Changes in depression following gastric banding: a 5- to 7-year prospective study.
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 > or =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.


CONCLUSIONS
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.
Schowalter
Marion
M
Institute of Psychotherapy and Medical Psychology, University of Wuerzburg, Klinikstr. 3, 97070 Wuerzburg, Germany. schowalter@uni-wuerzburg.de
Benecke
Andrea
A
Lager
Caroline
C
Heimbucher
Johannes
J
Bueter
Marco
M
Thalheimer
Andreas
A
Fein
Martin
M
Richard
Matthias
M
Faller
Hermann
H
D000328:Adult; D015992:Body Mass Index; D003863:Depression / Q000150:complications / Q000175:diagnosis*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D015391:Gastroplasty; D006801:Humans; D008297:Male; D017533:Marital Status; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D011594:Psychometrics; D012649:Self Concept; D011795:Surveys and Questionnaires; D015431:Weight Loss