Improvement in mood symptoms ​after 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 body mass index (BMI) post-operatively (pooled d+: −13.3 kg/m² [95% confidence interval [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 odds ratio (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 Hospital Anxiety and Depression Score (HADS) (anxiety component) by 0.64 (pooled d+: −0.64 [95% CI −1.06, −0.22], p = 0.003) and Generalized Anxiety Disorder Assessment-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), Beck’s Depression Inventory score (pooled d+: −1.04 [95% CI −1.46, −0.63], p < 0.001) and Patient Health Questionnaire-9 score (pooled d+: −1.11 [95% CI −1.21, −1.01], p < 0.001). Conclusion: Bariatric surgery was associated with significant reduction in the prevalence and severity of depressive and anxiety symptoms among people with obesity.