{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:05:03Z","timestamp":1786122303861,"version":"build-2736575974"},"reference-count":30,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: The rising prevalence of severe adolescent obesity has increased the number of young patients referred for bariatric surgery. The psychiatric and psychosocial profiles of adolescents and of adult women undergoing this treatment remain insufficiently characterized. This study compared preoperative and postoperative psychiatric, psychosocial, and metabolic profiles of adolescents and adult women undergoing bariatric surgery. Methods: This prospective cohort study recruited 77 consecutive female patients (32 adolescents aged &lt;18 years; 45 adult women aged 18\u201325 years) at a single bariatric center in Poland between December 2022 and December 2023. All participants underwent comprehensive preoperative and one-year postoperative assessments including laboratory testing, standardized psychiatric interviews, and psychometric screening with the Beck Depression Inventory (BDI) and the Patient Health Questionnaire-9 (PHQ-9). Results: Preoperatively, adolescents were more severely affected for their age (median BMI-for-age z-score 3.53) and waited longer between the first obesity clinic visit and surgery. Adolescents more frequently reported self-harm behaviors and moderate-to-severe depression on the BDI, whereas adult women more often reported psychoactive substance use. Both groups achieved comparable improvements in laboratory and comorbidity outcomes at one year, although relative weight loss was greater in adult women (median total weight loss 37.6% vs. 28.4%, p &lt; 0.0001). Postoperatively, a greater proportion of adolescents than adult women improved with respect to social anxiety (50.0% vs. 13.3%, p = 0.0007) and BDI depression severity (53.1% vs. 24.4%, p = 0.02), whereas a greater proportion of adult women improved with respect to psychoactive substance use (46.7% vs. 12.5%, p = 0.003). Generalized anxiety and suicidal ideation declined within both groups, but the extent of improvement did not differ significantly between them. These differences persisted, and for several outcomes became larger, after adjustment for the reduction in BMI, which was smaller in adolescents. Conclusions: In this observational cohort, bariatric surgery was associated with distinct psychiatric and psychosocial outcome profiles in adolescents compared with adult women. Because the study was uncontrolled and included no non-surgical comparison group, these findings are hypothesis-generating and cannot establish a causal effect of surgery or of its timing; confirmation in larger, multicenter studies with appropriate comparison groups is required. Comprehensive multidisciplinary perioperative care and tailored postoperative psychological support appear important for both age groups.<\/jats:p>","DOI":"10.3390\/jcm15166139","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T09:14:28Z","timestamp":1786094068000},"page":"6139","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psychiatric and Psychosocial Outcomes of Bariatric Surgery in Adolescents and Adult Women: A Prospective Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"given":"Marta","family":"Herstowska","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7831-0242","authenticated-orcid":false,"given":"Ada","family":"Przygocka-Pieni\u0105\u017cek","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnieszka","family":"Lejk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Burzy\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Translational Medicine, Medical University of Lodz, 92-215 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u0142gorzata","family":"My\u015bliwiec","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, 80-210 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0141ukasz","family":"Kaska","sequence":"additional","affiliation":[{"name":"Hospital of the Ministry of the Interior and Administration, 80-104 Gdansk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization, and UNICEF (2025). Global Status Report on Adolescent Obesity."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1056\/NEJMra1514009","article-title":"Mechanisms, Pathophysiology, and Management of Obesity","volume":"376","author":"Heymsfield","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1007\/s13679-013-0080-9","article-title":"Depression and Disordered Eating in the Obese Person","volume":"3","author":"Faulconbridge","year":"2014","journal-title":"Curr. Obes. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/obr.12334","article-title":"Predicting adult obesity from childhood obesity: A systematic review and meta-analysis","volume":"17","author":"Simmonds","year":"2016","journal-title":"Obes. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Jensen, M.D., Ryan, D.H., Apovian, C.M., Ard, J.D., Comuzzie, A.G., Donato, K.A., Hu, F.B., Hubbard, V.S., Jakicic, J.M., and Kushner, R.F. (2014). 2013 AHA\/ACC\/TOS guideline for the management of overweight and obesity in adults: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation, 129.","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2022060640","DOI":"10.1542\/peds.2022-060640","article-title":"Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity","volume":"151","author":"Hampl","year":"2023","journal-title":"Pediatrics"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1210\/jc.2016-2573","article-title":"Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline","volume":"102","author":"Styne","year":"2017","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.soard.2018.03.019","article-title":"ASMBS pediatric metabolic and bariatric surgery guidelines, 2018","volume":"14","author":"Pratt","year":"2018","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1056\/NEJMoa1813909","article-title":"Five-Year Outcomes of Gastric Bypass in Adolescents as Compared with Adults","volume":"380","author":"Inge","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/S2213-8587(16)30424-7","article-title":"Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): A prospective, 5-year, Swedish nationwide study","volume":"5","author":"Olbers","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00431-010-1329-x","article-title":"Polish 2010 growth references for school-aged children and adolescents","volume":"170","author":"Litwin","year":"2011","journal-title":"Eur. J. