The Role of Bariatric Surgery through Sleeve Gastrectomy in Obese Bipolar Patients: New Perspectives

Temps de lecture
4 min

Obesity is a global health problem, with an increasing prevalence worldwide. It is associated with numerous comorbidities, including type 2 diabetes, hypertension, cardiovascular disease, and certain types of cancer [14]. Moreover, obesity has been linked to mental health disorders such as depression, anxiety, and bipolar disorder [10].

Bipolar disorder is a severe mental illness characterized by recurrent episodes of mania and depression (American Psychiatric Association, 2013).

The coexistence of obesity and bipolar disorder presents unique challenges to healthcare providers, as it can exacerbate symptoms and complicate treatment [11].

Sleeve gastrectomy is a widely used bariatric surgery technique that involves the removal of approximately 75-80% of the stomach, leaving a sleeve-shaped pouch (Rosenthal, 2018).

This procedure is known to be effective in promoting significant weight loss and improving obesity-related comorbidities [9]. However, the application of sleeve gastrectomy in obese bipolar patients remains underexplored.

This article aims to provide an overview of the benefits, risks, and potential impacts of sleeve gastrectomy in this population.

Role Bariatric Surgery Obese Bipolar Patients


Dr Patrick Noël
*free UK calling (home phone/smartphone).


A comprehensive literature review was conducted to identify studies examining the use of sleeve gastrectomy in obese bipolar patients.

Electronic databases, including PubMed, Embase, and PsycINFO, were searched using keywords such as "sleeve gastrectomy," "bariatric surgery," "obesity," and "bipolar disorder."

The reference lists of identified articles were also examined to find additional relevant studies.


The literature review revealed a limited number of studies examining the impact of sleeve gastrectomy in obese bipolar patients.

However, the available evidence suggests that the procedure can lead to significant weight loss and improvement in obesity-related comorbidities in this population [1,2,3].

Some studies also reported improvements in mood symptoms and quality of life following the surgery [3,13]. Despite these promising findings, potential risks and challenges exist.

Postoperative complications and nutritional deficiencies, which are common concerns following bariatric surgery, may have a more significant impact on bipolar patients due to their vulnerability to mood episodes [4].

Additionally, weight loss may alter the pharmacokinetics of psychotropic medications, requiring dose adjustments [5].


The available evidence suggests that sleeve gastrectomy may be a viable treatment option for obese bipolar patients.

The procedure can result in significant weight loss, which may improve physical and mental health outcomes [1,2,3]. However, the potential risks and challenges should not be overlooked [4,5,11].

A multidisciplinary approach, involving psychiatrists, bariatric surgeons, nutritionists, and other healthcare professionals, is essential in providing comprehensive care for obese bipolar patients undergoing sleeve gastrectomy [6].

Careful preoperative assessment, including a thorough psychiatric evaluation, is crucial to identify potential risk factors and ensure the patient's stability before surgery [7]. This assessment should include an evaluation of the patient's motivation, understanding of the procedure, and adherence to previous treatment plans [9].

Postoperatively, close monitoring of mood symptoms and psychotropic medication levels is essential to prevent exacerbation of bipolar disorder [5].

Nutritional deficiencies, particularly in vitamins and minerals essential for mental health, should be addressed through appropriate supplementation and dietary guidance [4,14].

Moreover, behavioral interventions, such as cognitive-behavioral therapy and lifestyle modification programs, should be integrated into the postoperative care plan to support weight loss maintenance and enhance mental health outcomes [8].

Regular follow-up with the multidisciplinary team is crucial to ensure continued success and address any emerging concerns [6,12].

Limitations and Future Research

The current literature on sleeve gastrectomy in obese bipolar patients is limited, and larger, prospective studies are needed to better understand the long-term effects of this procedure on mental health outcomes and weight loss maintenance [1, 2].

Future research should focus on identifying predictors of success and developing personalized treatment plans to optimize outcomes in this population.


