Antidepresan Kullanımının Tek Anastomoz Gastrik Bypass Sonrası Kilo Kaybına Etkisi: Retrospektif Kohort Çalışması

Year 2025, Volume: 7 Issue: 3, 432 - 441, 13.10.2025

Recep Aktimur , Arda Kazım Demirkan

https://doi.org/10.52827/hititmedj.1717189

Abstract

Amaç: Antidepresan kullanımı genellikle kilo alımıyla ilişkilendirilmekte olup, bariatrik cerrahi sonrası kilo kaybı üzerindeki etkisi hakkında ise sınırlı bilgi mevcuttur. Bu çalışmada, ameliyat öncesi ve/veya sonrası antidepresan kullanımının, tek anastomozlu gastrik bypass (OAGB) geçiren hastalardaki kilo kaybı sonuçlarına etkisi incelenmiştir.
Gereç ve Yöntem: Bu retrospektif kohort çalışmasına, Ocak 2020 ile Aralık 2021 tarihleri arasında OAGB ameliyatı geçiren 181 hasta dahil edilmiştir. Hastalar antidepresan kullanımına göre dört gruba ayrılmıştır: hiç kullanmayanlar (n=87), sadece ameliyat öncesi kullananlar (n=25), ameliyat öncesi ve sonrasında kullanmaya devam edenler (n=36), ve sadece ameliyat sonrası başlayanlar (n=33). Kilo kaybı sonuçları, ameliyattan 12 ay sonra ölçülen vücut kitle indeksi fazlalığı kaybı yüzdesi (%EBMIL) ve toplam kilo kaybı yüzdesi (%TWL) ile değerlendirilmiştir. İstatistiksel karşılaştırmalar bağımsız örneklem t-testi ile yapılmıştır.
Bulgular: Gruplar arasında %TWL açısından anlamlı bir fark saptanmamıştır (aralık: %34,54–%37.05). Ancak, %EBMIL değeri, antidepresan kullanımını sürdüren grupta (%82,21), hiç kullanmayan gruba (p=0.0270) ve sadece preoperatif kullanan gruba (p=0.0196) kıyasla anlamlı derecede daha düşüktü. Diğer gruplar arasında istatistiksel olarak anlamlı fark bulunmamıştır. Demografik değişkenler genel olarak benzerdi; ancak hipertansiyon, hiperlipidemi ve cinsiyet dağılımı gruplar arasında anlamlı farklılık göstermekteydi.
Sonuç: OAGB sonrası antidepresan kullanımının devam etmesi, %EBMIL üzerinde olumsuz bir etki yaratabilir; bu durum %TWL sonuçlarının benzer olmasına rağmen geçerlidir. Bu bulgular, antidepresan maruziyetinin—özellikle postoperatif dönemde sürdüğünde—bariatrik cerrahinin optimal metabolik faydalarını azaltabileceğini düşündürmektedir. İlaçlara özgü etkilerin netleştirilebilmesi için farmakokinetik izlemi içeren ve daha geniş örneklemlerle yapılacak prospektif çalışmalara ihtiyaç vardır.

Keywords

antidepresanlar , bariatrik cerrahi , kilo kaybı , OAGB , %EBMIL , %TWL

The Effect of Antidepressant Use on Weight Loss After One Anastomosis Gastric Bypass: A Retrospective Cohort Study

Abstract

Objective: Antidepressant use is frequently associated with weight gain, yet little is known about its impact on postoperative weight loss following bariatric surgery. This study aimed to examine how antidepressant use—before and/or after surgery—affects weight loss outcomes in patients undergoing one-anastomosis gastric bypass (OAGB).
Material and Method: This retrospective cohort study included 181 patients who underwent OAGB between January 2020 and December 2021. Based on antidepressant use, patients were categorized into four groups: no use (n=87), preoperative use only (n=25), continued use before and after surgery (n=36), and new initiation after surgery (n=33). Weight loss outcomes were assessed using percentage of excess BMI loss (%EBMIL) and total weight loss (%TWL) at 12 months postoperatively. Statistical comparisons were conducted using independent samples t-tests.
Results: There were no significant differences in %TWL between any of the groups (range: 34.54%–37.05%). However, %EBMIL was significantly lower in the continued-use group (82.21%) compared to the no-use group (p=0.0270) and the preoperative-use-only group (p=0.0196). No statistically significant differences were found between other groups. Demographic variables were generally comparable, though hypertension, hyperlipidemia, and gender distribution differed significantly across groups.
Conclusion: Continued antidepressant use after OAGB may negatively affect %EBMIL, despite similar %TWL outcomes. These findings suggest that antidepressant exposure, particularly when continued into the postoperative period, may attenuate the optimal metabolic benefits of bariatric surgery. Future prospective studies with pharmacokinetic monitoring and larger samples are warranted to clarify medication-specific effects.

Keywords

antidepressants , bariatric surgery , OAGB , weight loss , %EBMIL , %TWL

Ethical Statement

Ethical approval: The study received ethical approval from the local ethical committee of Health Sciences University Samsun Training and Research Hospital (approval date/no: 07.07.2021/2021-13-12), and written informed consent was obtained. All procedures performed in studies involving human participants adhered to the 1964 Helsinki Declaration and its later amendments.

Supporting Institution

No financial support was received from any institution, company or person in our study.

Thanks

Not applicable.

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