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Joshi V, Graziani P, Del-Monte J. Bodily sensations and bariatric surgery: Links between interoceptive sensibility, intuitive and disordered eating behaviour in obesity and obesity surgery. EUROPEAN EATING DISORDERS REVIEW 2024; 32:514-523. [PMID: 38288998 DOI: 10.1002/erv.3066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/30/2023] [Accepted: 01/13/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE This study evaluated interoceptive sensibility, intuitive and disordered eating among bariatric candidates, operated individuals and individuals with obesity seeking non-surgical treatment. METHOD We recruited 57 individuals with obesity seeking nonsurgical weight-loss (IOB), 84 bariatric candidates (Pre) and 22 individuals post-bariatric surgery (Post) who responded to questionnaires: Multidimensional Assessment of Interoceptive Awareness, Intuitive Eating Scale-2 (IES-2), Dutch Eating Behaviour Questionnaire, Binge Eating Scale, State-Trait Anxiety Inventory, Beck's Depression Inventory. RESULTS Overall, the Post group manifested higher scores on 'Body-Listening' (F = 4.95, p = 0.01), 'Emotional Awareness' (F = 8.83, p < 0.001) and 'Trusting' (F = 6.71, p = 0.002) interoceptive dimensions, on the IES-2 total score (F = 5.48, p = 0.007) and 'Reliance on hunger and satiety cues' (F = 31.3, p < 0.001) when age was controlled. The IOB group presented higher scores on emotional (F = 3.23, p = 0.047) and binge eating (F = 5.99, p = 0.004). Among operated individuals, intuitive eating mediated the relationship between interoceptive sensibility dimensions and binge eating: 'Attention regulation' (54%) 'Self-regulation' (75.1%), 'Body listening' (94.09%) and 'Trusting' (84.9%). CONCLUSIONS Our results suggest the therapeutic potential of interoceptive sensibility and intuitive eating in obesity management in/beyond the bariatric context.
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Affiliation(s)
- Vrutti Joshi
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
| | - Pierluigi Graziani
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
| | - Jonathan Del-Monte
- Team ENACT, University of Nîmes, France
- Laboratoire de Psychologie Sociale, Aix-Marseille University, France
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Almuammar S, Aljaaly E, Alqarni L, Alazwari H, Alsubhi R, Alatawi N. Evaluating Night-Eating Syndrome in bariatric surgery patients: A cross-sectional study. BMC Res Notes 2024; 17:118. [PMID: 38664745 PMCID: PMC11046776 DOI: 10.1186/s13104-024-06774-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Night-Eating Syndrome (NES) is a complex eating disorder that has gained recognition in the context of bariatric surgery. However, its prevalence and associated factors in this specific patient population remain understudied, particularly in the Saudi Arabian context. METHODS This cross-sectional study was conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, from June to November 2022. Adult patients who had undergone bariatric surgery with a postoperative follow-up of 6 months were included. NES was assessed using the Night Eating Questionnaire (NEQ). RESULTS A total of 154 patients were enrolled in the study, with a mean age of 38.8 ± 11.4 years. The mean BMI before surgery was 44.8 ± 8.2 kg/m2, which reduced to 28.9 ± 5.8 kg/m2 post-surgery. Of these, 52 patients (33.8%) met the criteria for NES based on NEQ scores. The prevalence of NES was significantly higher among female patients, with 35 out of 83 females (42.2%) compared to 17 out of 71 males (23.9%) experiencing NES. While NES was not significantly associated with age, nationality, diet adherence, BMI, or surgery type, chronic diseases-particularly diabetes-emerged as significant risk factors for NES in post-bariatric surgery patients. CONCLUSION NES is a prevalent concern among post-bariatric surgery patients, with distinct associations with gender and chronic diseases, particularly diabetes. This study provides valuable insights into NES prevalence and its risk factors in the Saudi Arabian context, highlighting the importance of addressing eating disorders within the framework of bariatric surgery care.
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Affiliation(s)
- Sarah Almuammar
- Family Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Elham Aljaaly
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Lama Alqarni
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hadeel Alazwari
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ruba Alsubhi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nouf Alatawi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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3
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Marek RJ, Ben-Porath YS, Heinberg LJ. Six-year postoperative associations between the Minnesota Multiphasic Personality Inventory - 3 (MMPI-3) and weight recurrence, eating behaviors, adherence, alcohol misuse, and quality of life. Surg Obes Relat Dis 2024; 20:391-398. [PMID: 38216363 DOI: 10.1016/j.soard.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/20/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) leads to beneficial and sustained outcomes. However, many patients evidence weight recurrence and psychosocial functioning may be associated with weight recurrence. The Minnesota Multiphasic Personality Inventory - 3 (MMPI-3) is validated for use in presurgical MBS evaluations and likely has clinical utility in understanding weight recurrence and other aspects of postoperative functioning. OBJECTIVE The objective of the current investigation is to understand how postoperative psychosocial functioning relates to weight recurrence and other behaviors and constructs 6 years after MBS. SETTING Cleveland Clinic Bariatric and Metabolic Institute. METHODS A sample of 163 participants consented to take a battery of self-report measures related to psychological functioning, eating behaviors, adherence, alcohol misuse, and quality of life along with their postoperative weight. MMPI-3 scale scores were prorated from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form (MMPI-2-RF) or scored from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form - Expanded (MMPI-2-RF-EX). RESULTS Weight recurrence was quite variable in this sample. Postoperative MMPI-3 scales related to emotional/internalizing dysfunction were modestly associated with higher weight recurrence. Postoperative MMPI-3 scale scores also demonstrated associations with other postoperative outcomes including measures of eating behaviors, adherence, alcohol misuse, and quality of life. CONCLUSIONS Postoperative psychosocial functioning as assessed by the MMPI-3 was associated with weight recurrence and a number of other problematic psychological outcomes beyond weight recurrence.
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Affiliation(s)
- Ryan J Marek
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, Texas.
| | | | - Leslie J Heinberg
- Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
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Rossi AA, Mannarini S, Semonella M, Castelnuovo G, Pietrabissa G. The Association between Grazing and Food Addiction: The Italian Version of the Repetitive Eating Questionnaire (Rep(Eat)-Q) and Its Relationships with Food Addiction Criteria. Nutrients 2024; 16:949. [PMID: 38612983 PMCID: PMC11013059 DOI: 10.3390/nu16070949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Among the dysfunctional eating behaviors associated with excessive food intake, a construct that is gaining increasing attention is grazing-the constant, continuous, compulsive, and repetitive consumption of small/moderate amounts of food. Furthermore, in some cases, grazing seems to indicate a dependence on food and/or eating. Currently, the Repetitive Eating Questionnaire (Rep(Eat)-Q) appears to be the only questionnaire that comprehensively measures grazing, including its repetitive and compulsive eating component. Therefore, in a sample of individuals with severe obesity, the objective of this study was twofold: (A) to evaluate the psychometric properties of the Italian version of the Rep(Eat)-Q, and (B) to analyze the association between grazing and food addiction (FA). METHOD A cross-sectional research design was used. A total of 402 inpatients with severe obesity (BMI > 35) were recruited. Participants underwent a series of questionnaires to investigate structural validity and convergent validity and association with FA criteria. RESULTS The factorial structure of the Rep(Eat)-Q is robust and showed fit indexes: CFI = 0.973; RMSEA = 0.074; 90%CI [0.056-0.091]; and SRMR = 0.029. Also, it exhibited good internal consistency and convergent validity. Furthermore, logistic regression analysis highlights a specific association between certain FA criteria and grazing. CONCLUSIONS The Rep(Eat)-Q can be considered to be a concise, robust, reliable, and statistically sound tool to assess repetitive eating, specifically grazing. Its strong psychometric properties offer significant advantages for both research and clinical applications. Furthermore, in a sample of individuals with severe obesity, the results suggest that individuals with problematic grazing exhibit a typical behavioral profile of subjects with FA, indicating that FA can manifest through problematic grazing as well.
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Affiliation(s)
- Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35131 Padova, Italy;
- Interdepartmental Center for Family Research, University of Padova, 35131 Padova, Italy
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35131 Padova, Italy;
- Interdepartmental Center for Family Research, University of Padova, 35131 Padova, Italy
| | - Michelle Semonella
- Department of Psychology, Bar-Ilan University, Ramat Gan 5290002, Israel;
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.C.); (G.P.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy; (G.C.); (G.P.)
- Clinical Psychology Research Laboratory, IRCCS Istituto Auxologico Italiano, 20149 Milan, Italy
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Rachubińska K, Cybulska AM, Kupcewicz E, Panczyk M, Ślusarska B, Grochans E, Schneider-Matyka D. The Relationship between Depressiveness and Eating Behaviors among Women. Nutrients 2024; 16:195. [PMID: 38257089 PMCID: PMC10821179 DOI: 10.3390/nu16020195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
(1) The objective of the study was to determine the relationship between depressiveness and the occurrence of eating disorders, i.e., emotional eating, uncontrolled eating, cognitive restraint of eating, and the risk of orthorexia. (2) The study was conducted among 556 women from the West Pomeranian Voivodeship (Poland). The study employed the diagnostic survey method using a questionnaire technique: The Beck Depression Inventory, the ORTO-15 Questionnaire, the Three-Factor Eating Questionnaire, and a sociodemographic questionnaire. (3) Higher depressiveness severity is associated with a higher score on the "Cognitive Restraint of Eating" scale. The authors' original study demonstrated a statistically significant relationship only between depressiveness and the "Uncontrolled Eating" subscale (p = 0.001). (4) The results of this study suggest that depressiveness is an important factor that contributes to a better understanding of eating behaviors. In addition, the results of this study suggest that eating behaviors and psychological factors should be taken into account in psychological interventions in the treatment of eating disorders. The clinical goal can be considered to be an improvement in non-normative eating behaviors, such as a reduction in overeating episodes or eating less frequently in the absence of a feeling of hunger.
