Despite weight-loss surgery, one in five adolescents still suffers from depression

Teenagers suffering from severe obesity generally feel worse than their peers, but after undergoing gastric bypass nearly all experience improved mental health. One in five, however, still suffers from symptoms of depression - some quite seriously. These are the results of a new study from Lund University in Sweden, published in Obesity.

The study is the largest two-year follow-up in the world regarding mental health in adolescents who have undergone a form of weight-loss surgery known as gastric bypass. It includes 88 Swedish adolescents, 13-18 years old, with an average BMI of 45.6 prior to surgery.

Many operations on young people have been carried out in Sweden, where healthcare is free, compared to in the rest of the world. Other countries, such as Denmark, do not allow weight-loss surgery for patients under the age of 25, and in the United States you need health insurance to cover the procedure. The Swedish study is therefore based on an internationally unique and large group of patients.

There are some clear results, according to Kajsa Järvholm, a researcher and psychologist at Lund University.

"Most young people felt significantly better two years after surgery. On average, they felt like most other adolescents, so their mental health had been normalised", says Järvholm.

"There is also a big difference in how weight affected them in various social situations. Two years after the operation, they experienced far fewer limitations than before."

"Another important discovery was that some did not feel better. Just under 20 per cent of patients said they still did not feel well after having surgery, and their self-assessments showed symptoms of moderate to severe depression. 13 per cent showed symptoms of severe depression."

Kajsa Järvholm believes that it is important to continue studying the group of adolescent patients. She also considers it necessary to provide psychosocial support for young people undergoing gastric bypass surgery, especially those who do not feel better mentally even if they lost weight.

"More measures are needed to identify groups at risk and to provide the help and support they need," she explains.

The study examined the adolescents in three rounds: before surgery, one year after surgery, and two years after surgery.

The study of adolescents' mental health is part of a larger national Swedish study, AMOS, which examines the benefits and risks of providing weight-loss surgery for adolescents under 18.

The researchers want to investigate whether undergoing surgery before turning 18 rather than as an adult will have different results in terms of preventing disease, maintaining weight, and mental health. The study also examines whether there are differences in future developments in life, for example with regard to work and family, if one undergoes surgery before turning 18.