Perioperative antidepressant use improves body image to a greater extent compared to those not taking antidepressants in patients who undergo bariatric surgery

Abstract

Introduction: Body image often improves after bariatric surgery; however, those who are depressed are more vulnerable to continuing to have body image concerns. Body image dissatisfaction and depression are associated with poorer quality of life, less weight loss after surgery, and poorer overall physical/mental functioning. Our study aims to determine whether antidepressants influence the improvement seen in body image after bariatric surgery. Materials and methods: Body-Esteem Scale for Adolescents and Adults (BESAA), a validated tool for trending body image, was administered preoperatively and at 3, 6, and 12 months postoperative follow-ups. Scores were compared for improvement, and linear regression models were used to determine the influence of medications and demographic factors on score improvement. Results: The study sample was consisted of 47 men and 57 women (22–72 years of age). Preoperative BMI was in the range of 35.87–75.66 (mean: 49.26). Sixty-nine percent (69%) were taking psychiatric medications and 57% of those medications were antidepressants (12 different antidepressants represented). Improvement in BMI was in the range of 1.44–30.77 points (mean: 15.08). The majority (98.07%) showed improved BESAA scores; two factors revealed statistical significance for influence on score magnitude. For every 1 point of BMI improvement, our sample increased BESAA scores by 0.68 points (p = 0.021). Those taking antidepressants scored an average of 8.55 points higher than those not taking antidepressants (p = 0.032). There were no significant differences found for age, gender, race, type of surgery, use of anxiolytics/hypnotics, or stimulants. Conclusion: Perioperative antidepressant usage is associated with a greater improvement in body image after bariatric surgery compared to those who are not taking antidepressants. Given the high comorbidity of depression in bariatric surgery patients, this highlights potential for improved outcomes with treatment of psychiatric comorbidities in this population.