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Affiliation(s)
- Kamila Rachubińska
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Anna Maria Cybulska
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Ewa Kupcewicz
- Department of Nursing, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Mariusz Panczyk
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Litewska 14/16 St., 00-518 Warsaw, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Street, 20-081 Lublin, Poland;
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
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Benítez T, Caixàs A, Rebasa P, Luna A, Crivillés S, Gutiérrez T, Deus J. Psychopathological profile before and after bariatric surgery. Sci Rep 2023; 13:16172. [PMID: 37758783 PMCID: PMC10533840 DOI: 10.1038/s41598-023-43170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Presurgical psychopathological assessment usually focuses on detecting severe mental disorders. However, mild intensity psychopathology and eating behaviour pattern may also influence postsurgical outcomes. The aim was to identify psychopathology and eating behaviour pattern in candidates prepared for bariatric surgery compared to a normative population before and after surgery. A cohort of 32 patients seeking bariatric surgery in a university hospital between March 2016 and March 2017 were evaluated with Personality Assessment Inventory (PAI), 36-item EDE-Q and BES before and after surgery. Thirty-two patients before and 26 one year after surgery were included. The PAI presurgical psychometric profile suggested a mild mixed adjustment disorder focused on somatic complaints. After surgery, patients improved in somatic complaints (p < 0.001), and depression (p = 0.04). Related eating disorders were more common than those of the normative group and improved significantly after surgery in scores for compulsive intake (BES p < 0.001) and overall key behaviours of eating disorders and related cognitive symptoms (EDE-Q/G p < 0.001). In our cohort ready for bariatric surgery a mild psychopathological profile is still present and becomes closer to that of the normative group after surgery. Further studies are needed to evaluate the effects of mild psychopathology on outcomes after bariatric surgery.
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Affiliation(s)
- Tura Benítez
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
| | - Assumpta Caixàs
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain.
| | - Pere Rebasa
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Alexis Luna
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Sara Crivillés
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Teresa Gutiérrez
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003, Barcelona, Spain
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Jeong H, Hapenciuc G, Meza E, Le JT, Heinberg LJ, Marek RJ. Reevaluating the Binge Eating Scale cut-off using DSM-5 criteria: analysis and replication in preoperative metabolic and bariatric surgery samples. Surg Obes Relat Dis 2023; 19:945-949. [PMID: 36959027 DOI: 10.1016/j.soard.2023.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/30/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND Metabolic and bariatric surgery is effective for sustained weight loss, but binge eating disorder (BED) can be associated with poorer outcomes and lead to weight regain. A common measure used to screen for BED is the Binge Eating Scale (BES). A BES cut-off score of ≥17 previously identified patients who have a high likelihood of meeting criteria for BED. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), lowered the threshold for meeting criteria for BED, and the psychometrics of the BES need to be reevaluated. OBJECTIVE The objective of the current investigation is to evaluate whether alternative cut-scores on the BES result in better classification of BED based on the DSM-5 revision of the the BED diagnostic criteria. SETTING Academic medical hospital in the Midwestern United States. METHODS Patients (n =1133) seeking metabolic and bariatric surgery were randomly split into 2 samples for validation and replication. The validation sample consisted of 561 patients (30.1% men, 35% non-White). The replication sample consisted of 572 patients who were demographically similar to the first random split sample (e.g., 25.3% men, 34.4% non-White). RESULTS Of these patients, 13.5% met DSM-5 criteria for BED in the validation sample and 13.8% met criteria for BED in the replication sample. Lowering the interpretative cut-off to ≥15 on the BES yielded sensitivity values of >.72, specificity values of >.67, and an accurate classification of BED in >.70 of patients across both samples. These classification values were as good as or better than the standard cut-off score of ≥17 in both samples. CONCLUSIONS The BES is appropriate to screen for BED in patients who are seeking bariatric surgery. A 2-point decrease in the BES score for clinical interpretation is appropriate-lowering it from 17 to 15 given DSM-5 updates to diagnostic criteria.
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Affiliation(s)
- Hyeyoon Jeong
- Sam Houston State University College of Osteopathic Medicine, Conroe, Texas
| | - Gabriel Hapenciuc
- Sam Houston State University College of Osteopathic Medicine, Conroe, Texas
| | - Elizabeth Meza
- Sam Houston State University College of Osteopathic Medicine, Conroe, Texas
| | - Janet T Le
- Sam Houston State University College of Osteopathic Medicine, Conroe, Texas
| | - Leslie J Heinberg
- Department of Primary Care and Clinical Medicine, Sam Houston State University College of Osteopathic Medicine, Conroe, Texas
| | - Ryan J Marek
- Department of Primary Care and Clinical Medicine, Sam Houston State University College of Osteopathic Medicine, Conroe, Texas.
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Hacker KS, Salwen-Deremer JK. Comment on: Re-evaluating the binge eating scale cut-off using DSM-5 criteria: analysis and replication in presurgical metabolic and bariatric surgery samples. Surg Obes Relat Dis 2023; 19:950-951. [PMID: 37137802 DOI: 10.1016/j.soard.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/03/2023]
Affiliation(s)
- Katrina S Hacker
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
| | - Jessica K Salwen-Deremer
- Department of Psychiatry, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire; Department of Medicine, Section of Gastroenterology & Hepatology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire
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Lüscher A, Vionnet N, Amiguet M, Chartoumpekis D, Mantziari S, Frantz J, Favre L. Impact of Preoperative Psychiatric Profile in Bariatric Surgery on Long-term Weight Outcome. Obes Surg 2023; 33:2072-2082. [PMID: 37145292 PMCID: PMC10289928 DOI: 10.1007/s11695-023-06595-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 04/06/2023] [Accepted: 04/10/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Conflicting results have been reported regarding the predictive value of preoperative psychological assessment and weight outcome after bariatric surgery. This might be attributed to different factors affecting early weight loss and long-term weight loss. Herein, we investigated whether preoperative psychiatric profile was associated with preoperative BMI and with both early (1 year) and long-term (5 years) weight loss after Roux-en-Y gastric bypass (RYGB). METHODS Prospective observational cohort study of patients undergoing RYGB between 2013 and 2019. Symptoms related to anxiety, depression, eating disorder, and alcohol use disorders were assessed by employing validated, specific psychometric tests (STAI-S/T, BDI-II, BITE, AUDIT-C) prior to surgery. Pre-operative BMI, early weight loss (1 year), and long-term weight evolution (up to 5 years) were registered. RESULTS Two hundred thirty six patients (81% women) were included in the present study. Linear longitudinal mixed model showed a significant effect of preoperative high anxiety (STAI-S) on long-term weight outcome, after controlling for gender, age and type 2 diabetes. Patient with high preoperative anxiety score regained weight faster than those experiencing low anxiety (each year percent excess BMI loss (%EBMIL) - 4.02%, ± 1.72, p = 0.021). No other pre-operative psychiatric symptoms have been shown to have an impact on long-term weight loss. In addition, no significant association was found between any of the pre-operative psychiatric variables and pre-operative BMI, or early weight loss (%EBMIL) at 1-year post-RYGB. CONCLUSION Herein we identified high anxiety score (STAI-S) as a predictor for long-term weight regain. Thus, long-term psychiatric surveillance of these patients and the development of tailored management tools could serve as a means to prevent weight regain.
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Affiliation(s)
- Anouk Lüscher
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Nathalie Vionnet
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Michael Amiguet
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Dionysios Chartoumpekis
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Styliani Mantziari
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Service of Visceral Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Johanna Frantz
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Lucie Favre
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland.
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland.
- Centre Hospitalier Universitaire Vaudois, CHUV, Division of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital, Rue St Martin 3, CH-1003, Lausanne, Switzerland.
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Catania J, Spirou D, Gascoigne M, Raman J. Loss of control as a transdiagnostic feature in obesity-related eating behaviours: A systematic review. EUROPEAN EATING DISORDERS REVIEW 2023; 31:24-45. [PMID: 35801968 PMCID: PMC10084033 DOI: 10.1002/erv.2936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Emerging evidence suggests that loss of control (LOC) may present as a common feature across disordered eating behaviours. However, there has been limited research on the transdiagnostic nature of LOC in this area. The primary aim of this study was to systematically review disordered eating behaviours and measures of LOC in clinical and non-clinical populations. METHOD Electronic searches of the relevant databases were conducted. Selected articles were screened for eligibility and assessed for methodological quality. RESULTS Thirty-four studies met inclusion criteria. Findings demonstrated that LOC was associated with disordered eating behaviours across bariatric populations, eating disorder populations, and community populations. Specifically, LOC was associated with binge eating (subjective and objective episodes), grazing, night eating, and emotional or stress eating. Findings also revealed that LOC was inconsistently operationalised across studies, with varied approaches to measuring the construct. CONCLUSION Overall, the findings from this review provide support for LOC as a transdiagnostic feature of disordered eating behaviours. Future studies should utilise robust multi-method assessments to measure the severity of LOC, which may provide greater insight into how LOC manifests across different eating disorder presentations.
