Background

There are limited data regarding the impact of cannabis use on outcomes after bariatric surgery. As such, it is challenging to know how to counsel patients using cannabis. The purpose of this study was to examine whether cannabis use was associated with psychiatric symptoms and maladaptive eating among individuals up to 4 years after bariatric surgery.

Methods

All patients who underwent bariatric surgery at a single health system over a four-year period were invited to participate. Participants (N=765) completed questionnaires online regarding cannabis use, psychiatric symptoms, and maladaptive eating.

Results

Any cannabis use after bariatric surgery was associated with increased likelihood of having significant anxiety (OR= 1.88, p= .003; 20.8% vs. 12.3%), increased likelihood of grazing behaviors (OR= 1.77, p= .01; 17.2% vs. 10.5%), and higher scores for eating in response to depression (p= .01; 12.13 vs. 10.75). Those who use cannabis at least once per week were also more likely to engage in loss of control eating (OR= 1.81, p= .04; 11.2% vs. 6.5%), binge eating (OR= 2.16, p= .03; 14.1% vs. 7.1%), and night eating behaviors (OR= 2.11, p= .01; 12.4% vs. 6.3%). Cannabis use was not associated with depression (p> .05).

Conclusions

Cannabis use after bariatric surgery was associated with anxiety and engaging in maladaptive eating behaviors. Frequent cannabis use (i.e., >1 per week) was associated with additional types of maladaptive eating. Clinicians involved in pre-surgical and post-surgical care may want to counsel patients currently using cannabis, especially those who are engaging in frequent use.