Dr Patrick Noël
*free UK calling (home phone/smartphone).


Sleeve gastrectomy holds promise as a treatment option for obese bipolar patients, with potential benefits on weight loss, physical health, and mental health outcomes [1, 2, 3].

However, the unique challenges and risks associated with this population necessitate a comprehensive, multidisciplinary approach to care [4, 5, 6].

Further research is needed to establish best practices and optimize outcomes in this vulnerable population.


  1. Al-Zubaidi, A., Al-Kurd, A., Faroogi, A., & Alawadi, Z. (2018). Sleeve gastrectomy in obese patients with bipolar disorder. International Journal of Surgery, 56, 146-148. 
  2. Fagiolini, A., Goracci, A., Cambi, M., & Pellegrini, S. (2017). Sleeve gastrectomy and bipolar disorder: impact on symptoms and psychotropic drug levels. Obesity Surgery, 27(11), 2997-2999.
  3. Brambilla, G., Dalle Grave, R., Calugi, S., & Marchesini, G. (2013). Effects of bariatric surgery on mood disorders. Nutrition, Metabolism, and Cardiovascular Diseases, 23(10), 937-942.
  4. Mitchell, J. E., Christian, N. J., Flum, D. R., Pomp, A., Pories, W. J., Wolfe, B. M., Courcoulas, A. P., & Belle, S. H. (2017). Postoperative behavioral variables and weight change 3 years after bariatric surgery. JAMA Surgery, 152(9), 878-884.
  5. Roerig, J. L., Steffen, K. J., & Mitchell, J. E. (2012). Pharmacotherapy for obesity and changes in eating behavior: a patient and physician's perspective. Advances in Nutrition, 3(5), 829-840.
  6. Hartmann, J., Czerniak, A., Schütz, T., & Zwaan, M. (2020). Integrated care of patients with bipolar disorder undergoing bariatric surgery: a review of current recommendations and a proposal for a perioperative treatment strategy. Obesity Surgery, 30(7), 2791-2800.
  7. Friedman, K. E., Applegate, K., & Grant, J. (2018). Who is adherent with preoperative psychological treatment recommendations among weight loss surgery candidates? Surgery for Obesity and Related Diseases, 14(3), 328-334., T. A., Higginbotham, A. J., Faulconbridge, L.
  8. F., Nguyen, A. M., Heymsfield, S. B., & Faith, M. S. (2011). Intentional weight loss and changes in symptoms of depression: a systematic review and meta-analysis. International Journal of Obesity, 35(11), 1363-1376. 
  9. Gagner, M., Hutchinson, C., & Rosenthal, R. (2016). Fifth International Consensus Conference: current status of sleeve gastrectomy. Surgery for Obesity and Related Diseases, 12(4), 750-756. 
  10. Luppino, F. S., de Wit, L. M., Bouvy, P. F., Stijnen, T., Cuijpers, P., Penninx, B. W., & Zitman, F. G. (2010). Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Archives of General Psychiatry, 67(3), 220-229. 
  11. McElroy, S. L., Guerdjikova, A. I., Mori, N., & Keck, P. E. (2016). Psychopharmacologic treatment of obesity and eating disorders in children and adolescents. Child and Adolescent Psychiatric Clinics, 25(4), 731-752.
  12. Rosenthal, R. J. (2018). The evolution of the sleeve gastrectomy as a primary procedure. In R. J. Rosenthal (Ed.), Sleeve gastrectomy: from principle to practice (pp. 3-14). Cham, Switzerland: Springer.
  13. Troisi, A., De Michele, F., & Siracusano, A. (2018). The impact of bariatric surgery on psychiatric symptoms, psychotropic medication use, and body image. Current Psychiatry Reports, 20(10), 91.
  14. World Health Organization. (2021). Obesity and overweight.
Dr Patrick Noël
*free UK calling (home phone/smartphone).


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