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Affiliation(s)
- Justin Catania
- Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia.,School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Michael Gascoigne
- School of Psychology, Western Sydney University, Sydney, New South Wales, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - Jayanthi Raman
- School of Psychological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
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Marek RJ, Ivezaj V, Parikh MS, Jayade M, Davila-Shiau E, Grilo CM. Factor structure and measurement invariance of the English- versus Spanish-language Eating Disorder Examination Questionnaire: Brief Form (S-EDE-Q-BF) in Hispanic/Latino/a/x persons seeking bariatric surgery. Surg Obes Relat Dis 2022; 19:576-584. [PMID: 36639321 DOI: 10.1016/j.soard.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/14/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Assessment of eating disorder psychopathology during preoperative psychological evaluations could be facilitated with psychometrically valid measures. One of the most commonly used measures, the Eating Disorder Examination Questionnaire (EDE-Q), is lengthy and has been found to have psychometric limitations. Research has identified a shorter version that has received reliable support across diverse samples but requires further validation for use with patients being evaluated for bariatric surgery. OBJECTIVES To cross-validate the factor structure of the EDE-Q: Brief Form (EDE-Q-BF, standalone, nonnested version) with patients being evaluated for bariatric surgery across English- and Spanish-language versions and establish measurement invariance for gender and language. SETTING Northeastern hospital in the United States. METHODS Participants (n = 618) undergoing evaluations prior to bariatric surgery who identified as Hispanic/Latino/a/x and consented to participate in this research study (which did not influence eligibility for bariatric surgery) completed self-reports. Of the 618 participants, 92 were male and 526 were female, 318 preferred English and were administered English versions of the measures, and 300 preferred Spanish and were administered Spanish versions of the measures. RESULTS The 3-factor structure ("Restraint," "Weight/Shape Concerns," and "Body Dissatisfaction") of the EDE-Q-BF fit the data well (χ2 [11] = 18.47; P = .071; root mean square error of approximation [RMSEA] = .033; comparative fit index [CFI] > .99; standardized root mean squared residual [SRMR] = .02). Scaler invariance was met for both gender and language. Correlations with external criteria further supported its validity. CONCLUSION The EDE-Q-BF can easily be administered as part of a preoperative psychological assessment battery to screen for eating disorder psychopathology and is valid for Hispanic/Latino/a/x men and women who speak either English or Spanish.
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Affiliation(s)
- Ryan J Marek
- Sam Houston State University College of Osteopathic Medicine, Conroe, Texas.
| | - Valentina Ivezaj
- Department of Psychiatry, Program for Obesity, Weight, and Eating Research, Yale University School of Medicine, New Haven, Connecticut
| | - Manish S Parikh
- Department of General Surgery, Bellevue Hospital/NYU Langone Health, New York, New York
| | - Maansi Jayade
- Department of General Surgery, Bellevue Hospital/NYU Langone Health, New York, New York
| | - Elissa Davila-Shiau
- Department of General Surgery, Bellevue Hospital/NYU Langone Health, New York, New York
| | - Carlos M Grilo
- Department of Psychiatry, Program for Obesity, Weight, and Eating Research, Yale University School of Medicine, New Haven, Connecticut
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12
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Aylward L, Konsor M, Cox S. Binge Eating Before and After Bariatric Surgery. Curr Obes Rep 2022; 11:386-394. [PMID: 36287376 DOI: 10.1007/s13679-022-00486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW The purpose is to review the state of the literature of binge eating in the context of bariatric surgery including prevalence, conceptualization, assessment, course, and related sequela throughout the perioperative continuum, particularly highlighting new advancements and future directions. RECENT FINDINGS Accurate assessment of binge eating in bariatric samples is essential for optimization of patient outcomes. Binge eating is less prevalent after bariatric surgery; however, prevalence rates increase over time. Most studies do not find a relationship between pre-operative binge eating and suboptimal weight outcomes after surgery. Refinement in understanding and conceptualization of post-operative binge eating is needed; new conceptualizations have proposed such a definition. Emerging constructs relevant to binge eating for bariatric patients include food addiction and food insecurity. Despite the introduction of formal diagnostic criteria for binge eating disorder, many uncertainties regarding the prevalence, course, and effects of binge eating currently exist; varied assessment methods continue to be a barrier to research on binge eating in bariatric surgery samples. Consensus on operational definitions for post-operative binge eating and best practices for assessment are areas for future consideration.
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Affiliation(s)
- Laura Aylward
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, USA
| | - Madeline Konsor
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Stephanie Cox
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, USA.
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13
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Davies G, Kalika E, Hussain M, Egan H, Mantzios M. Exploring the association of body mass index, mindful and emotional eating, and orthorexia. HEALTH PSYCHOLOGY REPORT 2022; 11:342-352. [PMID: 38178968 PMCID: PMC10762304 DOI: 10.5114/hpr/153966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/12/2022] [Accepted: 09/09/2022] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Orthorexia nervosa (ON) is defined as a fixation on healthy eating behaviours. Research exploring ON and body mass index (BMI) has been inconsistent, with some findings indicating a positive relationship between ON and BMI, while other studies have suggested no relationship. To date, potential associations with emotional and mindful eating have been explored only in a vegan population. The present research adopted an exploratory approach and examined the relationship between orthorexia and BMI, and possible associations with emotional and mindful eating. The potential predictive value of mindful and emotional eating with respect to ON was also explored, while the role of four different types of emotional eating (happiness, sadness, anger, anxiety), utilising an emotional eating scale incorporating positive and negative emotions, was further explored. PARTICIPANTS AND PROCEDURE Two hundred and twenty-three participants completed the online survey that was distributed via social media to a British sample. RESULTS The findings suggested a negative correlation between ON and BMI. Participants who presented higher levels of orthorexia were more likely to display higher levels of focused eating, a central aspect of mindful eating, as well as lower levels of emotional eating in response to happiness - two elements that further predicted ON in multiple regression models. CONCLUSIONS The results suggest a need to conduct further research to explore the possible role of happiness as a potential protective tool against ON, and further suggest the likely negative role of some components of mindful eating in ON. Future directions are discussed in light of the present findings.
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Affiliation(s)
| | - Eliza Kalika
- Birmingham City University, Birmingham, United Kingdom
| | - Misba Hussain
- Birmingham City University, Birmingham, United Kingdom
| | - Helen Egan
- Birmingham City University, Birmingham, United Kingdom
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Decker KM, Reiter‐Purtill J, Bejarano CM, Goldschmidt AB, Mitchell JE, Jenkins TM, Helmrath M, Inge TH, Michalsky MP, Zeller MH. Psychosocial predictors of problematic eating in young adults who underwent adolescent bariatric surgery. Obes Sci Pract 2022; 8:545-555. [PMID: 36238228 PMCID: PMC9535670 DOI: 10.1002/osp4.590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/23/2021] [Indexed: 11/08/2022] Open
Abstract
Introduction This study examined problematic eating and eating-related psychopathology among young adults who underwent adolescent bariatric surgery including concurrent and prospective associations with psychosocial factors and weight change. Methods VIEW point is a 6-year follow-up study within a prospective observational study series observing adolescents with severe obesity who had bariatric surgery (n = 139) or who presented to nonsurgical lifestyle modification programs (n = 83). Participants completed height/weight measurements, questionnaires, and diagnostic interviews. Regression analyses compared problematic eating across groups and examined Year 6 correlates (i.e., psychosocial factors and weight change) and baseline predictors (i.e., psychosocial factors) of eating-related psychopathology. Results Compared to the nonsurgical group, the surgical group reported lower eating-related psychopathology, objective binge eating, and grazing at Year 6. While chewing/spitting out and vomiting for weight/shape-related reasons were very infrequent for the surgical group, self-induced vomiting for other reasons (e.g., avoid plugging) was more common. For the surgical group, lower self-worth, greater internalizing symptoms, and higher weight-related teasing in adolescence predicted increased eating-related psychopathology in young adulthood. Year 6 eating-related psychopathology was concurrently associated with lower percent weight loss for the surgical group and greater percent weight gain for the nonsurgical group. Conclusion Undergoing adolescent bariatric surgery appears to afford benefit for problematic eating and eating-related psychopathology. Current findings suggest that the clinical intervention related to problematic eating and associated psychosocial concerns may be needed for young adults with obesity, regardless of surgical status.
