Study: Mental Disorders Should Not Keep Obese Youth from Bariatric Surgery

A new study published in the journal Pediatrics finds that psychiatric disorders should not necessarily disqualify a severely obese adolescent from bariatric surgery.

The new findings counter the prevailing belief which holds that mental health disorders could influence a patient’s ability to adhere to the pre- and post-surgical guidelines and as a result might contraindicate surgical intervention.

Rather, the study found that identifying anxiety, depressive disorders, attention-deficit/hyperactivity disorder (ADHD), and eating disorders among young surgery candidates had no predictive value for how much post-surgical weight loss an adolescent would achieve. Still, the researchers recognize that identifying these disorders remains a crucial pre-surgical evaluation step.

The study is the first to look at a large, diverse sample of adolescent patients with severe obesity to investigate any potential links between weight loss outcomes and pre-surgical psychiatric disorders.

“This procedure actually seems to be equally beneficial across ages, race/ethnicity and presence or absence of psychiatric disorders for weight loss,” said Eleanor Mackey, Ph.D., lead author of the study and a psychologist with the Obesity Program’s IDEAL clinic at Children’s National Health System.

“Unlike other interventions that may be influenced by cultural or socioeconomic factors, surgical intervention appears to offer all kids the same opportunity to succeed. Most important, there’s no scientific basis for denying an adolescent this procedure based simply on the presence of a psychiatric disorder.”

“This does not mean adolescents should not be evaluated and treated for these disorders, which themselves have a significant impact on functioning and quality of life, but in terms of weight loss after surgery, the presence of psychiatric disorders is not predictive of outcomes,” Mackey said.

For the study, the researchers compared severely obese adolescents (body mass index greater than 120 percent of the 95th percentile) who underwent the laparoscopic sleeve gastrectomy procedure at Children’s National (169). Even after controlling for demographic factors in study participants, the findings were clear: No difference was found between those with diagnosed psychiatric disorders and those without at 3 and 12 months post-surgery.

While bariatric surgery is an increasingly utilized option for the treatment of severe obesity among young people, very few studies have looked specifically at which characteristics in obese adolescents tend to lead to favorable surgery outcomes.

In the future, the research team plans to follow participants long term to continue building their understanding of any potential links between post-surgical weight loss and these pre-existing psychiatric disorders.

Source: Children’s National Health System

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