Journal of Depression and Anxiety
Open Access

Abstract

Lifestyle, Depression and Metabolic/ Bariatric Surgery

Snezana Polovina and Dragan Micic

Obesity alters brain structure and disturbs mood and cognition. Increase in BMI was associated with changes in
white matter structures which may accelerate cognitive decline among obese individuals. Metabolic/bariatric surgery
may be the last chance for good long-term weight-loss when conservative therapy did not produce results. Weight
loss after metabolic surgery causes changes in self-perception and possible in inter-personal relationships. These
changes may be mediators of different mental health outcomes such as depression. Different mental problems, mild,
moderate or severe depressive symptoms and increase in self-harm are more prevalent in patients undergoing
metabolic surgery in comparison with the general population. Some studies indicated that bariatric surgery is
associated with long-term reductions in depression and anxiety, while the other studies have found elevated risk of
major depression disorders. Increased risk for suicide after metabolic surgery may be explained by insufficient
weight loss, weight regain, recurrence of obesity-related comorbidities or non-achieved life-changing effects after
weight loss. Another issue is the five times higher risk of alcohol abuse after some types of the metabolic surgery.