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Affiliation(s)
- Kristina M. Decker
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Jennifer Reiter‐Purtill
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Carolina M. Bejarano
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Andrea B. Goldschmidt
- Department of Psychiatry and Human BehaviorWarren Alpert Medical SchoolBrown University and Weight Control and Diabetes Research CenterThe Miriam HospitalProvidenceRhode IslandUSA
- Department of PsychiatryUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - James E. Mitchell
- Department of Clinical NeuroscienceSchool of Medicine and Health SciencesUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - Todd M. Jenkins
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Michael Helmrath
- Division of Pediatric General and Thoracic SurgeryCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
| | - Thomas H. Inge
- Department of SurgeryUniversity of ColoradoAnschutz Medical Campusand Children's Hospital ColoradoAuroraColoradoUSA
| | | | - Meg H. Zeller
- Behavioral Medicine and Clinical PsychologyCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA
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Guerrero-Hreins E, Foldi CJ, Oldfield BJ, Stefanidis A, Sumithran P, Brown RM. Gut-brain mechanisms underlying changes in disordered eating behaviour after bariatric surgery: a review. Rev Endocr Metab Disord 2022; 23:733-751. [PMID: 34851508 DOI: 10.1007/s11154-021-09696-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 02/07/2023]
Abstract
Bariatric surgery results in long-term weight loss and an improved metabolic phenotype due to changes in the gut-brain axis regulating appetite and glycaemia. Neuroendocrine alterations associated with bariatric surgery may also influence hedonic aspects of eating by inducing changes in taste preferences and central reward reactivity towards palatable food. However, the impact of bariatric surgery on disordered eating behaviours (e.g.: binge eating, loss-of-control eating, emotional eating and 'addictive eating'), which are commonly present in people with obesity are not well understood. Increasing evidence suggests gut-derived signals, such as appetitive hormones, bile acid profiles, microbiota concentrations and associated neuromodulatory metabolites, can influence pathways in the brain implicated in food intake, including brain areas involved in sensorimotor, reward-motivational, emotional-arousal and executive control components of food intake. As disordered eating prevalence is a key mediator of weight-loss success and patient well-being after bariatric surgery, understanding how changes in the gut-brain axis contribute to disordered eating incidence and severity after bariatric surgery is crucial to better improve treatment outcomes in people with obesity.
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Affiliation(s)
- Eva Guerrero-Hreins
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Melbourne, Australia
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia
| | - Claire J Foldi
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Brian J Oldfield
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Aneta Stefanidis
- Department of Physiology, Monash University, Clayton, Melbourne, Australia
- Biomedicine Discovery Institute, Monash University, Clayton, Melbourne, Australia
| | - Priya Sumithran
- Department of Medicine (St Vincent's), University of Melbourne, Melbourne, Australia
- Department of Endocrinology, Austin Health, Melbourne, Australia
| | - Robyn M Brown
- Department of Biochemistry and Pharmacology, University of Melbourne, Parkville, Melbourne, Australia.
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Melbourne, Australia.
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16
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Hilbert A, Staerk C, Strömer A, Mansfeld T, Sander J, Seyfried F, Kaiser S, Dietrich A, Mayr A. Nonnormative Eating Behaviors and Eating Disorders and Their Associations With Weight Loss and Quality of Life During 6 Years Following Obesity Surgery. JAMA Netw Open 2022; 5:e2226244. [PMID: 35951326 PMCID: PMC9372790 DOI: 10.1001/jamanetworkopen.2022.26244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Individuals with severe obesity presenting for obesity surgery (OS) frequently show nonnormative eating behaviors (NEBs) and eating disorders (EDs), but the long-term course and prospective associations with weight loss and health-related quality of life (HRQOL) remain unclear. OBJECTIVE To examine the prevalence and prospective relevance of presurgical and postsurgical NEBs and EDs according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosed through clinical interview, for weight loss and HRQOL up to 6 years following OS. DESIGN, SETTING, AND PARTICIPANTS In the prospective, multicenter Psychosocial Registry for Obesity Surgery cohort study, patients seeking OS were recruited at 6 OS centers in Germany and assessed at baseline before surgery and at 6 months and 1 to 6 years after surgery. From a consecutive sample of 1040 volunteers with planned OS from March 1, 2012, to December 31, 2020, a total of 748 (71.92%) were included in this study. Across follow-up, 93 of the 748 patients (12.43%) dropped out. Data were analyzed from April to November 2021. INTERVENTIONS Laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy. MAIN OUTCOMES AND MEASURES Both NEBs and EDs were identified using the Eating Disorder Examination interview. Main outcomes were the percentage of total body weight loss (%TBWL) and HRQOL (Impact of Weight on Quality of Life-Lite; range, 0-100, with 0 indicating worst and 100 indicating best). RESULTS In 748 patients undergoing OS (mean [SD] age, 46.26 [11.44] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 48.38 [8.09]; 513 [68.58%] female), the mean (SD) %TBWL was 26.70% (9.61%), and the mean (SD) HRQOL improvement was 35.41 (20.63) percentage points across follow-up. Both NEBs and EDs were common before surgery, with postsurgical improvements of varying degrees. Whereas NEBs and EDs did not reveal significant prospective associations with %TBWL, loss-of-control eating at follow-up was concurrently associated with lower %TBWL (estimate, -0.09; 95% CI, -0.14 to -0.04). Loss-of-control eating (estimate, -0.10; 95% CI, -0.17 to -0.03 percentage points) and binge-eating disorder of low frequency and/or limited duration (estimate, -6.51; 95% CI, -12.69 to -0.34 percentage points) at follow-up showed significant prospective associations with lower HRQOL. CONCLUSIONS AND RELEVANCE This cohort study found prospective relevance of loss-of-control eating and binge-eating disorder of low frequency and/or limited duration for reduced long-term HRQOL following OS. These findings underline the importance of monitoring both NEBs, especially loss-of-control eating, and EDs in the long term postsurgically to identify patients in need of targeted prevention or psychotherapy.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Christian Staerk
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Annika Strömer
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Thomas Mansfeld
- Department of General Surgery, Asklepios Clinic, Hamburg, Germany
| | - Johannes Sander
- Schön Klinik Hamburg Eilbek, Obesity Clinic, Hamburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, Konstanz, Germany
| | - Arne Dietrich
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Andreas Mayr
- Department of Medical Biometrics, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
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Bauraitė K, Mikuckytė D, Gudaitytė R, Petereit R, Maleckas A. Factors associated with quality of life and weight regain 12 years after Roux-en-Y gastric bypass. Surg Endosc 2022; 36:4333-4341. [PMID: 34708293 DOI: 10.1007/s00464-021-08778-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 10/13/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND Scarce evidence exists in the literature about the factors influencing the long-term quality of life (QoL) and weight regain (WR) after Roux-en-Y gastric bypass (RYGB). The aim of the present study was to investigate factors associated with WR and QoL, measured by obesity specific Moorehead-Ardelt Quality of Life Questionnaire II (M-A QoLQ II), 12 years after RYGB. METHODS This prospective longitudinal cohort study included 74 patients with obesity who had RYGB at the Lithuanian University of Health Sciences hospital Surgery department in 2005. Gastrointestinal and dumping symptoms, hypoglycemia, depression and anxiety disorders, hunger, satiety after meals, portion size, and grazing were assessed in the patients who agreed to participate in the study. General linear models were constructed to estimate the effect of variables on the WR and QoL. RESULTS 12-year follow-up data were available for 50 patients (38 female, median body mass index (BMI) before surgery 42.4). The mean % excess BMI loss (%EBMIL) after 12 years was 63.1 (24.6) and the average %WR was 32.2 (19.4). The mean M-A QoLQ II score was 1.44 (1.3). Majority of the patients (76.6%) reported good or very good QoL. In multivariable analysis, only grazing (17.41% 95% CI 7.61-27.21; P = 0.001) was found to be a significant independent factor associated with WR. Factors independently associated with worse QoL were grazing (- 0.97 95% CI - 1.72, - 0.22; P = 0.013) and frequency of abdominal pain once or more per month (- 1.82 95% CI - 2.79, - 0.85; P = 0.001). CONCLUSION 12 years after RYGB majority of the patients report good or very good QoL and despite some WR have achieved and maintained significant weight loss. Grazing was associated with both WR and worse QoL, while the frequency of abdominal pain once or more per month was associated with only decreased QoL.
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Affiliation(s)
- Karolina Bauraitė
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307, Kaunas, Lithuania.
| | - Deimantė Mikuckytė
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rita Gudaitytė
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rūta Petereit
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, A. Mickevičiaus g. 9, 44307, Kaunas, Lithuania
| | - Almantas Maleckas
- Department of Surgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Nonino CB, Barato M, Ferreira FC, Delfino HBP, Noronha NY, Nicoletti CF, Junior WS, Welendorf CR, Souza DRS, Ferreira-Julio MA, Watanabe LM, de Souza Pinhel MA. DRD2 and BDNF polymorphisms are associated with binge eating disorder in patients with weight regain after bariatric surgery. Eat Weight Disord 2022; 27:1505-1512. [PMID: 34478125 DOI: 10.1007/s40519-021-01290-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
AIM The aim of this study was to analyze the association and susceptibility of Single Nucleotide Polymorphisms (SNPs) in the DRD2 and BDNF genes with BED in patients with weight regain in the postoperative period of bariatric surgery. METHODS One hundred and seventy-seven individuals who underwent bariatric surgery with weight regain were evaluated and divided into two groups according to the BED diagnostic. The individuals were submitted to an anthropometric evaluation, analysis of the presence of BED using a validated questionnaire, and blood collection for genotyping of the polymorphisms rs6265 (BDNF) and rs1800497 (DRD2) by real-time polymerase chain reaction (RT-PCR). RESULTS The presence of wild-type alleles for rs1800497 (CC) and rs6265 (GG) was more frequent in patients without BED. Nevertheless, the presence of one or two variant alleles for rs1800497 (CT + TT) and rs6265 (GA + AA) was more frequent in patients with BED. The combination of the two studied SNPs prevailed in patients with BED. CONCLUSIONS The presence of allele frequency of rs1800497 SNP in the DRD2 gene and rs6265 SNP in the BDNF gene, isolated and/or combined, indicated an additional risk for the development of BED in patients with obesity, especially in the context of weight regain. LEVEL OF EVIDENCE III (evidence obtained from the case-control analytic study).
