- Body image issues
- Relationship changes
- Alcohol use disorders
It is essential to note that the risk of psychiatric issues after gastric bypass surgery is significant, and patients should be aware of these potential effects. Comprehensive pre-surgical psychiatric evaluation and post-surgical mental health monitoring are crucial components of gastric bypass care 1. Patients should maintain regular follow-up with mental health professionals as part of their post-surgical care plan to address any emerging psychiatric issues. The most recent and highest quality study, published in 2019, emphasizes the importance of pre-surgical mental health assessment and ongoing mental health services after surgery 1.
From the Research
Gastric Bypass and Psychiatric Issues
- Gastric bypass surgery has been associated with psychiatric issues, including depression, anxiety, and suicidal ideation 2, 3, 4.
- A study found that patients who underwent gastric bypass surgery had a high prevalence of psychopathology and personality disturbance, and that psychological disturbance may have an impact on post-operative outcome 2.
- Another study found that patients with a history of self-harm or depression before surgery were at increased risk of self-harm and hospitalization for depression after surgery, and that the risk of suicide was increased in females 3.
- The use of antidepressant medications in patients who have undergone gastric bypass surgery can be challenging due to changes in drug absorption and metabolism, and close clinical follow-up and therapeutic drug monitoring are recommended 5, 6.
- A study of young adults who underwent gastric bypass surgery as adolescents found that a substantial minority still struggled with mental health issues, including depression and anxiety, 5 years after surgery, and that women were more burdened than men 4.
- The study also found an association between less optimal weight loss and suicidal ideation 5 years after surgery, highlighting the importance of long-term follow-up and mental health treatment 4.
- Gastric bypass surgery can affect the pharmacokinetics of serotonin reuptake inhibitors, leading to reduced drug bioavailability and increased risk of depressive symptoms, and close psychiatric monitoring is recommended after surgery 6.