Obesity and mental health disorders occur together frequently. Our clinical experience suggests that patients who suffer from both tend to be the most resistant to traditional healthy lifestyle and weight management approaches.
In select patients, bariatric surgery may be recommended to help manage and mitigate serious medical co-morbidities such as type 2 diabetes mellitus, hypertension, and hyperlipidemia. Our teams often struggle in determining ideal candidates and patient readiness for surgery, especially among those adolescents with co-morbid mental illness.
A recent (Jan, 2016) meta-analysis published in JAMA examined the (1) prevalence of mental health conditions among candidates for and recipients of bariatric surgery and (2) association between pre-operative mental illness and health outcomes post-surgery. The 3 most common mental health diagnoses included depression (19% [ 95% CI 14-25%]), binge eating disorder (17% [95% CI 13-21%]), and anxiety (12% [95% CI 6-20%]). The evidence is still unclear regarding the connection between pre-operative mental health conditions and post-operative weight loss; however, bariatric surgery was associated with a decreased prevalence and severity of depression post-operatively.
Although the data reported in this meta-analysis was for adults, anecdotally, we are seeing increasing numbers of adolescent patients present with binge eating disorders in addition to mood disorders in our specialty obesity clinics. More information, including data derived from the multi-centre, US-based Teen-LABS project (which includes Meg Zeller, Team ABC3 Scientific Advisory Board member) is needed to improve our understanding of the short and long-term outcomes of adolescent patients with mental health conditions seeking and undergoing bariatric surgery.