Impact of selective serotonin reuptake inhibitors on weight loss after vertical sleeve gastrectomy.

ABSTRACT

BACKGROUND: Mental health disorders, such as depression, are prominent within the bariatric population, with antidepressants ranking among the most frequently prescribed medications. OBJECTIVES: Our surgery aimed to investigate selective serotonin reuptake inhibitor (SSRI) effects on weight loss in patients undergoing vertical sleeve gastrectomy (VSG). SETTING: University affiliated Community Hospital, United States. METHODS: We performed a retrospective chart review at a single bariatric center, involving multiple bariatric surgeons, on adults (>18 years of age) who underwent VSG between 2011 and 2018. The patients were followed for a total of 2 years. Exclusion criteria included revisional surgery during the 2-year follow-up period, SSRI prescription initiated after the index surgery or within 2 years following surgery, and individuals who missed 3 or more postoperative visits. A total of 267 patients met the criteria and were categorized into 2 groups those prescribed an SSRI prior to surgery and those not on an SSRI. Statistical analysis was performed using T-tests and chi-square tests, with significance set at P < .05. RESULTS: The preoperative weight in the SSRI group averaged 118.57 kg (±20.59), whereas in the non-SSRI group, it averaged 129.60 kg (±24.39) (P < .0001). Similarly, the preoperative body mass index (BMI) in the SSRI group averaged 43.34 (±6.14), while in the non-SSRI group, it averaged 46.13 (±6.82) (P = .001). At the 1-month, 3-month, and 6-month follow-ups, the average BMI and weight were lower in the SSRI group compared to the non-SSRI group. However, at the 1-year and 2-year follow-ups, the weight and BMI were no longer statistically different. There was no significant difference in the percentage total weight change (%TWC) between the groups; the %TWC was 22.17 in the SSRI group and 23.35 in the non-SSRI group (P = .324). Follow-up attendance significantly decreased at each subsequent interval, with 65.41% in the SSRI group and 29.27% in the non-SSRI group at the 2-year follow-up. CONCLUSIONS: Based on our analysis, we suggest that VSG can be an effective option for weight loss in patients taking SSRIs. However, due to the limitations, particularly with follow-up of this study, further research is needed to support this conclusion.