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Affiliation(s)
- Carla Barbosa Nonino
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
| | - Mariana Barato
- Department of Molecular Biology, Sao Jose Do Rio Preto Medical School, São José Do Rio Preto, SP, Brazil
| | - Flávia Campos Ferreira
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Heitor Bernardes Pereira Delfino
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Natalia Yumi Noronha
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Carolina Ferreira Nicoletti
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Wilson Salgado Junior
- Department of Surgery and Anatomy, Ribeirao Preto Medical School, Ribeirão Preto, SP, Brazil
| | - Caroline Rossi Welendorf
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Doroteia Rossi Silva Souza
- Department of Molecular Biology, Sao Jose Do Rio Preto Medical School, São José Do Rio Preto, SP, Brazil
| | | | - Ligia Moriguchi Watanabe
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Marcela Augusta de Souza Pinhel
- Laboratory of Nutrigenomic Studies, FMRP/USP, Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo, Av Bandeirantes, 3900, Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
- Department of Molecular Biology, Sao Jose Do Rio Preto Medical School, São José Do Rio Preto, SP, Brazil
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Li Z, Pan Y, Zhang Y, Qin J, Lei X. Dietary experiences after bariatric surgery in patients with obesity: A qualitative systematic review. Obes Surg 2022; 32:2023-2034. [PMID: 35359201 DOI: 10.1007/s11695-022-06018-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/24/2022]
Abstract
This systematic review evaluated the dietary experience of patients with obesity post-bariatric surgery. Scopus, CINAHL, Medline, Psych INFO, and Embase databases were searched and JBI Critical Appraisal Tool was used for quality assessment. Thomas and Harden's three-stage thematic synthesis was undertaken using the Enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) statement for reporting. Of the 24 studies extracted, we coded and developed 34 descriptive themes into 7 categories, which were then categorized to 3 analytical themes. The number of all the participants in the 24 articles is 383 people. The results revealed most patients can control their diet for a short period post-surgery. However, this was a matter of gradual self-consciousness as patients also required support and dietary management in postoperative recovery. CLINICAL TRIAL REGISTRATION NUMBER: The protocol for this qualitative systematic review has been registered with PROSPERO (registration number CRD42021229083).
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Affiliation(s)
- Zhiwen Li
- The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Yingli Pan
- The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
| | - Yingchun Zhang
- The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Jingjing Qin
- The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xuejiao Lei
- The Fourth Affiliated Hospital of China Medical University, Shenyang, China
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TAŞKIN HE. Effect of bariatric surgery on night eating syndrome: A retrospective study. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2022. [DOI: 10.25000/acem.1076456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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21
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Conceição EM, Moreira CS, de Lourdes M, Ramalho S, Vaz AR. Exploring Correlates of Loss of Control Eating in a Nonclinical Sample. Front Psychol 2022; 12:787558. [PMID: 35222152 PMCID: PMC8874330 DOI: 10.3389/fpsyg.2021.787558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
ObjectiveLoss of control (LOC) eating has been directly related to the core aspects of the psychopathology of eating disorders and to different dimensions of emotion and behavior regulation and self-criticism. This study investigates a model representing the interplay between these dimensions to understand LOC eating among a nonclinical sample.MethodsA total of 341 participants, recruited in a college campus (mean age 23.21, SD = 6.02), completed a set of self-report measures assessing LOC eating, weight suppression, psychopathology of eating disorders, depression, negative urgency, emotion regulation difficulties, and self-criticism. Path analysis modeling tested a hypothesized model with 3 paths for LOC eating as follows: (1) psychopathology of eating disorders; (2) emotion and behavior regulation; and (3) interplay between these paths.ResultsWe found goodness-of-fit indexes to our data: χ2 = 17.11, df = 10, Comparative Fit Index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98, Root Mean Square Error Approximation (RMSEA) = 0.045, Standardized Root Mean Square Residual (SRMR) = 0.041, suggesting that: (1) participants with higher weight suppression showed higher degrees of the psychopathology of eating disorders, which was linked to higher levels of LOC eating; (2) self-criticism was a mediator between emotion regulation and depression/negative urgency; (3) self-criticism was a mediator between emotion regulation and disorder eating, which was significantly associated with LOC eating via increased negative urgency.ConclusionOur model shows that LOC eating occurs for individuals with the psychopathology of higher eating disorders who experience depressive symptoms and act rashly under distress for their inability to cope adequately with negative feelings of self-devaluation. These findings point to the importance of negative self-evaluations and feelings of inadequacy or worthlessness to understand LOC eating among college students.
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Affiliation(s)
- Eva M. Conceição
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- *Correspondence: Eva M. Conceição, ; orcid.org/0000-0002-1982-5796
| | - Célia S. Moreira
- Department of Mathematics and Center of Mathematics (FCUP-CMUP), University of Porto, Porto, Portugal
| | - Marta de Lourdes
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Sofia Ramalho
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Rita Vaz
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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22
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Prevention of eating disorders in obesity. NUTR HOSP 2022; 39:121-127. [DOI: 10.20960/nh.04187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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23
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Mele C, Caputo M, Ferrero A, Daffara T, Cavigiolo B, Spadaccini D, Nardone A, Prodam F, Aimaretti G, Marzullo P. Bone Response to Weight Loss Following Bariatric Surgery. Front Endocrinol (Lausanne) 2022; 13:921353. [PMID: 35873004 PMCID: PMC9301317 DOI: 10.3389/fendo.2022.921353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
Obesity is a global health challenge that warrants effective treatments to avoid its multiple comorbidities. Bariatric surgery, a cornerstone treatment to control bodyweight excess and relieve the health-related burdens of obesity, can promote accelerated bone loss and affect skeletal strength, particularly after malabsorptive and mixed surgical procedures, and probably after restrictive surgeries. The increase in bone resorption markers occurs early and persist for up to 12 months or longer after bariatric surgery, while bone formation markers increase but to a lesser extent, suggesting a potential uncoupling process between resorption and formation. The skeletal response to bariatric surgery, as investigated by dual-energy X-ray absorptiometry (DXA), has shown significant loss in bone mineral density (BMD) at the hip with less consistent results for the lumbar spine. Supporting DXA studies, analyses by high-resolution peripheral quantitative computed tomography (HR-pQCT) showed lower cortical density and thickness, higher cortical porosity, and lower trabecular density and number for up to 5 years after bariatric surgery. These alterations translate into an increased risk of fall injury, which contributes to increase the fracture risk in patients who have been subjected to bariatric surgery procedures. As bone deterioration continues for years following bariatric surgery, the fracture risk does not seem to be dependent on acute weight loss but, rather, is a chronic condition with an increasing impact over time. Among the post-bariatric surgery mechanisms that have been claimed to act globally on bone health, there is evidence that micro- and macro-nutrient malabsorptive factors, mechanical unloading and changes in molecules partaking in the crosstalk between adipose tissue, bone and muscle may play a determining role. Given these circumstances, it is conceivable that bone health should be adequately investigated in candidates to bariatric surgery through bone-specific work-up and dedicated postsurgical follow-up. Specific protocols of nutrients supplementation, motor activity, structured rehabilitative programs and, when needed, targeted therapeutic strategies should be deemed as an integral part of post-bariatric surgery clinical support.
