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Changes in Depression Following Gastric Banding: A 5- to 7-year Prospective Study.

Schowalter M, Benecke A, Lager C, Heimbucher J, Bueter M, Thalheimer A, Fein M, Richard M, Faller H

Institute of Psychotherapy and Medical Psychology, University of Wuerzburg, Klinikstr. 3, 97070, Wuerzburg, Germany, schowalter@uni-wuerzburg.de.

BACKGROUND: Long-term outcomes of gastric banding regarding depression and predictors of change in depression are still unclear. This prospective, controlled study investigated depression and self-acceptance in morbidly obese patients before and after gastric banding. METHODS: A total of 248 morbidly obese patients (mean body mass index [BMI] = 46.4, SD = 6.9) seeking gastric banding completed questionnaires for symptoms of depression (Beck Depression Inventory) and self-acceptance. One hundred twenty-eight patients were treated with gastric banding and 120 patients were not. After 5 to 7 years, patients who either had (n = 40) or had not (n = 42) received gastric banding were reassessed. RESULTS: In the preoperative assessment, 35% of all obese patients suffered from clinically relevant depressive symptoms (BDI score >/=18). The mean depression score was higher and the mean self-acceptance score was lower than those of the normal population. Higher preoperative depression scores were observed among patients living alone and who had obtained low levels of education. After 5 to 7 years, patients with gastric banding had lost significantly more weight than patients without gastric banding (mean BMI loss 10.0 vs. 3.3). Gastric banding patients improved significantly in depression and self-acceptance, whereas no change was found in patients without gastric banding. Symptoms of depression were more reduced in patients who lost more weight, lived together with a partner, and had a high preoperative depression score. CONCLUSION: Morbid obesity is associated with depressive symptoms and low self-acceptance. Gastric banding results in both long-term weight loss and improvement in depression and self-acceptance.

Published 28 February 2008 in Obes Surg, 18(3): 314-20.
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