Weight-reducing treatments are associated with an improvement in depression, functional health status, and quality of life: A meta-analysis of randomized controlled trials.
Level 1 - systematic review of randomized trials
Meta-analysis of randomized controlled trials
PubMed 41131966 · doi:10.1111/dom.70202
What was done
A meta-analysis of randomized controlled trials investigating surgical, endoscopic, or EMA-approved pharmacological weight-loss interventions. Studies were included if weight loss at endpoint was >5% in the intervention arm and <5% in the control arm. Endpoints evaluated were the incidence of overall and specific psychiatric adverse events, as well as functional health status and quality of life metrics.
What was found
Weight loss was associated with a reduced risk of major depression (MH-OR 0.45, 95% CI [0.21, 0.94], I² = 0) and overall depression (MH-OR 0.72, 95% CI [0.54, 0.97]). In subgroup analyses, weight loss >10% was associated with a lower incidence of depression than smaller weight loss (p = 0.04), with no difference between intervention types. No differences were found for anxiety (MH-OR 1.04, 95% CI [0.78, 1.39]), overall psychiatric adverse events (MH-OR 1.09, 95% CI [0.89, 1.34]), serious psychiatric adverse events (MH-OR 1.07, 95% CI [0.78, 1.47]), suicidal ideation (MH-OR 0.87, 95% CI [0.44, 1.70]), or suicide (MH-OR 0.87, 95% CI [0.44, 1.70]). Functional health status improved for SF-36 Mental (SMD 0.45, 95% CI [0.37, 0.52]), SF-36 Physical function (SMD 0.29, 95% CI [0.14, 0.44]), and IWQOL-Lite Physical function (MD 3.96, 95% CI [1.60, 6.32]).
Why it matters
This review shows that substantial weight reduction from surgical, endoscopic, or pharmacological interventions improves mental well-being and functional quality of life without signaling an increased risk for psychiatric adverse events or suicidality.
Limits
The abstract does not state the total number of included trials, participant count, follow-up durations, or baseline psychiatric morbidity. Wide confidence intervals for rare endpoints such as suicidal ideation and suicide reflect limited statistical power to rule out small risk differences.
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