Multimorbidity: A Review of the Complexity of Mental Health Issues in Bariatric Surgery Candidates Informed by Canadian Data

BACKGROUND: Multimorbidity is significant for obesity and mental health issues. As a consequence, mental illness is overrepresented in patients seeking bariatric surgery. This review addresses that overlap, with a focus on Canadian data. CONCLUSION: The healthcare system in Canada is unique, but issues related to prevalence of mental health in patients seeking bariatric surgery are similar to those in studies conducted in other countries. Although data on suicide are lacking, Canadian data have shown similar rates of self-harm behaviours and linkages between psychopathology and weight regain after surgery. Geographic issues that make it difficult for individuals to attend regular follow-up appointments have encouraged the use of e-health tools to engage patients and ensure access to follow-up care, which may provide unique opportunities going forward. Additional work is needed to inform best practices in the Canadian system, but in keeping with other data, the consistent message from Canada is that appropriate evaluation and aftercare are essential components of a well-informed bariatric program.