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Affiliation(s)
- Chiara Mele
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Chiara Mele,
| | - Marina Caputo
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Alice Ferrero
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Tommaso Daffara
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Beatrice Cavigiolo
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Daniele Spadaccini
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Antonio Nardone
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation and Spinal Unit of Pavia Institute, Pavia, and Neurorehabilitation of Montescano Institute, Montescano, PV, Italy
| | - Flavia Prodam
- Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
| | - Gianluca Aimaretti
- Division of Endocrinology, University Hospital “Maggiore della Carità”, Novara, Italy
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
| | - Paolo Marzullo
- Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
- Istituto Auxologico Italiano, IRCCS, Laboratory of Metabolic Research, S. Giuseppe Hospital, Piancavallo, Italy
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24
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Goueslard K, Jollant F, Petit JM, Quantin C. Self-harm hospitalization following bariatric surgery in adolescents and young adults. Clin Nutr 2021; 41:238-245. [PMID: 34915275 DOI: 10.1016/j.clnu.2021.11.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/02/2021] [Accepted: 11/25/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND While bariatric surgery has demonstrated physical and psychological benefits, a risk of suicide and non-fatal self-harm has also been shown. The aim of this study was to compared the rate of hospitalization for self-harm during a three-year observational follow-up period between adolescents/young adults who underwent bariatric surgery in France in 2013-2014 and two control groups. METHODS All individuals aged 12-25 years old who underwent bariatric surgery in France between January 1st, 2013, and December 31st, 2014, were identified with a validated algorithm from the French national hospital database, and compared to a healthy sample of the general population matched for age and gender. Information relative to hospitalizations, including for self-harm (ICD-10 codes X60-84), were extracted i) between 2008 and the surgery, and ii) for a three-year follow-up period. A second unmatched control group with obesity but no bariatric surgery was also identified. Survival analyses with adjustments for confounding variables were used. RESULTS In 2013-2014, 1984 youths had bariatric surgery in France. During follow-up, 1.5% were hospitalized for self-harm vs. 0.3% for controls (p < 0.0001). After adjustment, subsequent hospitalization for self-harm was associated with bariatric surgery (HR 3.64, 95% CI 1.70-7.81), prior psychiatric disorders (HR 7.76, 95% CI 3.76-16.01), and prior self-harm (HR 4.43, 95% CI 1.75-11.24). When compared to non-operated youths with obesity, bariatric surgery was not associated with self-harm while prior mental disorders and self-harm were. Mortality reached 0.3% after surgery. CONCLUSIONS Bariatric surgery is associated with an increased risk of self-harm, mainly in relation to preexisting psychological conditions. Vigilance and appropriate care are thus warranted in vulnerable individuals.
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Affiliation(s)
- K Goueslard
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France
| | - F Jollant
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany; Nîmes Academic Hospital (CHU), Nîmes, France; University of Paris, Faculty of Health, Medicine School, Paris, France; GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, CMME, Paris, France; McGill Group for Suicide Studies, McGill University, Montréal, Canada; Moods Team, INSERM UMR-1178, CESP, Le Kremlin-Bicêtre, France
| | - J M Petit
- Centre de Recherche INSERM Unité 866, Univ. Bourgogne Franche-Comté, F-21000, Dijon, France; Services de diabétologie et endocrinologie, CHRU Dijon, Dijon, F-21000, France
| | - C Quantin
- Biostatistics and Bioinformatics (DIM), University Hospital, Dijon, France; Inserm, CIC 1432, Dijon, France; Dijon University Hospital, Clinical Investigation Center, Clinical Epidemiology/ Clinical Trials Unit, Dijon, France; Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, High-Dimensional Biostatistics for Drug Safety and Genomics, CESP, Villejuif, France.
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25
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Martin-Fernandez KW, Martin-Fernandez J, Marek RJ, Ben-Porath YS, Heinberg LJ. Associations among psychopathology and eating disorder symptoms and behaviors in post-bariatric surgery patients. Eat Weight Disord 2021; 26:2545-2553. [PMID: 33548052 DOI: 10.1007/s40519-021-01111-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/13/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE A considerable number of post-bariatric surgery patients report problematic eating behaviors (PEBs) and/or eating disorders (EDs). Examining psychosocial variables associated with ED symptoms may identify targets for postoperative interventions to reduce these behaviors and improve surgical outcomes. METHODS A total of 161 participants completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Eating Disorder Examination-Questionnaire (EDE-Q). Participants were classified into ED risk or no ED risk groups and subjective binge eating (SBE) or no SBE groups. Independent-sample t tests were computed to examine mean differences in total weight loss (%TWL) and MMPI-2-RF scale scores between the ED groups. Relative Risk Ratios (RRRs) were computed to determine which MMPI-2-RF scales were associated with increased risk of ED group membership. RESULTS The ED risk group lost significantly less weight (19.36% TWL) than the no ED risk group (25.18% TWL). The SBE group lost significantly less weight (17.98% TWL) than the no SBE group (25.57% TWL). Participants in the ED groups scored significantly higher on internalizing and externalizing MMPI-2-RF scales than the no ED groups. These scales were associated with increased risk (1.55-2.55 times the risk) of being classified into the ED groups. CONCLUSIONS Patients who experienced postoperative ED symptoms lost significantly less weight than patients without ED symptoms. Postoperative ED symptoms are related to, and may be impacted by, higher levels of internalizing and externalizing dysfunction after surgery. Postoperative assessment of and interventions targeting psychosocial dysfunction could decrease ED symptoms. LEVEL OF EVIDENCE III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
| | | | - Ryan J Marek
- Department of Primary Care, Sam Houston State University College of Osteopathic Medicine, Conroe, TX, 77304, USA
| | - Yossef S Ben-Porath
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA
| | - Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
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26
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Cheng TY, Akhiyat YM, Mehta N, Ahlich E, Verzijl CL, Chermak R, Weiss AL, Rancourt D. Eating Disorder Symptomatology Among Adolescents Presenting for Bariatric Surgery Candidacy: Examining Differences by Sex and Racial Minority Status. Obes Surg 2021; 31:5295-5302. [PMID: 34599727 DOI: 10.1007/s11695-021-05723-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/15/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Research on adolescent bariatric surgery candidates is limited by insufficient inclusion of ethnic minorities and males, and lack of consideration of the full spectrum of disordered eating behaviors (i.e., restriction, compensatory behaviors [e.g., purging], overeating/binge eating behaviors). OBJECTIVES The current study investigated differences in the full range of disordered eating behaviors across sex and ethnicity among adolescents seeking bariatric surgery. SETTING Teaching hospital, United States. METHODS Data were collected using retrospective chart review of 79 adolescent bariatric surgery candidates (59% female, 46.8% Hispanic, MBMI = 50.2, SDBMI = 10.0, Mage = 17.3, SDage = 2.02) who had completed the self-reported Eating Disorder Diagnostic Scale for DSM-5 at intake. RESULTS Approximately 33% of study participants met self-reported criteria for an eating disorder, with 35% endorsing binge eating behaviors and 50% endorsing compensatory behaviors. Few differences in behavior frequencies were observed across sex or racial/ethnic status. CONCLUSIONS Findings underscore the importance of assessing the full spectrum of disordered eating behaviors among adolescent bariatric surgery candidates.
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Affiliation(s)
- Tiffany Y Cheng
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Yasmine M Akhiyat
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Nitisha Mehta
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Erica Ahlich
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA
| | - Christina L Verzijl
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA
| | - Rebecca Chermak
- Tampa General Hospital and USF Health Bariatric Center, 5 Tampa General Cir, Tampa, FL, 33606, USA
| | - Amy L Weiss
- Morsani College of Medicine, University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA.,Tampa General Hospital and USF Health Bariatric Center, 5 Tampa General Cir, Tampa, FL, 33606, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, 4202 East Fowler Ave., PCD4118G, Tampa, FL, 33620, USA.
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Teodoro MC, Conceição EM, de Lourdes M, Alves JR, Neufeld CB. Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review. Appetite 2021; 167:105620. [PMID: 34352352 DOI: 10.1016/j.appet.2021.105620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
The term grazing is generally described as the repetitive and nonplanned consumption of small amounts of food, not in response to hunger/satiety sensations. The present study aims to identify and critically review studies examining the frequency of grazing in both clinical and community samples, as well as, to investigate its relationship with eating disorder psychopathology, Loss of Control eating (LOC), psychological impairment, and weight-related variables. This systematic review followed the PRISMA recommendations for reporting systematic reviews and meta-analysis. A total of 138 articles were initially retrieved from the database search. In the end, 18 articles were considered for this systematic review. The results were separated in Grazing and Grazing-like behavior (picking and nibbling). Results of studies of grazing-like behaviors displays that, in these studies, the results are sometimes inconsistent and controversial. On the other hand, studies of Grazing behavior showed more consistent results. These results show that the use of different definitions across the literature makes it difficult to establish comparisons across studies. In this literature review, the studies selected used five different definitions of grazing and five different instruments to assess this eating behavior which reinforces the requirement for standardized definition and evaluation. More, the studies hereby revised suggested that LOC eating was considered in association with grazing, being significantly associated with higher levels of psychopathology and psychological impairment. In accordance, a growing body of research argues that LOC eating was a stronger predictor of eating disorder psychopathology than the amounts of food consumed. Furthermore, the results found by studies show an advance to literature with an accordance about LOC, supported by evidences in studies of this review.
