Depression is associated with increased severity of co-morbidities in bariatric surgical candidates

Mohamed R Ali, Jason J. Rasmussen, Jeffrey B. Monash, William D. Fuller

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Background: Depression is prevalent among bariatric surgical patients, and previous studies have suggested a link between depression and quality of life. Our objective was to examine the relationship between depression and other co-morbidities of obesity at a university hospital in the United States. Methods: Data were collected from 1368 consecutive patients evaluated for bariatric surgery. The demographic and co-morbidity profiles of these patients were compared between the depressed and nondepressed individuals. Depression was defined as an Assessment of Obesity-Related Co-morbidities score of ≥3, signifying that the patient required medical treatment for (score of 3) or had complications of (score of 4-5) depression. Results: The prevalence of depression among these patients was 36%. The mean age of the patients with depression was older (44.3 ± 9.4 versus 42.2 ± 9.6, P <.05), but the mean body mass index was similar. Depression was more prevalent among the female patients (37.4% versus 29.6%, P <.05). Diabetes mellitus, hypertension, polycystic ovarian syndrome, idiopathic intracranial hypertension, and obesity hypoventilation syndrome occurred with similar frequency and severity in persons with and without depression. The analysis revealed a significantly greater prevalence and severity of dyslipidemia (P <.05), gastroesophageal reflux disease (P <.05), back pain (P <.0001), joint pain (P <.05), sleep apnea (P <.01), stress incontinence (P <.01), and hernia (P <.05) among patients with depression. Overall, patients with depression had more co-morbidities per patient (5.46 versus 4.55) and a greater likelihood of severe or complicated co-morbidities (2.67 versus 1.89 per patient). Conclusion: This report has characterized a link between depression and other co-morbidities in bariatric surgical patients. This association was independent of the body mass index. Although a causal relationship could not yet be identified, our findings indicate that depression, in this patient population, is associated with a greater prevalence and increased severity of medical co-morbidities that express distinct physical symptoms.

Original languageEnglish (US)
Pages (from-to)559-564
Number of pages6
JournalSurgery for Obesity and Related Diseases
Issue number5
StatePublished - Sep 2009


  • Bariatric surgery
  • Co-morbidities
  • Depression
  • Laparoscopy
  • Morbid obesity
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery


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