# A safe path to bariatric surgery: Mental health disorders in pre-operative patients

## TL;DR

This study finds that many bariatric surgery patients have mental health issues like depression and eating disorders, highlighting the need to address these before surgery.

## Contribution

The study reveals new insights into the prevalence and inter-associations of mental health disorders among pre-bariatric surgery patients.

## Key findings

- 31.2% of patients had a history of depression, with 46.5% receiving treatment.
- Childhood trauma was found in 22.6% of patients and linked to eating disorders and depression.
- Abnormal eating behaviors were reported in 66.2% of participants, including emotional and compulsive eating.

## Abstract

Obesity is one of the most significant global health concerns. As per the World Health Organization (WHO), obesity currently affects nearly 1.9 billion individuals around the world. Patients suffering from such a metabolic disease exhibit multiple medical conjoint medical conditions, and are predisposed to future high-morbidity and mortality complications. In addition, such patients might suffer from psychiatric compromises, at any time during their lives, that might have contributed to obesity. For many of these patients, bariatric surgery remains one of the leading methodologies in facilitating weight loss.

To study the prevalence of selected mental health disorders history, including depression, childhood trauma, and eating disorders, plus abnormal eating behaviors in patients with obesity undergoing pre-bariatric surgery evaluation. In addition, we intended to find any inter-associations between different mental health disorders and demographics in such patients.

In this cross-sectional study, conducted at the Nutrition and Obesity Department at Louis Pasteur Hospital, France, we enrolled 234 patients with obesity undertaking pre-bariatric surgery evaluation.

Around 31.2 % of participants had a history of depression, with 46.5 % receiving treatment. Childhood trauma was identified in 22.6 % of patients, and 12.8 % exhibited eating disorders, subclassified into binge eating disorder (6.4 %), bulimia (3.2 %), and night eating syndrome (3.4 %). Abnormal eating behaviors was also prominent in such patients, with 66.2 % engaging in activities such as snacking, hyperphagia, emotional eating, and compulsive eating. Sociodemographic associations showed that females were more likely to be diagnosed with depression, binge eating disorder, and compulsive eating, while males were more prone to hyperphagia. Childhood trauma was significantly associated with depression, binge eating disorder, bulimia, and abnormal eating behaviors. Multinomial logistic regression analysis revealed various predictors for depression, eating disorders, and abnormal eating behaviors across different categories. Notably, depression was associated with unemployment, trauma, and compulsions. Binge eating disorder showed significant associations with trauma and the female sex, while bulimia was notably associated with trauma. Night eating syndrome was inversely related to marriage status. Subgroup analysis further highlighted associations between depression, eating disorders, and abnormal eating behaviors in specific demographic groups.

There is a complex link between mental health disorders and eating patterns in individuals with obesity undergoing pre-bariatric surgery evaluation. Understanding this association is important for developing comprehensive preoperative care strategies that address both physical and mental health aspects in the management of obesity.

•There is an importance of addressing mental health concerns in the pre-surgery phase.•Depression was identified in pre-bariatric surgery patients, revealing a potential link between early life experiences and adult obesity.•Childhood traumas were highlighted in pre-bariatric surgery patients.•Many participants showed abnormal eating behaviors, emphasizing the complexity of eating patterns in the context of obesity.•There was a relationship between depression in participants with obesity and socioeconomic factors such as unemployment.

There is an importance of addressing mental health concerns in the pre-surgery phase.

Depression was identified in pre-bariatric surgery patients, revealing a potential link between early life experiences and adult obesity.

Childhood traumas were highlighted in pre-bariatric surgery patients.

Many participants showed abnormal eating behaviors, emphasizing the complexity of eating patterns in the context of obesity.

There was a relationship between depression in participants with obesity and socioeconomic factors such as unemployment.