Self-Reported Depression and Duodenal Cortisol Biomarkers Are Related to Weight Loss in Young Metabolic and Bariatric Surgery Patients

Background: Abnormal cortisol and serotonin concentrations are reported in obese, anxious, and/or depressed individuals. We examined how duodenal levels of these hormones correlated with self-reported anxiety and depression and their individual and combined contribution to weight loss among young metabolic and bariatric surgery (MBS) patients. Methods: Patients ≤30 years of age who had scheduled MBS were recruited. Weight, depression, and anxiety were collected within 2 weeks before MBS, and weight was again collected 6-months post-MBS. Duodenum serotonin and cortisol tissue samples were collected during MBS. Results: The majority of the sample (N = 18, mean age 23.6 years, standard deviation: 4.8 years) was female (72.2%) and Hispanic (66.7%), and 33.3% were non-Hispanic black. Duodenum cortisol (pg/mL) was inversely correlated with the Beck Anxiety Inventory (r = -0.76, p = 0.04) and Beck Depression Inventory (BDI)-II (r = -0.83, p = 0.02). For every pg/mL increase in the amount of (tissue) cortisol plus BDI-II, the score showed a 0.029 pound increase post-MBS (p = 0.02). Conversely, after adjusting for age every unit increase in BDI-II score showed a 1.83 pound decrease post-MBS (p = 0.03). Conclusions: A combined effect of cortisol and depression had a significant effect on weight loss, while depression was independently associated with weight gain. Longitudinal biospecimen collection would add information to these complex relationships.