With Melbourne Bariatric Surgeon Dr Jason Winnett and Winnett Specialist Group Psychologist Kylie Murphy  

Bariatric surgery and mental health disorders 

In decades past, patients with bipolar disorder, depression or schizophrenia were once routinely advised against bariatric surgery.

While this view is shifting, careful assessment selection and monitoring remain essential.

A 2025 meta-analysis of more than 732,000 patients found that compared to nonsurgical interventions, surgery may improve depression, anxiety, non-normative eating, and attention, but slightly increase suicides and substance use disorders. 

Another large Western Australian study found in JAMA Psychiatry that there were more presentations to the ER and psychiatric episodes after bariatric surgery, especially if there were post-surgical complications or if there was a history of deliberate self-harm and psychiatric substance use disorder before surgery. 

‘Certainly, these patients need to be carefully monitored, and the evidence is mixed on whether surgery can exacerbate mental health conditions,’ says Dr Winnett.

However, the results suggested reductions in depression ranging from 8-74%  according to a meta-analysis of 65,363 patients in the Journal of the American Medical Association. The study found ‘moderate quality evidence supports an association between bariatric surgery and lower rates of depression post-operatively.’

Why psychological support is important before and after surgery

‘There is no silver bullet for long-term weight management,’ says Winnett Specialist Group psychologist Kylie Murphy. ‘Psychological support before and after bariatric surgery is vital for building sustainable habits, monitoring progress, and navigating inevitable challenges like weight plateaus.’ 

Rather than relying on willpower alone, Kylie works with patients to understand the powerful link between thoughts, emotions, and eating patterns. Her approach focuses on breaking automatic behavioural patterns, untangling emotional eating, and developing practical coping tools for life after surgery.

Strategies to share with patients dealing with cravings 

Kylie shares some ways patients can manage their cravings while taking care of their mental health:

Plan, don’t react

‘The key to managing cravings is to expect them and respond with a plan rather than reacting on impulse,’ explains Kylie. ‘Something as simple as changing your environment, pausing before meals, or doing a quick breathing exercise such as inhaling for four counts, holding for four, and exhaling for four, can effectively interrupt an automatic habit loop.

Practice self-compassion

‘A single slip doesn’t undo your progress. Harsh self-criticism only fuels low mood and emotional eating, so aim to speak to yourself with the same kindness you’d offer a close friend.’

Ride the craving wave

Kylie also encourages patients to practice ‘urge surfing’ when an intense craving strikes:

‘Cravings behave like waves – they rise, peak, and usually subside within 10 to 15 minutes. Rather than fighting the urge or immediately giving in, notice it without judgment and allow it to pass.’

Put a name to the feeling

‘It helps to pause and get curious: Is this genuine physical hunger, or am I bored, stressed, lonely, or tired? Naming the emotion or physical state strips away its power and keeps you from responding on autopilot.’

A shared-care approach to obesity and depression

For patients living with obesity and depression, the best outcomes come from treating both conditions together. 

GPs are well placed to identify these patients early, review medications that may affect weight or mood, and support mental health before and after any weight-loss intervention. 

At Winnett Specialist Group, our multidisciplinary team works alongside GPs to provide careful assessment, ongoing monitoring and practical support for patients throughout their journey. To refer a patient or discuss a case, please contact our team.

References

1. Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. JAMA Psychiatry 2010;67(3):220–229.
2. Jokela M, Laakasuo M. Obesity as a causal risk factor for depression: systematic review and meta-analysis of Mendelian randomization studies and implications for population mental health. J Psychiatr Res. 2023.
3. Gafoor R, Booth HP, Gulliford MC. Antidepressant utilisation and incidence of weight gain during 10 years’ follow-up: population based cohort study. BMJ. 2018;361:k1951.
4. Bazo-Alvarez JC, Morris TP, Carpenter JR, Hayes JF, Petersen I. Effects of long-term antipsychotics treatment on body weight: a population-based cohort study. J Psychopharmacol. 2020;34(1):79–85.
5. Kornelius E, Huang JY, Lo SC, Huang CN, Yang YS. The risk of depression, anxiety, and suicidal behavior in patients with obesity on glucagon like peptide-1 receptor agonist therapy. Sci Rep. 2024;14:24433. doi:10.1038/s41598-024-75965-2.
6. Bi Z, et al. Glucagon-like peptide-1 receptor agonists and risk of depression: a systematic review and meta-analysis. BMC Psychiatry. 2026;26(1):379. doi:10.1186/s12888-026-08016-x.
7. Taipale H, Taylor M, Lähteenvuo M, Mittendorfer-Rutz E, Tanskanen A, Tiihonen J. Association between GLP-1 receptor agonist use and worsening mental illness in people with depression and anxiety in Sweden: a national cohort study. Lancet Psychiatry. 2026;13(4):327–335. doi:10.1016/S2215-0366(26)00014-3.
8. Dawes AJ, Maggard-Gibbons M, Maher AR, et al. Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. JAMA. 2016;315(2):150–16
9. Psychiatric and cognitive functioning after metabolic and bariatric surgery: a systematic review and meta-analysis. Obes Rev. 2025. doi:10.1111/obr.13968.
10. Morgan DJR, Ho KM, Platell C. Incidence and determinants of mental health service use after bariatric surgery. JAMA Psychiatry. 2020;77(1):60–67.
11. Dawes AJ, et al. JAMA. 2016;315(2):150–163

Contact

P (03) 9417 1555

admin@winnettspecialistgroup.com.au

www.winnettspecialistgroup.com.au

Queens Terrace, 382 Victoria Parade, East Melbourne 3002

This page was reviewed by Dr Jason Winnett and psychologist Kylie Murphy, October 2026, AHPRA No: MED0001155541 

This article contains general information only, not medical advice. All procedures carry risks and results are individual. Consult your GP and a qualified surgeon or seek a second opinion before proceeding.