Objective:

To compare sleeve gastrectomy (SG) and silastic-ring Roux-en-Y gastric bypass (SR-RYGB) in patients with obesity and type 2 diabetes mellitus (T2DM), focusing on long-term changes in psychological health (specifically depressive and anxiety symptoms) and quality of life (QOL) after 10 years.

Key Findings:

• Depressive symptoms improved significantly within the first year after both surgeries, but only SG maintained lower depressive symptoms at 10 years, indicating a potential long-term benefit.
• Anxiety symptoms returned to baseline levels by year five for both surgical groups, suggesting a need for ongoing psychological support.
• Quality of life outcomes showed significant improvements in various domains, reflecting better overall health post-surgery.

Interpretation:

The study indicates that while both SG and SR-RYGB improve psychological health and QOL, SG may offer better long-term outcomes for depressive symptoms in patients with obesity and T2DM.

Limitations:

• The study is limited to a single centre, which may affect generalizability to broader populations.
• Long-term psychological outcomes were not comprehensively assessed beyond 10 years, leaving a gap in understanding the full trajectory of psychological health post-surgery.

Conclusion:

Both surgical options improve psychological well-being and QOL, but SG may provide superior long-term benefits for depressive symptoms in obese patients with T2DM.