University of Colorado Anschutz Medical Campus Aurora, Colorado
Introduction: Depression has been shown to negatively correlate with weight loss after bariatric surgery. However, the effect of depression on weight loss after endoscopic bariatric therapy is poorly understood. The primary aims of this study were to evaluate if either the presence and severity of depression symptoms or change in symptoms over time affected weight loss after intragastric balloon (IGB) placement.
Methods: A retrospective cohort study was performed on patients who underwent IGB placement at a tertiary academic medical center from 2017 to present. Descriptive statistics were performed for all variables. The effects of depression on weight loss over time were investigated using both simple linear regression as well as generalized linear mixed effect models, specifying an unstructured variance-covariance matrix with random intercept and slope.
Results: Fifty-three patients underwent IGB placement during the study period. Eight were excluded due to absence of depression measurements. Among the remaining 45 patients [gas-filled IGB, 33 patients (73.3%), single fluid filled IGB, 10 patients (22.2%), double fluid filled IGB, 2 patients (4.5%)], the mean age was 46 ± 4.3 years old, mean starting BMI was 35 ±4.5 kg/m2, and 39 patients (86.7%) were female. Twenty-two patients (49.9%) scored positive for depression by initial scoring [mild depression, 9 patients (35.6%), moderate depression, 2 patients (4.4%), moderately severe depression, 4 patients (8.9%)]. Eight patients (17.8%) were previously diagnosed with depression, 7 (15.6%) with anxiety, and 5 (11.1%) had prior evaluation by a psychiatrist or psychologist. Weight loss outcomes are reported in Table 1. There was no significant association between depression severity and weight loss on either simple linear regression (Figure 1), or generalized linear mixed regression (Figure 2). Patient sex, device type, previous mental health diagnoses or treatment, and worsening or improvement in depression following IGB placement did not significantly correlate with weight loss over time.
Discussion: A significant proportion of patients undergoing IGB placement carried a prior diagnosis of either depression or anxiety, and almost half of all patients reported depressive symptoms at initial intake visit. Contrary to the effect seen in bariatric surgery, in this cohort there was no evidence of a relationship between the presence of, severity of, or change in depressive symptoms and weight loss after IGB therapy.
