title: High preoperative depression, phobic anxiety, and binge eating scores and low medium-term weight loss in sleeve gastrectomy obese patients: a preliminary cohort study.
abstract: OBJECTIVE
  Although depression, anxiety, and binge eating are prevalent in candidates for bariatric surgery, their impact on weight loss is unknown following sleeve gastrectomy. This study assesses the associations between weight loss and preoperative depression, anxiety, and binge eating scores in patients undergoing sleeve gastrectomy for morbid obesity.
  
  
  METHODS
  This cohort study included 34 patients who underwent sleeve gastrectomy for morbid obesity between May 2006 and February 2010 in a French tertiary referral center. We assessed preoperative depression (using the Beck depression inventory and the SCL-90-R depression subscale), anxiety (using the Hamilton anxiety rating scale and the SCL-90-R anxiety subscales), and binge eating (using the bulimic investigatory test, Edinburgh). The primary outcome was the percentage of excess weight loss at 12 months (PEWL).
  
  
  RESULTS
  The preoperative mean body mass index (BMI) was 55.3 kg/m2 ± 10.2 kg/m2 and 41.7 kg/m2 ± 8.7 kg/m2 at the 12-month follow-up visit. The mean PEWL was 46.8% ± 15.8%. After adjusting for the preoperative BMI, the PEWL was negatively associated with preoperative scores for depression (β= -0.357; P < 0.05), phobic anxiety (β = -0.340; P < 0.05), interpersonal sensitivity (β = -0.328; P < 0.05), and binge eating (β = -0.315; P = 0.05). Other forms of anxiety were not correlated with the PEWL.
  
  
  CONCLUSIONS
  Higher preoperative depression, phobic anxiety, interpersonal sensitivity, and binge eating scores are associated with low postoperative weight loss in patients undergoing sleeve gastrectomy. Future studies should assess the preoperative prevalence of syndromal or subsyndromal atypical depression and its relationship to postoperative weight loss in bariatric surgery candidates.
authors.affiliation: CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France. paul.brunault@gmail.com
authors.forename: Paul
authors.initials: P
authors.lastname: Brunault
authors.forename: David
authors.initials: D
authors.lastname: Jacobi
authors.forename: Vaïda
authors.initials: V
authors.lastname: Miknius
authors.forename: Céline
authors.initials: C
authors.lastname: Bourbao-Tournois
authors.forename: Noël
authors.initials: N
authors.lastname: Huten
authors.forename: Philippe
authors.initials: P
authors.lastname: Gaillard
authors.forename: Charles
authors.initials: C
authors.lastname: Couet
authors.forename: Vincent
authors.initials: V
authors.lastname: Camus
authors.forename: Nicolas
authors.initials: N
authors.lastname: Ballon
mesh_terms: D000328:Adult; D056912:Binge-Eating Disorder / Q000453:epidemiology*; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000523:psychology / Q000534:rehabilitation / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D010698:Phobic Disorders / Q000453:epidemiology*; D057234:Preoperative Period; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology*