title: Psychiatric Disorders and Weight Change in a Prospective Study of Bariatric Surgery Patients: A 3-Year Follow-Up.
abstract: To document changes in Axis I psychiatric disorders after bariatric surgery and examine their relationship with postsurgery weight loss.
  
  
  
  As part of a three-site substudy of the Longitudinal Assessment of Bariatric Surgery Research Consortium, 199 patients completed the Structured Clinical Interview for DSM-IV before Roux-en-Y gastric bypass or laparoscopic adjustable gastric band. At 2 or 3 years after surgery, 165 (83%) patients completed a follow-up assessment (presurgery median body mass index = 44.8 kg/m, median age = 46 years, 92.7% white, 81.1% female). Linear-mixed modeling was used to test change in prevalence of psychiatric disorders over time, report remission and incidence, and examine associations between psychiatric disorders and weight loss.
  
  
  
  Compared with status presurgery, the prevalence of any Axis I psychiatric disorder was significantly lower at 2 and 3 years after surgery (30.2% versus 16.8% [p = .003] and 18.4% [p = .012], respectively). Adjusting for site, age, sex, race, presurgery body mass index, and surgical procedure, presurgery mood, anxiety, eating or substance use disorders (lifetime or current) were not related to weight change, nor were postsurgery mood or anxiety disorders (p for all > .05). However, having a postsurgery eating disorder was independently associated with less weight loss at 2 or 3 years (β = 6.7%, p = .035).
  
  
  
  Bariatric surgery was associated with decreases in psychiatric disorders through 3 years after surgery. Postsurgical eating disorders were associated with less weight loss after surgery, adding to the literature suggesting that disordered eating after surgery is related to suboptimal weight loss.
authors.affiliation: From the Duquesne University School of Nursing (Kalarchian), Pittsburgh, Pennsylvania; Department of Epidemiology (King), Department of Biostatistics (Chen), University of Pittsburgh, Pittsburgh, Pennsylvania; Columbia University College of Physicians and Surgeons/New York State Psychiatric Institute (Devlin), New York, New York; Department of Psychiatry, University of Pittsburgh School of Medicine (Marcus), Pittsburgh, Pennsylvania; Sanford Health System and the University of North Dakota School of Medicine and Health Sciences (Garcia), Grand Forks, North Dakota; Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (Yanovski), Bethesda, Maryland; and Neuropsychiatric Research Institute and the University of North Dakota School of Medicine and Health Sciences (Mitchell), Grand Forks, North Dakota.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Kalarchian
authors.forename: Wendy C
authors.initials: WC
authors.lastname: King
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Devlin
authors.forename: Marsha D
authors.initials: MD
authors.lastname: Marcus
authors.forename: Luis
authors.initials: L
authors.lastname: Garcia
authors.forename: Jia-Yuh
authors.initials: JY
authors.lastname: Chen
authors.forename: Susan Z
authors.initials: SZ
authors.lastname: Yanovski
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000706:statistics & numerical data*; D001068:Feeding and Eating Disorders / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D015431:Weight Loss