Psychopathology and Eating Behaviour in People with Type 2 Diabetes Referred to Bariatric Surgery

Abstract Purpose Psychopathology and disordered eating behaviours are putative pre-operative risk factors for suboptimal post-operative outcomes among people seeking bariatric surgery. Studies vary in the prevalence rates reported for psychopathology in bariatric candidates. Further, less attention has been paid to vulnerable subgroups such as people with diabetes who might be at an elevated risk. For these reasons this study aimed to investigate the rates of psychopathology and disordered eating in pre-surgical candidates with Type 2 Diabetes Mellitus (T2DM). Methods Participants were 401 consecutive patients from a statewide bariatric surgery service for people with T2DM comparing indigenous and non-indigenous Australians. Psychopathology was measured using multi-modal assessment (e.g. diagnostic interview and battery of validated questionnaires). The mean age of the sample was 51 years (18–65 years) with a mean body mass index (BMI) of 46 (30.5–69.3). The majority of the sample was female (60.6%) and born in Australia (87%), and 19.2% identified as Aboriginal and/or Torres Strait Islander. Results High prevalence rates of depression, history of attempted suicide, generalised anxiety, emotional eating and post-traumatic stress disorder were found in this sample in comparison to reference groups. There were no significant differences between those who identified as Aboriginal and/or Torres Strait Islander and those who did not. Conclusion Our cross-sectional findings indicate psychopathology is common in this population. Longitudinal designs in future studies could provide important insights into how psychopathology and disordered eating relate to post-bariatric surgical outcomes for people with T2DM. Further research is warranted to explore mood, anxiety, emotional eating and alcohol use post-operatively.