title: Changes in depression following gastric banding: a 5- to 7-year prospective study.
abstract: 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.
authors.affiliation: Institute of Psychotherapy and Medical Psychology, University of Wuerzburg, Klinikstr. 3, 97070 Wuerzburg, Germany. schowalter@uni-wuerzburg.de
authors.forename: Marion
authors.initials: M
authors.lastname: Schowalter
authors.forename: Andrea
authors.initials: A
authors.lastname: Benecke
authors.forename: Caroline
authors.initials: C
authors.lastname: Lager
authors.forename: Johannes
authors.initials: J
authors.lastname: Heimbucher
authors.forename: Marco
authors.initials: M
authors.lastname: Bueter
authors.forename: Andreas
authors.initials: A
authors.lastname: Thalheimer
authors.forename: Martin
authors.initials: M
authors.lastname: Fein
authors.forename: Matthias
authors.initials: M
authors.lastname: Richard
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
mesh_terms: 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