Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status

Am J Psychiatry. 2007 Feb;164(2):328-34; quiz 374. doi: 10.1176/ajp.2007.164.2.328.


Objective: The present study was designed to document psychiatric disorders among candidates for weight loss surgery and to examine the relationship of psychopathology to degree of obesity and functional health status.

Method: The authors collected demographic and clinical information from 288 individuals seeking surgery. Assessments were administered independently of the preoperative screening and approval process. The study group was mostly female (83.3%) and white (88.2%). Mean body mass index (BMI) of the group was 52.2 kg/m(2) (SD=9.7), and the mean age was 46.2 years (SD=9.4).

Results: Approximately 66% of the participants had a lifetime history of at least one axis I disorder, and 38% met diagnostic criteria at the time of preoperative evaluation. In addition, 29% met criteria for one or more axis II disorders. Axis I psychopathology, but not axis II, was positively related to BMI, and both axis I and axis II psychopathology were associated with lower scores on the Medical Outcomes Study 36-item Short-Form Health Survey.

Conclusions: Current and past DSM-IV psychiatric disorders are prevalent among bariatric surgery candidates and are associated with greater obesity and lower functional health status, highlighting the need to understand potential implications for surgery preparation and outcome. Future work also will focus on the course of psychiatric disorder during the post-surgery period and its relationship to weight loss and maintenance.

Publication types

  • Case Reports
  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Bariatric Surgery*
  • Body Mass Index
  • Comorbidity
  • Diagnostic and Statistical Manual of Mental Disorders
  • Female
  • Health Status*
  • Humans
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / epidemiology*
  • Middle Aged
  • Obesity / epidemiology*
  • Obesity / psychology
  • Obesity / surgery*
  • Patient Selection
  • Personality Disorders / diagnosis
  • Personality Disorders / epidemiology
  • Preoperative Care
  • Prevalence
  • Prognosis
  • Psychiatric Status Rating Scales
  • Treatment Outcome