Background

Studies have shown men are more likely to underreport depression and have less favorable outcomes after bariatric surgery than women. The lack of data comparing the influence of mental health factors on postoperative weight loss in men and women provides an opportunity to investigate whether depression is limiting achievable weight loss in male patients undergoing bariatric surgery.

Methods

A retrospective, single-institution observational study looking at mental health modulators of postoperative bariatric outcomes. Beck Depression Inventory Volume 2 (BDI-II) score and psychotropic medication use served as depression severity proxies. Student’s T-test and ANOVA were used for continuous data. P-values < 0.05 were considered significant.

Results

125 patients, 107 female and 18 male, were included in this study. Average BDI-II was significantly higher in patients taking psychotropic medications (p<0.008, 95% CI 0.98, 6.29). Men reported worse depressive symptoms than women, however women were more likely to be using psychotropic medications (NS). In RYGB patients taking psychotropic medications, men had significantly lower excess body weight loss (%EBWL, p=0.0061), total weight loss (%TWL, p=0.0049), change in BMI (ΔBMI, p=0.0165), and excess BMI loss (%EBMIL, p=0.0077) than women. These men also had significantly lower %EBWL (p=0.031) than men not taking psychotropic medications.

Conclusions

Psychotropic medication use in men is associated with worse bariatric weight loss outcomes compared to women and men not taking psychotropics. This data suggests that psychotropic medication use may not be a strategic option for treating mental health in men seeking to maximize weight loss after bariatric surgery.