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Affiliation(s)
- Marília Consolini Teodoro
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Eva M Conceição
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jéssika Rodrigues Alves
- Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carmem Beatriz Neufeld
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
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28
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Sherf-Dagan S, Sinai T, Goldenshluger A, Globus I, Kessler Y, Schweiger C, Ben-Porat T. Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice. Adv Nutr 2021; 12:1020-1031. [PMID: 33040143 PMCID: PMC8262552 DOI: 10.1093/advances/nmaa121] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022] Open
Abstract
Bariatric surgery (BS) has proven to be highly efficacious in the treatment of obesity and its comorbidities. However, careful patient selection is critical for its success. Thus, patients should undergo medical, behavioral, and nutritional assessment by a multidisciplinary team. From the nutritional point of view, BS candidates should undergo nutritional assessment, preparation, and education by a registered dietitian in the preoperative period. Currently, detailed specified and comprehensive information on these topics is lacking. The present narrative review aimed to summarize the available literature concerning both the preoperative nutritional assessment components and the preoperative nutritional preparation and education components of patients planning to undergo BS. Current literature indicates that proper management before BS should include a comprehensive nutritional assessment, in which it is advisable to perform a clinical interview to assess patients' medical background, weight management history, eating patterns and pathologies, oral health, physical activity habits, nutritional status, supplementation usage, BS knowledge, surgery expectations and anthropometric measurements. Nutritional preparation and educational strategies should include an individualized preoperative weight-loss nutrition program, improvement of glycemic control, micronutrients deficiencies correction, eating and lifestyle habits adaptation, physical activity initiation, and strengthening knowledge on obesity and BS. At this stage, more well-designed intervention and long-term cohort studies are needed in order to formulate uniform evidence-based nutritional guidelines for patients who plan to undergo BS, including populations at higher nutritional risk. Moreover, postoperative outcomes of presurgical nutritional intervention programs should be studied.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
- School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ariela Goldenshluger
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel Aviv, Israel
| | | | - Yafit Kessler
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
| | - Chaya Schweiger
- Nutrition Service, Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel
| | - Tair Ben-Porat
- Department of Nutrition, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
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29
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Watson C, Riazi A, Ratcliffe D. Exploring the Experiences of Women Who Develop Restrictive Eating Behaviours After Bariatric Surgery. Obes Surg 2021; 30:2131-2139. [PMID: 32060849 PMCID: PMC7475057 DOI: 10.1007/s11695-020-04424-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to explore the experiences of women who had developed excessively restrictive eating behaviours following bariatric surgery. METHOD Five female participants, who were at least nine months post-bariatric surgery and exhibiting restrictive eating behaviours, were recruited from Bariatric Surgery Psychology Services and asked to complete qualitative face-to-face semi-structured interviews. The data was analysed using interpretative phenomenological analysis (IPA). RESULTS Three super-ordinate themes emerged: (1) experiences of weight stigma and weight history on self, (2) the impact of loose skin, (3) thoughts about food and disordered eating patterns. These captured the impact of past weight-related experiences-including weight stigma, intense fears of weight gain, negative cognitions about the self, the impact of excess skin, changes in the way the women thought about food and restrictive eating behaviours. DISCUSSION This study is one of the first to specifically explore restrictive eating disorders after bariatric surgery using a qualitative approach. The findings of this study may offer helpful aspects for professionals to hold in mind when identifying individuals with problematic restrictive eating behaviours following bariatric surgery. Body contouring surgery, internalised weight bias and weight stigma are explored in relation to the post-bariatric surgery treatment pathway. The current diagnostic criterion for anorexia nervosa are discussed to highlight difficulties in diagnosing this presentation in the post-bariatric surgery population, where people can have BMIs over 25 kg/m2 but are severely restricting energy intake.
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Affiliation(s)
- Charlotte Watson
- Department of Psychology, Royal Holloway, University of London, London, UK.
| | - Afsane Riazi
- Department of Psychology, Royal Holloway, University of London, London, UK
| | - Denise Ratcliffe
- Bariatric Surgery Psychology Department, Chelsea and Westminster NHS Foundation Trust, Fulham, London, UK
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30
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Oved I, Endevelt R, Mardy-Tilbor L, Raziel A, Sherf-Dagan S. Health Status, Eating, and Lifestyle Habits in the Long Term Following Sleeve Gastrectomy. Obes Surg 2021; 31:2979-2987. [PMID: 33829384 DOI: 10.1007/s11695-021-05336-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Sleeve gastrectomy (SG) is an established bariatric procedure. However, long-term data on eating and lifestyle behaviors and their effect on weight outcomes are scarce. Therefore, this study aimed to examine these long-term behaviors and their associations to weight outcomes following SG. METHODS A long-term follow-up study (>5 years post-surgery) of 266 adult patients admitted to a primary SG surgery during 2008-2012 and who participated in a pre-surgery study was conducted. Data on pre-surgery demographics, anthropometrics, and medical status were obtained from the patients' medical records. Data on long-term health status, anthropometrics, lifestyle and eating habits, eating pathologies, follow-up regime, and satisfaction from the surgery were collected by an interview phone calls according to a structured questionnaire. RESULTS Data of 169 patients were available before and 7.8±1.0 years post-SG. Their baseline mean age was 41.8±11.3 years, and 71.6% of them were females. The mean post-surgery excess weight loss (EWL) was 53.2±31.2%, and 54.2% had EWL of ≥50%. Eating 3-6 meals per day, not having the urge to eat after dinner, separating liquids from solids, avoiding carbonated beverages, and performing physical activity were related to better weight-loss outcomes (P≤0.026). However, frequent need for eating sweets, binge eating, and feeling guilty or sad after eating were related to worse weight-loss outcomes (P≤0.010). Furthermore, only a minority reported taking a multivitamin and participating in follow-up meetings after more than 1 year since the surgery (≤21.3%). CONCLUSIONS In the long term following SG, approximately half achieved EWL of ≥50%, and physical activity, certain eating patterns, and eating pathologies were related to weight outcomes.
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Affiliation(s)
- Irit Oved
- School of Public Health, University of Haifa, Haifa, Israel
| | - Ronit Endevelt
- School of Public Health, University of Haifa, Haifa, Israel.,Nutrition Division, Ministry of Health, Jerusalem, Israel
| | | | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel
| | - Shiri Sherf-Dagan
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ramat HaGolan St 65, 40700, Ariel, Israel. .,Department of Nutrition, Assuta Medical Center, Tel-Aviv, Israel.
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31
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Geerts MM, van den Berg EM, van Riel L, Peen J, Goudriaan AE, Dekker JJM. Behavioral and psychological factors associated with suboptimal weight loss in post-bariatric surgery patients. Eat Weight Disord 2021; 26:963-972. [PMID: 32472495 DOI: 10.1007/s40519-020-00930-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 05/14/2020] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Bariatric surgery is the most effective long-term treatment for sustained weight loss in obesity. Studies have shown that not all patients lose the expected amount of weight. The aim of this study was to develop a better understanding of which behavioral and psychological factors are associated with suboptimal weight loss. METHODS The present paper describes a cross-sectional study that included 140 participants. The mean follow-up period after bariatric surgery was 3.16 years. Eating disorder pathology (Eating Disorder Examination-Questionnaire), impulsivity (Barratt Impulsiveness scale-II) and depressive symptoms (Beck Depression Inventory) were compared with successful and suboptimal participants. A weight loss of more than or equal to 50% of excess weight, was considered to be successful. RESULTS More than 81% of the participants met the criterion for successful weight loss. The suboptimal weight loss group reported more symptoms of eating disorder pathology (p = .001), more loss of control over eating (p = .001), and more avoidant behavior due to poor body image (p < .001). The suboptimal weight loss group scored higher on impulsivity (p = .007) and on depression (p < .001). More early weight loss was associated with better weight outcome later on (r = .491). Reporting more eating disorder pathology, a longer follow-up period and pre-operative super-obesity (body mass index ≥ 50 kg/m2) at the time of surgery were associated with poorer weight loss (p < .001). CONCLUSION Eating disorder pathology, loss of control over eating and avoidant behavior due to poor body image, as well as depressive symptoms and impulsivity, (as reported postoperatively) are associated with suboptimal weight loss. Level III: Case-control analytic study.
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Affiliation(s)
- Marjolein M Geerts
- Novarum, Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, The Netherlands.
| | - Elske M van den Berg
- Novarum, Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, The Netherlands
| | - Laura van Riel
- Novarum, Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, The Netherlands
| | - Jaap Peen
- Arkin, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - Anna E Goudriaan
- Novarum, Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, The Netherlands.,Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands
| | - Jack J M Dekker
- Arkin, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
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Newman AKR, Herbozo S, Russell A, Eisele H, Zasadzinski L, Hassan C, Sanchez-Johnsen L. Psychosocial interventions to reduce eating pathology in bariatric surgery patients: a systematic review. J Behav Med 2021; 44:421-436. [PMID: 33580454 DOI: 10.1007/s10865-021-00201-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
Bariatric surgery is the most effective treatment for severe obesity; however, a subset of patients experience suboptimal outcomes. Psychosocial interventions that address eating pathology may ameliorate negative consequences, although their efficacy has not been examined. Thus, a systematic review to evaluate the impact of psychosocial randomized controlled trials (RCTs) on eating pathology in adults pre and post-bariatric surgery was conducted. Six scientific databases were searched for psychosocial trials assessing eating pathology as an outcome. Ten RCTs representing seven distinct interventions were identified (i.e., four preoperative and six postoperative). Trials utilized cognitive-behavioral therapy, mindfulness-based approaches, acceptance-based treatment, motivational interviewing, and psychoeducational interventions. Findings provide initial support for reducing eating pathology pre and postoperatively in the short-term (i.e., 6 months); however, the small number of RCTs and heterogeneity among postoperative trials made it difficult to draw conclusions. Additional longitudinal studies are needed to determine the long-term impact of psychosocial interventions that address eating pathology in bariatric surgery patients endorsing significant eating pathology.
