Severe obesity and major depressive disorder in two siblings undergoing sleeve gastrectomy: a case report and review of the literature

One of the most concerning conditions of the twenty-first century is obesity and its related complications. It has been shown that there is a close association between obesity and psychiatric disorders, such as major depressive disorder (MDD). Severe obesity is associated with a higher risk of these psychiatric disorders. Treating obesity can facilitate improvement of both comorbid disorders. In this case report, we report familial severe obesity in two Iranian siblings of Persian ethnicity from Mazandaran province, Savadkuh county, northern Iran which was associated with MDD. Both patients had severe obesity, with a body mass index (BMI) > 50 kg/m 2 . The 35-year-old male patient underwent laparoscopic sleeve gastrectomy (LSG) with a BMI of 115 kg/m 2 , and his sister had a BMI of 58.8 kg/m 2 . They were both diagnosed with MDD. After the surgery, both patients’ MDD improved significantly with psychotherapy and medical management. In Case 1, antidepressant medications were discontinued without recurrence of symptoms, and in Case 2, a significant dose reduction of antidepressant medications was achieved under psychiatric supervision. Bariatric surgery is the gold standard for treating severe obesity. Although other treatments, such as glucagon-like peptide 1 receptor agonists (GLP1-RAs), have shown significant efficacy, bariatric surgery, especially sleeve gastrectomy, has been approved as a safe and effective solution for severe obesity. On the other hand, these surgeries may be associated with a substantial effect on the improvement of psychiatric conditions, such as MDD.