Kristine J. Steffen, PharmD, PhD, Research Scientist, Neuropsychiatric Research Institute, Fargo, ND
Bariatric surgery is the most effective treatment for obesity (defined as a body mass index [BMI] >30 kg/m2) and is recommended for extremely obese individuals (BMI >40 kg/m2) age >18. Most patients experience significant weight loss accompanied by improvements in mood, physical comorbidities, and quality of life. Despite these favorable outcomes, several aspects of postoperative care—such as management of mental health issues—remain unclear. Bariatric surgery candidates show high rates of preoperative psychopathology, particularly depression and dysphoria. Little is known about how bariatric surgery affects absorption of psychiatric medications, leaving prescribing clinicians with minimal guidance when a postoperative patient reports changes in mood symptoms.
This article discusses the psychosocial status of bariatric surgery candidates and presents a rationale for increased medication monitoring after surgery.