ghrelin and gastric sleeve

[Twinbanucci]

I am considering a gastric sleeve as I am overweight and unable to lose the weight despite exercise and diet attempts. My question is; given neurotransmitter like dopamine and serotonin are produced in the gut would having 80% of stomach removed mean the body cannot produce enough of these neurotransmitters? I know there is an increased suicide risk following gastric sleeve (5 x normal population group?) and depression post sleeve is not uncommon. I have a history of depression and would like to know if this can be adequately managed post surgery. I have atypical depression (excessive sleeping and eating, leaden limbs). My meds have recently been changed and my  health is much improved but I still can't shift the weight and suspect reduced dopamine not serotonin is my main problem. I have read dopamine and seratonin don't cross the blood/brain barrier from the stomach, although this is not definitive and some suggest transfer does occur. Does the brain produce enough of these chemicals without support from the stomach for me to stay well psychologically if I have this surgery? I would love to hear from an endocrinologist, neuropsychiatrist or from someone with a history of chronic depression who has had the surgery. Thank you for your advice.

[Twinbanucci]

Thanks for your reply.  It's good to hear you are doing well.  I saw the specialist and he won't do the surgery as not overweight enough apparently.  Back to dieting.  How did you manage to stick to 400 calls per day pre surgery?  It is so hard even sticking to 1200 calls I think!  Take care, Maddie

[Twinbanucci]

Thank you for your reply.  I saw the specialist but he said he wouldn't do a gastric sleeve as am not overweight enough for that option.  So, I guess back to dieting for me.  

[Dr. Kokil Mathur]

Hi!
I do appreciate your worries. Dopamine is produced by the neurons in the central nervous system and the adrenal gland. Serotonin on the other hand is mainly produced by the gut and less by the brain. However, most of it is produced by the intestines.
So a gastric sleeve operation would not substantially decrease the levels of these two neurotransmitters. Also, the nutrition expert can help with diet modifications such that you do not suffer from any nutritional deficiency. Most depression cases after gastric sleeve operation is due to unrealistic expectations and due to difficulty in adjusting to post op situations.
So, please discuss everything in detail before the operation. Also, let your doctor know about your psychological problem. Psychotherapy and appropriate medications before and after surgery will help in holistic treatment of weight loss. Please consult your doctor regarding this. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.

[soliB]

I had depression and ocd (picking my face and skin on feet) I was suicidal and didn't work. I had the sleeve almost 2 years ago now and haven't had any issues. I go to support groups and still follow up with my psychiatrist but I did have a problem with pill withdrawal. It was the worst! I had to stop my meds 2 weeks prior to surgery so not only was I starving (pre surgery I could only consume 400 calories a day) sick from withdrawals, crying, sweating, and super bitchy. After surgery I went back of small dosages for a month to help with the withdrawal and weaned off of them.
Good luck.