Effect of bariatric surgery on anxiety symptoms in morbidly obese patients: A systematic narrative literature review

Correlation between bariatric surgery (BS), weight loss, and alleviation of anxiety symptoms has been assessed frequently. Research indicates a rather positive effect on anxiety symptoms for the first 3 years after surgery. Beyond this time frame, alleviation of symptoms becomes less apparent. The aim of this study was to investigate the connection between anxiety and BS based on the following research question: does BS lead to an alleviation of their anxiety symptoms in adults with morbid obesity and anxiety symptomatology? The basic mechanism underlying this study was a comprehensive literature search in PubMed and PsycINFO, combining search terms for “anxiety” with “bariatric surgery” related terms. The data set resulting from this search was assessed for relevant studies, which were the basis for the following narrative literature review. A set of 30 studies, 24 prospective cohort studies, and 6 literature reviews met inclusion criteria.The studies included 2228 participants (81% female). At baseline, mean age was 41.4 years and mean body mass index (BMI) was 47 kg/m2. The mean BMI at the end of the studies was 34 kg/m2. Different BS techniques were used for weight loss. A trend for change in anxiety at different time points postsurgery seems to exist. No clear statement can be made about a correlation between weight loss and alleviation of anxiety symptoms. Some studies found a significant correlation between the two parameters for up to 4 years; however, just as many studies found no correlation. The type of weight loss surgery utilized does most likely not determine the effect on anxiety symptoms. BS should not be thought of as a therapy method for anxiety.