{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T11:36:59Z","timestamp":1793878619602,"version":"4.7.0"},"reference-count":33,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"unspecified","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,27]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess depressive and anxiety symptoms after bariatric surgery and to identify clinical, socioeconomic and psychosocial factors associated with postoperative psychological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 300 adults who had undergone bariatric surgery at least 12\u2009months previously (172 sleeve gastrectomy and 128 gastric bypass). Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7). Psychosocial factors were assessed using the Rosenberg Self-Esteem Scale (RSES), Body Shape Questionnaire (BSQ), Emotional Eating Scale (EES) and Multidimensional Scale of Perceived Social Support (MSPSS). Socioeconomic status, psychotropic medication use and percentage of total weight loss (%TWL) were recorded. Group comparisons, correlation analyses and multivariable linear regression were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients who underwent gastric bypass reported significantly higher depressive and anxiety symptoms compared with sleeve gastrectomy patients (PHQ-9: 9.7\u00b14.2 vs 7.3\u00b13.7; GAD-7: 8.5\u00b14.0 vs 6.5\u00b13.9; both p&lt;0.01). Greater %TWL was inversely associated with depressive (r = \u22120.29, p&lt;0.001) and anxiety symptoms (r = \u22120.24, p&lt;0.001). Participants with struggling socioeconomic status had higher PHQ-9 scores than those with comfortable status (10.4\u00b14.5 vs 7.1\u00b13.4; Cohen\u2019s d=0.73), and psychotropic medication users reported greater symptom severity than non-users (PHQ-9: 10.8\u00b14.3 vs 7.3\u00b13.6; p&lt;0.001). Depressive and anxiety symptoms were moderately correlated with lower self-esteem (RSES), greater body image dissatisfaction (BSQ), higher emotional eating (EES) and lower perceived social support (MSPSS) (all |r|=0.30\u20130.55). In multivariable regression, surgery type, %TWL, socioeconomic status and psychotropic medication use independently predicted depressive symptoms, with the model explaining approximately 33% of the variance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bariatric surgery affects physical and mental health. Gastric bypass patients report more depression and anxiety, sleeve gastrectomy boosts self-esteem, and weight loss improves well-being, though social and medication factors raise psychological risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113203","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T14:56:00Z","timestamp":1773154560000},"page":"e113203","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Psychological and emotional outcomes after bariatric surgery: a cross-sectional comparison of sleeve gastrectomy and gastric bypass patients\n                    <b>\u2003<\/b>"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1606-280X","authenticated-orcid":false,"given":"Arsalan","family":"Tariq","sequence":"first","affiliation":[{"name":"University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ammar","sequence":"additional","affiliation":[{"name":"Alhamd Islamic University, Quetta, Balochistan, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"2026062609361203000_16.3.e113203.1","article-title":"Prevalence and Outcomes of Depression After Bariatric Surgery: A Systematic Review and Meta-Analysis","volume":"14","author":"Alyahya","year":"2022","journal-title":"Cureus"},{"key":"2026062609361203000_16.3.e113203.2","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.tem.2021.10.005","article-title":"The menace of obesity to depression and anxiety prevalence","volume":"33","author":"Fulton","year":"2022","journal-title":"Trends in Endocrinology & Metabolism"},{"key":"2026062609361203000_16.3.e113203.3","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1001\/jama.2015.18118","article-title":"Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-analysis","volume":"315","author":"Dawes","year":"2016","journal-title":"JAMA"},{"key":"2026062609361203000_16.3.e113203.4","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3458","article-title":"Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis","volume":"37","author":"Loh","year":"2021","journal-title":"Diabetes Metab Res Rev"},{"key":"2026062609361203000_16.3.e113203.5","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-025-17358-7","article-title":"Immediate improvement in anxiety and sleep quality with delayed depression response after bariatric surgery in a longitudinal cohort study","volume":"15","author":"Yin","year":"2025","journal-title":"Sci Rep"},{"key":"2026062609361203000_16.3.e113203.6","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-023-07025-z"},{"key":"2026062609361203000_16.3.e113203.7","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2023.1283621","article-title":"Bariatric surgery and mental health outcomes: an umbrella review","volume":"14","author":"Law","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"2026062609361203000_16.3.e113203.8","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0176-8"},{"key":"2026062609361203000_16.3.e113203.9","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291797006077"},{"key":"2026062609361203000_16.3.e113203.10","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066254"},{"key":"2026062609361203000_16.3.e113203.11","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-0236"},{"key":"2026062609361203000_16.3.e113203.12","unstructured":"Segal Y , Gunturu S . 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