Depression, Obesity and Bariatric Surgery
DOI:
https://doi.org/10.25752/psi.9965Keywords:
bioavailability, bariatric surgery, obesity, depression.Abstract
Background: Overweight is an increasing problem worldwide. Data from 2008 show that, in Portugal, 60% of the adult population was overweight and 25% was obese. The relation between mood disorders and obesity is well known and about 2/3 of those who search for bariatric surgery have a psychiatric diagnosis, being depression the most common.
Aims: We reviewed the relation between depression and obesity before and after bariatric surgery and evaluated its impact in the pharmacokinetics of antidepressant medication and nutrients that influence depressive symptomatology.
Methods: We conducted a non-systematic review of the literature published in English between 1988 and 2015, through research in MEDLINE with the keywords absorption, bioavailability, bariatric surgery, obesity, depression, antidepressants.
Results: Depression and obesity potentiates each other in a bidirectional way and the strength of this association is modulated by gender, physical activity, diet and antidepressant medication usage. Bariatric surgery leads to changes in the pharmacokinetics of antidepressant medication and nutrients that have a regulatory role on mood symptomatology.
Discussion and Conclusions: Available data show we need to pay special attention to obese depressive patients proposed for bariatric surgery. The existence of depressive symptoms leads to a greater risk of not losing weight after a bariatric surgery but, in the opposite direction, bariatric surgery leads to a lower bioavailability of antidepressant medication.
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