Improvement in mood symptoms post-bariatric surgery among people with obesity: A systematic review and meta-analysis.

AIMS We aimed to examine if bariatric surgery was associated with a reduction in the prevalence of depressive and anxiety symptoms among people with obesity. MATERIALS AND METHODS We pooled data from 49 studies involving 11,255 people with obesity who underwent bariatric surgery. The study outcomes were the prevalence of depressive and anxiety symptoms among these patients pre- and post-surgery. RESULTS There was a significant reduction in BMI post-operatively (pooled d+: -13.3 kg/m2 [95% CI -15.19, -11.47], p<0.001). The pooled proportion of patients with anxiety symptoms reduced from 24.5% pre-operatively to 16.9% post-operatively, with an OR of 0.58 (95% CI 0.51, 0.67, p<0.001). The reduction remained significant in women aged ≥40 years and irrespective of post-operative BMI. There were significant reductions in HADS score (anxiety component) by 0.64 (pooled d+: -0.64 [95% CI -1.06, -0.22], p=0.003) and GAD-7 score by 0.54 (pooled d+: -0.54 [95% CI -0.64, -0.44], p<0.001]). The pooled proportion of depressive symptoms reduced from 34.7% pre-operatively to 20.4% post-operatively, with an OR of 0.49 (95% CI 0.37, 0.65, p<0.001). The reduction remained significant irrespective of patient's age and post-operative BMI. There were also significant reductions in HADS score (depressive component) (pooled d+: -1.34 [95% CI -1.93, -0.76], p<0.001), BDI score (pooled d+: -1.04 [95% CI -1.46, -0.63], p<0.001) and PHQ-9 score (pooled d+: -1.11 [95% CI -1.21, -1.01], p<0.001). CONCLUSION Bariatric surgery was associated with significant reductions in the prevalence and severity of depressive and anxiety symptoms among people with obesity. This article is protected by copyright. All rights reserved.