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.soard.2022.08.013","article-title":"2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery","volume":"18","author":"Eisenberg","year":"2022","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Stanford, F.C., Mushannen, T., Cortez, P., Campoverde Reyes, K.J., Lee, H., Gee, D.W., Pratt, J.S., Boepple, P.A., Bredella, M.A., and Misra, M. (2020). Comparison of Short and Long-Term Outcomes of Metabolic and Bariatric Surgery in Adolescents and Adults. Front. Endocrinol., 11.","DOI":"10.3389\/fendo.2020.00157"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1038\/ijo.2012.160","article-title":"Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: Results from a Swedish Nationwide Study (AMOS)","volume":"36","author":"Olbers","year":"2012","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Herstowska, M., Mysliwiec, K., Bandura, M., Chrzanowski, J., Burzy\u0144ski, J., Michalak, A., Lejk, A., Karamon, I., Fendler, W., and Kaska, L. (2025). Beyond Metabolism: Psychiatric and Social Dimensions in Bariatric Surgery Candidates with a BMI \u2265 50\u2014A Prospective Cohort Study. Nutrients, 17.","DOI":"10.3390\/nu17152573"},{"key":"ref_16","unstructured":"Supreme Audit Office (Poland) (2024, March 26). Obesity Prevention and Treatment Overwhelmed the System, Available online: https:\/\/www.nik.gov.pl\/en\/news\/obesity-prevention-and-treatment-overwhelmed-the-system.html."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1056\/NEJMoa1506699","article-title":"Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents","volume":"374","author":"Inge","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/SLA.0000000000002525","article-title":"Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort","volume":"269","author":"Schauer","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_19","first-page":"1467","article-title":"Change, predictors and correlates of weight- and health-related quality of life in adolescents 2-years following bariatric surgery","volume":"44","author":"Ley","year":"2020","journal-title":"Int. J. Obes."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1038\/oby.2008.636","article-title":"The stigma of obesity: A review and update","volume":"17","author":"Puhl","year":"2009","journal-title":"Obesity"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/s41380-018-0017-5","article-title":"Depression and obesity: Evidence of shared biological mechanisms","volume":"24","author":"Milaneschi","year":"2019","journal-title":"Mol. Psychiatry"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.jad.2022.03.021","article-title":"Age and gender effects on non-suicidal self-injury, and their interplay with psychological distress","volume":"306","author":"Wilkinson","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jad.2023.10.106","article-title":"Exploring gender differences in risk factors for self-harm in adolescents using data from the Millennium Cohort Study","volume":"345","author":"Diggins","year":"2024","journal-title":"J. Affect. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.jad.2016.10.014","article-title":"Age-related differences in self-harm presentations and subsequent management of adolescents and young adults at the emergency department","volume":"208","author":"Diggins","year":"2017","journal-title":"J. Affect. Disord."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/j.soard.2015.04.008","article-title":"Health-related quality of life and psychological functioning 9 years after restrictive surgical treatment for obesity","volume":"11","author":"Herpertz","year":"2015","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.soard.2019.03.001","article-title":"Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery","volume":"15","author":"Zeller","year":"2019","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/j.soard.2011.01.034","article-title":"Two-year trends in psychosocial functioning after adolescent Roux-en-Y gastric bypass","volume":"7","author":"Zeller","year":"2011","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1916038","article-title":"A Randomized, Controlled Trial of Liraglutide for Adolescents with Obesity","volume":"382","author":"Kelly","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S2352-4642(23)00311-5","article-title":"Mental health from 5 years before to 10 years after bariatric surgery in adolescents with severe obesity: A Swedish nationwide cohort study with matched population controls","volume":"8","author":"Bruze","year":"2024","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S2352-4642(20)30024-9","article-title":"5-year mental health and eating pattern outcomes following bariatric surgery in adolescents: A prospective cohort study","volume":"4","author":"Bruze","year":"2020","journal-title":"Lancet Child Adolesc. Health"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6139\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T09:29:29Z","timestamp":1786094969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/16\/6139"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,7]]},"references-count":30,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["jcm15166139"],"URL":"https:\/\/doi.org\/10.3390\/jcm15166139","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,7]]}}}