Deciding to Have Surgery

The Correlation Between Bariatric Surgery and Mental Health

by Brenda Hoehn on Jan 11, 2024

The Correlation Between Bariatric Surgery and Mental Health


The Correlation Between Bariatric Surgery and Mental Health

Mounting evidence for the association between obesity and mental illness has prompted researchers to focus their sights specifically on the relationship between bariatric surgery and its impact on a patient’s mental health status.

Data shows that significant weight loss, seen with bariatric surgery, can induce profound positive change in a person’s mental health.

Please keep reading to learn about the obesity-mental health connection and its pre- and post-surgery significance for bariatric patients.

How Can Obesity Affect Your Quality of Life?

It is not uncommon for individuals with obesity to experience a decline in their quality of life and psychological condition. Excess weight can negatively impact daily life due to diminished physical wellness and the presence of social stigmas and discrimination associated with obesity. People who face these challenges have an increased risk of developing:

  • Anxiety,
  • Depression,
  • Eating Disorders, and
  • Substance Abuse Disorders.

Bariatric surgery may impact more than a patient’s weight. Surgical intervention can also become the catalyzing force for a range of causes and their effects on mental health.

Possible Mental Health Outcomes After Weight Loss Surgery

A 2023 umbrella review [Law, S. (2023)] from the Frontiers in Endocrinology research journal found that “…bariatric surgery was beneficial to improving overall mental health…”  in patients with obesity, reducing symptoms of depression and anxiety symptoms and the prevalence of eating disorders (e.g., binge eating disorder).

However, the review emphasized that patients may experience negative mental health outcomes after weight loss surgery—that there can be an increased risk of:

  • Suicide,
  • Self-Harm,
  • and Alcohol Use Disorder (AUD).

It is crucial to note that mental wellness is firmly tied to an individual’s specific genetics, environment, and traumatic life experiences. While there are notable trends in the psychological aftereffects of bariatric surgery, “it may not be bariatric surgery itself, but the life changes caused by weight loss. The same is true of harmful consequences.”

Simply put, there is no guarantee that a patient will or will not experience changes in their mental and emotional states.

What Is Bariatric Psychiatry? Why Is It Important?

Scientific and medical reviews are beginning to focus on bariatric psychiatry, an emerging sub-specialty in the mental health and psychopathology fields. The basis of bariatric psychiatry is that medical teams must consider all aspects of a patient’s health when planning and managing a bariatric care plan. Thus, bariatric surgeons often require patients to receive a mental health evaluation before a bariatric surgical procedure.

The goals of bariatric psychiatry fall into one of three categories:

  1. Determine the existence or absence of psychiatric conditions that may affect the safety of bariatric surgery.
  2. Diagnose and treat pre-surgery mental illness that may cause poor weight loss following surgery.
  3. Diagnose and treat post-surgery mental illness that may worsen quality of life.”

Anxiety Disorders and Clinical Depression

Anxiety disorders frequently present in bariatric community members. According to a study [Kalarchian, M. A. et al. (2007)] from The American Journal of Psychiatry, “The most common anxiety disorder in candidates for bariatric surgery is social anxiety disorder, found in 9% of patients.” The Western world’s fixation on thinness and its association with physical beauty may be a significant factor in the development and severity of anxiety in individuals with obesity.

The pressure to achieve society’s standards for physical appearance and the implied judgment for not meeting those standards can make social situations particularly distressing. The authors of the clinical review “The Psychosocial Burden of Obesity” [Sarwer, D. B. et al. (2018)] explain that the resulting “uncontrolled anxiety may negatively impact engagement in weight loss treatment in all its forms.”

“The Psychosocial Burden of Obesity” also reports that about one-third of candidates for bariatric treatment report symptoms of clinical depression at the time of surgery. 50% of candidates have a lifetime history of depression. Sizeism, physical pain (and impairments), and disordered eating may contribute to the high rate of depression in the bariatric community

Eating Disorders

People may develop disordered eating habits and conditions due to a need to feel control in their daily lives or for emotional comfort. Binge eating disorder is often a coping mechanism to combat overwhelming and distressing emotions.

Individuals experiencing this condition may struggle with:

  • Controlling how often they eat,
  • Portion size control, or
  • Eating behavior in response to social food cues.

Binge eating disorder places a physical burden on the body. Furthermore, doctors also associate the illness with:

Recent studies [Mitchell, J. E. et al. (2015)] show that binge eating disorder occurs in 5%-15% of patients eligible for bariatric surgery. Evidence also suggests the condition increases the risk of subpar weight loss or early secondary weight gain after surgery.

Substance Abuse Disorder

Less frequent, but worth mentioning, is the minority of weight loss treatment patients who are actively abusing substances at the time of treatment. [Law, S. (2023)] explains that about 10% of bariatric surgery candidates—one percent higher than the general population—disclose a history of substance or alcohol use disorder.

Bariatric surgery may exacerbate a pre-existing alcohol or substance abuse disorder. However, some research has observed in cases of extreme obesity that there may be a correlation between a lifetime history of a substance abuse disorder and substantial weight loss. One reason for this may be that these patients have developed stronger impulse control and self-regulation skills to manage their addictions, which can be applied to forming and maintaining healthy eating and lifestyle habits after surgery.

Prioritize Your Physical and Mental Health

The bariatric professionals at ProCare Health will tell you that your physical and mental health is equally important to your overall health and wellness. We firmly believe you can achieve your best self when nourishing your body and soul. The mind-body connection is powerful, and when you support it, you increase your potential to achieve your long-term emotional, mental, and physical health goals.

The ProCare Bari Connected Community offers valuable clinical and emotional support from other community members who understand your health journey. Brenda Hoehn, MSN, BSN, RN, CHTP, and a bariatric patient herself, leads ProCare’s Bari Connected virtual weekly educational live events and virtual monthly support groups.

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