OB2025 Obesity Update 2025 Case Discussions (3 abstracts)
Pre-existing mental health diagnosis and outcomes post-bariatric surgery
Dana Mahdi 1 , Luke Boyle 1,2 , Zahra Al-Essah 1 , Ali Abdul Hussein 1 , Mina Abdul Hussein 1 , Aslesha Deshraju 1 , Elena Brachimi 1 , Prasidha Rai 1 , Elsie Ampomah 3 , Neha Hussain 3 , Faizan Kiani 3 , Mary Obigbesan 3 , Sanjay Purkayastha 1,4 , Christos Tsironis 1 , Sherif Hakky 1 , Ahmed Ahmed 1,3 , Tricia Tan 1,3 , Julia Kenkre 1 , Kleopatra Alexiadou 1,3 , Saira Hameed 1,3 , Harvinder Chahal 1 , Lucy Tweedlie 1 , Samantha Scholtz 1 , Patricia Ortega 1 & Chioma Izzi-Engbeaya 1,2
1Imperial College Healthcare NHS Trust, London, United Kingdom; 2Barts Health NHS Trust, London, United Kingdom; 3Imperial College London, London, United Kingdom; 4Brunel University, London, United Kingdom
Background: Up to 50% of people with obesity have mental health conditions (mental health in obesity, MHO), and this may affect outcomes post-bariatric surgery. We conducted a retrospective cohort analysis of patients in the Imperial Weight Centre, to assess outcomes and identify where additional intervention may be required.
Methods: Anthropometric, demographic and clinical data were collected from the electronic health records of patients who had primary bariatric surgery between April 2021 and March 2024 (i.e. in the post-COVID era) with up to 2 years follow-up. Patients were excluded if they became pregnant or were diagnosed with cancer during the follow-up period. For patients who had a revisional or second stage procedure during the follow-up period, only data up to the time of the revisional or second stage procedure were included. Weight loss and metabolic outcomes were assessed. Data were analysed using linear regression (for continuous data) or Poisson regression (for categorical data), with models adjusted for age, sex, body mass index (BMI) and type of bariatric surgery.
Results: 482 patients were included in the analysis. Some baseline characteristics of people without a mental health condition (no MHO, n = 265) and people with ≥1 mental health condition (MHO, n = 217) were similar (no MHO vs MHO: mean age±SD 45.4±11.7 vs 43.6±11.1 years, P = 0.09; mean BMI±SD 44.6±7.8 vs 45.8±8.6 kg/m2, P = 0.10; female 76.2% vs 88.0%, P <0.001). There were no significant associations between percentage of total weight lost (P = 0.34), <20% weight lost (P = 0.39) or weight regain (P = 0.17). MHO was associated with a decreased likelihood of discontinuation of lipid-lowering medication post-bariatric surgery (RR 0.42 [0.21-0.87], P = 0.019). The likelihood of stopping glucose-lowering medication and blood pressure-lowering medication was similar between groups.
Discussion and Conclusion: Weight loss outcomes are similar in people with and without MHO. However, MHO is associated with a decreased likelihood of discontinuation of lipid-lowering medication post-bariatric surgery. This may be due to concomitant use of medication for MHO, some of which are known to promote dyslipidaemia. Prospective studies are required to determine if additional targeted lifestyle interventions pre- and post-bariatric surgery would be beneficial in people with MHO.
Volume 5
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Obesity Abstracts
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