Sleeve gastrectomy vs gastric bypass in improvement of depressive symptoms following one year from bariatric surgery, Tehran Obesity Treatment Study (TOTS)

Background: The Beck Depression Inventory (BDI) has been frequently employed as a measure of depression in studies of obesity, with the majority of studies reporting an improvement in scores following weight loss after bariatric surgery. However, the effects of different bariatric techniques on depression score improvement is uncertain. Method: The study included 685 obese patients who underwent laparoscopic sleeve gastrectomy (SG) (n = 443) or gastric bypass (GB) (n = 242) and completed BDIs at baseline and 1 year after surgery. Results: Mean age of the patients was 38.7 +/- 10.9 (84.8% female), and mean body mass index (BMI) was 45.1 +/- 6.0 kg/m(2). One year after surgery, excess weight loss (EWL %) in the GB group was more than the SG group (65.4% vs 62.8% P = 0.02). At baseline, 29.9% of patients had BDI scores in the normal range (0-9), and respectively 32.4 %, 28.3 % and 9.3 % had mild (10-18), moderate (19-29) and sever (+30) depression score; these corresponding values after 1 year were 60.6, 23.2, 11.8 and 4.4%. Overall, BDI scores fell in both surgery groups after 1 year, in the GB group it was 17.2 +/- 10.5 vs 11.1 +/- 9.6, and for the SG group 16.1 +/- 10.2 vs 9.6 +/- 8.9. However BDI score change (Delta BDI) was not significantly different between two surgery groups (-6.04 +/- 10.6 vs -6.4 +/- 9.5, P = 0.149). Conclusion: Bariatric surgery had a beneficial effect on weight reduction and BDI score regardless of its type. Further studies with longer follow-up and more samples are needed to clarify the differences between bariatric procedures. (C) 2019 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.