• Sinead Haugh, Paul Cromwell, Richelle Kirrane, and Helen Heneghan.
• Department of Psychiatry, Blanchardstown Mental Health Services, Connolly Hospital, Blanchardstown, Dublin, West, Ireland. sineadmhaugh@gmail.com.
• Ir J Med Sci. 2024 Apr 1; 193 (2): 903908903-908.

BackgroundAntidepressant medication can be associated with weight gain. Consideration should be given to the specific agent prescribed to optimize bariatric surgery outcomes.AimThe aim of this study is to investigate if patients treated with antidepressants stratified by risk of weight gain are associated with less weight loss at 1 year postbariatric surgery.MethodA single centre, retrospective analysis of all patients who underwent bariatric surgery between July 2018 and 2021 within St Vincent's University Hospital group. The exposure was antidepressant use, stratified for risk of weight gain, and the control group was patients who underwent surgery but no antidepressant use. The primary outcome was % TWL (total weight loss) at 6 weeks, 6 months and 12 months post-surgery. Multivariate linear regression analysis was used to estimate the impact of antidepressant treatment on post-surgery weight loss at 12 months using the variables of age, gender and pre-operative BMI.ResultsOf the total cohort (n = 315), 70 patients (22.2%) were taking antidepressants. At 12 months, post-operatively patients taking medium risk for weight gain antidepressants had significantly less mean %TWL compared to those not taking antidepressants (p = 0.015). Overall, taking any antidepressant was not found to be a significant predictor of %TWL at 12 months after surgery (β =  - 2.590, p = 0.0836).ConclusionMany patients undergoing bariatric surgery have concurrent psychiatric conditions. Given the complex relationship between bariatric surgery and mental health, psychotropic medications may be best managed by a specialist in the field such as a bariatric psychiatrist in order to optimize patient outcomes.© 2023. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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