Does bariatric surgery affect mental health?
Matthew Maciejewski, PhD, Professor of Medicine (Duke General Internal Medicine) is the new recipient of a $2.2 million funding award from the National Institute on Drug Abuse (NIDA). This research project will assess long-term mental health outcomes of veterans who have undergone bariatric surgery between 2000-2016.
“The outcomes to be compared are alcohol misuse (AM) via the AUDIT-C (the Alcohol Use Disorders Identification Test), opioid use disorder (OUD) and depression treatment in veterans,” says principal investigator, Matthew Maciejewski. The study team includes Maren Olsen, PhD, and Valerie Smith DrPH, from the Durham VAMC and their colleagues from the Group Health Research Institute in Seattle, Washington – David Arterburn, MD, MPH, and Kathy Bradley, MD, MPH.
Though bariatric surgery has recognizable short term benefits “there is very little evidence about mental health outcomes in the long-term, so we are hopeful to make useful contributions to the field in these areas,” Maciejewski says.
This 4.5-year R01 project builds on prior work by leveraging the same cohort of veterans who did or did not have bariatric surgery. The setting is ideal because of access to data from the longstanding EHR in the VA and the loyalty of this patient population. The AUDIT-C survey tool, introduced as a standard in 2008, will further strengthen the results.
Maciejewski states, “No other U.S.-based health system, except possibly Kaiser, has the national data systems in place to enable extraction of EHR data and patient-reported outcomes like the VA.”
“Duke University has tremendous resources and faculty to support this kind of work, so we look forward to building upon the momentum that we’ve been developing over the past 10 years.”
Maciejewski et al previously have conducted studies of veterans’ outcomes following bariatric surgery. Building on their experience with matched cohorts of more than 2,000 veterans undergoing surgery between 2002-2011, compared to more than 7,000 non-surgical controls, the team proposes to address critical evidence gaps about 5-year post-surgical rates related to prevalence of alcohol misuse and depression, to prescriptions for opioid medications, and how these moderate the effect of bariatric surgery on long-term weight change.