Mental health before and after bariatric surgery: a systematic review on the development of psychiatric outcomes
DOI:
https://doi.org/10.55892/jrg.v9i20.3501Keywords:
Bariatric Surgery, Mental Health, Depression, Anxiety, Psychiatric DisordersAbstract
Objective: To analyze the scientific evidence regarding the evolution of mental health before and after bariatric surgery, with emphasis on the development of psychiatric disorders, symptom changes, and factors associated with psychological outcomes in the postoperative period. Methodology: This systematic review was conducted according to the PRISMA guidelines. Searches were performed in PubMed, Virtual Health Library (VHL), and SciELO databases using descriptors related to bariatric surgery, mental health, and psychotropic medications. Original studies published within the last five years in Portuguese, English, or Spanish that evaluated psychiatric outcomes in adults undergoing bariatric surgery were included. After the selection process and eligibility assessment, 11 studies were included in the final sample. Results: The studies demonstrated significant improvements in depressive and anxiety symptoms, as well as quality of life, particularly during the first postoperative year. However, long-term follow-up studies revealed a gradual increase in the prevalence of psychiatric disorders in subsequent years, including mood disorders, bipolar disorder, eating disorders, and risk behaviors. Factors such as elevated systemic inflammation, greater preoperative depression severity, and adverse childhood experiences were associated with poorer psychological outcomes and reduced weight-loss success. Furthermore, sustained weight loss did not necessarily correspond to long-term improvement in mental health. Conclusion: Bariatric surgery provides important short-term mental health benefits, particularly through reductions in depressive symptoms and improvements in quality of life. However, these effects may diminish over time, highlighting the need for continuous psychological and psychiatric follow-up. Integrating mental health care into long-term multidisciplinary bariatric management is essential to optimize clinical outcomes and prevent late psychiatric complications.
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