New Onset Mental Health Diagnosis and Emergent Service Utilization Associated With Bariatric Surgery

Mark M. Halim, MD; AnMarie Nguyen, PhD; Karen J. Coleman, PhD; Hilary A. Bennett, MD

J Clin Psychiatry 2025;86(4):25m15806

Abstract

Objective: The objective of this study was to investigate potential associations between bariatric surgery and new onset mental health diagnoses and emergent psychiatric care utilization.

Methods: This was an observational retrospective cohort study. Patients without a history of mental health diagnoses who underwent bariatric surgery between 2010-2016 were matched to patients who were eligible for but did not undergo bariatric surgery on demographic, body mass index (BMI), and comorbidity burden at baseline (date of surgery for cases and matching date for controls). Outcomes of new onset mental health diagnoses after baseline and emergent care utilization were measured in 2-year increments between baseline (ranged from 2010 to 2016) until the end of follow-up (December 31, 2021) to assess changes in risk over time.

Results: The surgical group had lower risk of a new onset mental health diagnosis in the first 2 years (hazard ratio [HR]: 0.82, 95% CI, 0.76–0.88) and approximately 20% higher risk in years 4–8 of follow-up than the control group (years 4–6 HR: 1.22, 95% CI, 1.09–1.36; years 6–8 HR: 1.19, 95% CI, 1.03–1.39). However, emergent psychiatric service utilization did not differ between the groups during follow-up. Utilization was associated with a higher BMI (HR: 1.03, 95% CI, 1.02–1.04) and higher comorbidity burden (HR: 1.43, 95% CI, 1.37–1.49) at baseline.

Conclusions: Bariatric surgery may have a delayed impact on new onset mental health diagnoses, with surgical patients having higher risk of diagnoses than their nonsurgical counterparts 4–8 years following surgery. Despite these increases, there was no change in emergent psychiatric service utilization.

J Clin Psychiatry 2025;86(4):25m15806

Author affiliations are listed at the end of this article.

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