IMPACT OF BARIATRIC SURGERY ON THE COURSE OF PRE-EXISTING PSYCHIATRIC DISORDERS

Abstract

Obesity is recognized as a chronic multifactorial pathology, and bariatric surgery has established itself as the most effective intervention for sustained weight loss. However, therapeutic success transcends metabolic indices, intrinsically depending on the patient's psychological stability. The objective of this study was to analyze the impact of bariatric surgery on the clinical evolution of pre-existing psychiatric disorders. To this end, an integrative literature review was conducted, structured by the PRISMA model, searching the PubMed, SciELO, and BVS databases. The final sample consisted of 25 articles published between 2021 and 2026. The results reveal that, although initial symptomatic improvement occurs during the "honeymoon" phase, there are high risks of relapse of depressive states and exacerbation of body image-related anxiety in the long term. A statistically significant increase in addiction transfer was identified, with an emphasis on alcoholism, in addition to the resurgence of fragmented compulsive behaviors, such as grazing. Furthermore, anatomical changes and gastric pH impact the pharmacokinetics of psychotropic drugs, requiring rigorous monitoring and dosage adjustments. It is concluded that surgery does not have a curative character for psychopathologies and that lifelong multidisciplinary follow-up is the main determinant to avoid serious outcomes, such as self-harm. The balance between physical and mental health is indispensable for the effectiveness of bariatric treatment.