Association of Components of Metabolic Syndrome with Depression and Anxiety in Patients Undergoing Weight Reduction Surgery

Jillian B. Kallman3, 4, Angela Wheeler1, Husam K. Alathari2, Yun Fang3, 4, Maria Stepanova1, 3, 4, Hazem Elrainy1, 3, 4, Zobair M. Younossi*, 1, 3, 4
1 Center for Liver Diseases, Inova Health System, 3300 Gallows Road, Falls Church, Virginia, USA
2 Comprehensive Addiction Treatment Services, Inova Health System, 3300 Gallows Road, Falls Church, Virginia, USA
3 Outcomes Research Program, Inova Health System, 3300 Gallows Road, Falls Church, Virginia, USA
2 Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia, USA

© 2010 Kallman et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Center for Liver Diseases at Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA; Tel: (703) 776-2540; Fax: (703) 776-4388; E-mail:



Obesity can be associated with psychiatric disorders such as depression.


To determine the prevalence and association of psychiatric disorders in patients with excess body weight.


Patients scheduled for weight reduction surgery were included. For each patient, pre-surgical clinical and psychiatric data were collected. Follow-up data were available 1-year after surgery. Patients with psychiatric disorders were compared to those without psychiatric disorders. Mann-Whitney non-parametric test was used for comparison of numerical parameters, while prevalence of certain clinical and demographic events were validated using chi-square homogeneity test.


499 patients were included: age: 42.8 ±11.0 years, 20% male, 76% Caucasians, BMI 46.8 ± 10.8, ALT 32.5 ± 21.7 and AST 25.0 ± 14.3. At baseline, a history of psychiatric disorder was documented in 214 (43%) patients (depression in 35% of patients, anxiety in 6% and other psychiatric diagnosis in 2.2%). Patients with a history of depression were older (p=0.0021), more likely to report a history of drinking alcohol either at baseline (p=0.0434) or 1-year after surgery (p= 0.0302), and more likely to be female (p=0.0079) and Caucasian (p=0.0096) than patients without psychiatric history. The depression cohort of this study also had significantly higher triglyceride levels (p= 0.0492) than any other psychiatric diagnosis cohort, and the highest rates of hyperlipidemia (p = 0.012) and hypertension diagnoses (p = 0.0074) out of all cohorts, including the cohort of subjects never diagnosed with a psychiatric disorder.


Patients undergoing weight reduction surgery seem to have high prevalence of depression and anxiety. Patients previously diagnosed with depression also appear to have a significantly higher rate of hypertension and hyperlipidemia than patients who were never diagnosed with a psychiatric disorder.

Keywords: Depression, hypertension, hyperlipidemia, morbid obesity, weight reduction surgery.