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Affiliation(s)
- Alison Kaylen-Reynard Newman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA. .,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sylvia Herbozo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea Russell
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Heather Eisele
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lindsay Zasadzinski
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Chandra Hassan
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA.,Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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Harris SR, Carrillo M, Fujioka K. Binge-Eating Disorder and Type 2 Diabetes: A Review. Endocr Pract 2021; 27:158-164. [PMID: 33554873 DOI: 10.1016/j.eprac.2020.10.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2020] [Accepted: 10/27/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To familiarize health care providers with diagnosis and treatment of binge-eating disorder (BED), a common comorbidity of type 2 diabetes (T2DM). METHODS Literature review of binge eating and T2DM. Key words used in search include BED, T2DM, obesity, and treatment. RESULTS The prevalence of BED in patients with T2DM appears to be much higher than the 2% to 3.5% prevalence seen in the general population. Studies suggest that up to 20% of patients with T2DM have an underlying eating disorder, the most common of which is binge eating. BED is probably underdiagnosed, even though there are multiple simple tools that providers can use to improve screening for the disorder. Though the relationship between BED and hemoglobin A1c control can vary, it appears that binge-eating behaviors can worsen metabolic markers, including glycemic control. Various medications used by patients with diabetes have been associated with new-onset BED, and treatment may be as simple as removing or replacing such agents. Several medications have been found to significantly reduce binge-eating frequency, and potentially, weight. Patients with BED generally benefit from psychotherapy, including cognitive behavioral therapy. CONCLUSION BED, only recently added to the International Classification of Disease-10 diagnostic list, is very common in patients with obesity and T2DM. The diagnosis is important to establish, as treatment or referral for treatment, could potentially improve many of the comorbidities and metrics of T2DM.
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Affiliation(s)
- Samantha R Harris
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
| | - Maritza Carrillo
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California.
| | - Ken Fujioka
- Scripps Clinic Medical Group, Division of Diabetes and Endocrinology, La Jolla, California
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Eik-Nes TT, Vrabel K, Raman J, Clark MR, Berg KH. A Group Intervention for Individuals With Obesity and Comorbid Binge Eating Disorder: Results From a Feasibility Study. Front Endocrinol (Lausanne) 2021; 12:738856. [PMID: 34803910 PMCID: PMC8597950 DOI: 10.3389/fendo.2021.738856] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. MATERIAL AND METHODS A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). RESULTS All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect. CONCLUSION This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
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Affiliation(s)
- Trine T. Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
- *Correspondence: Trine T. Eik-Nes,
| | | | - Jayanthi Raman
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Melinda Rose Clark
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Kjersti Hognes Berg
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
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Yagin NL, Aliasgari F, Alizadeh M, Aliasgharzadeh S, Mahdavi R. Comparison of endocannabinoids levels, FAAH gene polymorphisms, and appetite regulatory substances in women with and without binge eating disorder: a cross- sectional study. Nutr Res 2020; 83:86-93. [DOI: 10.1016/j.nutres.2020.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 08/04/2020] [Accepted: 09/02/2020] [Indexed: 01/23/2023]
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Food insecurity is linked to poorer dietary quality in prebariatric surgery patients. Surg Obes Relat Dis 2020; 17:263-270. [PMID: 33272853 DOI: 10.1016/j.soard.2020.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/02/2020] [Accepted: 10/12/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Research exploring dietary quality patterns within bariatric populations is limited, despite the significance of eating behaviors for postoperative outcomes. Recent studies revealed associations between food insecurity and disordered eating behavior in bariatric patients; however, the relationship between food insecurity and dietary quality is not known. OBJECTIVE To examine the association between dietary quality and levels of food security within a sample of presurgical bariatric patients. SETTING One academic medical center in central Pennsylvania, United States of America. METHODS Patients completed three self-report measures as part of their presurgical psychological assessment process. Food security status was measured by the United States Department of Agriculture's Food Security Module, modified for self-reports. Participants also completed the Rapid Eating Assessment for Participants, short version, which is a measure of dietary quality with scores ranging from 13-39, and the Adult Eating Behavior Questionnaire. Hierarchical multiple regressions were used to assess relationships between dietary quality and food security levels, and mediation models were built to explore associations between variables. RESULTS Of the 197 participants, 35.5% reported high food security, while 35.0% and 29.5% reported marginal food security and food insecurity, respectively. Compared with patients with high food security, the dietary quality scores of food-insecure patients were 1.3 points lower (95% confidence interval [CI], -3.3 to .7; P = .2) of and marginally food-secure patients were 1.2 points lower (95% CI, -2.9 to .5) than those reporting high food security (P = .2). CONCLUSIONS Our findings indicate a need for further exploration into the barriers that prebariatric patients may face when attempting to adhere to pre- and postoperative dietary requirements, particularly for those reporting marginal food security and food insecurity. Future research should target postoperative outcomes, including weight gain, weight regain, and dietary adherence, among the most economically vulnerable bariatric patients.
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Marek RJ, Martin-Fernandez K, Ben-Porath YS, Heinberg LJ. Psychosocial Functioning of Bariatric Surgery Patients 6-Years Postoperative. Obes Surg 2020; 31:712-724. [PMID: 33040294 DOI: 10.1007/s11695-020-05025-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/29/2020] [Accepted: 10/05/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Mental health professionals routinely assess psychosocial risk factors prior to bariatric surgery to help identify factors that may impede surgical outcomes. Data regarding longer-term psychosocial functioning postoperatively are needed. PURPOSE Assess the psychosocial functioning of patients who obtained bariatric surgery approximately 6 years ago. METHODS A total of 161 patients consented to participate in the outcome study. Participants were compensated for their time and participation. Participants were weighed by the research/clinical staff and asked to complete a battery of self-report measures, including the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF). Other measures targeted adherence, eating behaviors/body image, alcohol use, and quality of life. RESULTS Postoperative MMPI-2-RF scores indicate psychosocial functioning is largely similar to previously published pre-surgical functioning data. Six-year weight loss outcomes were lower than previous studies reported for a similar postoperative time period (mean %total weight loss = 22.98%; standard deviation = 11.71), though quality of life scores were relatively high. Postoperative MMPI-2-RF scale scores were associated with poorer psychosocial functioning, reduced adherence, greater eating behaviors/body image concerns, greater alcohol use severity, lower quality of life, and less overall weight loss. CONCLUSIONS Psychological dysfunction 6 years after surgery is associated with various adverse outcomes. Ongoing, postoperative treatment may result in better long-term functioning for patients.
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Affiliation(s)
- Ryan J Marek
- Department of Clinical, Health, and Applied Sciences, University of Houston-Clear Lake, Houston, TX, 77058, USA.
| | | | - Yossef S Ben-Porath
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA
| | - Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue/M61, Cleveland, OH, 44195, USA
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Gradaschi R, Molinari V, Sukkar SG, De Negri P, Adami GF, Camerini G. Disordered eating and weight loss after bariatric surgery. Eat Weight Disord 2020; 25:1191-1196. [PMID: 31302883 DOI: 10.1007/s40519-019-00749-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/04/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSES Aberrant eating patterns are frequently observed in bariatric patients. Since bariatric operations produce alterations in food transit and in appetite/satiety balance, postoperative eating behavior changes are not surprising. METHODS 88 consecutive obese patients undergoing Roux-en-Y gastric bypass (RYGBP, 50 cases) and Sleeve Gastrectomy (SG, 38 cases) were retrospectively evaluated. Beside anthropometric data measurement, eating behavior was assessed by direct interview prior to the operation and at the first and second postoperative years: patients were considered as eating disordered (ED) when referred habitual occurrence of binge eating and nibbling/grazing. Weight loss was assessed by percent of BMI loss (% Δ BMI). Together with standard follow-up, patients received additional behavioral/dietetic support upon request. RESULTS Postoperative ED patients showed lower % Δ BMI than the not ED ones at one (30.7% ± 8,5 vs. 26.8% ± 10, p < 0.02) and two (32% ± 10.3 vs. 27.4% ± 12.9, p < 0.05) years after operation, the follow-up rate being 82% and 76%, respectively, without differences between RYGBP and SG group. After RYGBP, an improvement of eating behavior was observed (ED patients from 75 to 28% at 1 year and to 27% at 2 years), while no changes were observed after SG. In SG patients, the number of additional behavioral/dietetic support sessions throughout the follow-up was positively associated with % Δ BMI. DISCUSSION The postoperative normalization of eating pattern has a role in weight loss after bariatric surgery. Behavioral/dietetic support is indicated in all SG patient, while after RYGBP is useful only when weight loss is unsatisfactory. LEVEL OF EVIDENCE III: retrospective cohort study.
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Affiliation(s)
- Raffaella Gradaschi
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Virginia Molinari
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Samir Giuseppe Sukkar
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Paola De Negri
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Gian Franco Adami
- Department of Internal Medicine, University of Genova, Largo Benzi 8, Genova, 16132, Italy.
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Bariatric and Cosmetic Surgery in People with Eating Disorders. Nutrients 2020; 12:nu12092861. [PMID: 32962048 PMCID: PMC7551175 DOI: 10.3390/nu12092861] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
Rates of eating disorders (EDs) are increasing in Australia, as are rates of bariatric and cosmetic surgery including weight-related procedures. It is known that binge eating disorder (BED) is common in bariatric surgery candidates and that people with EDs are likely to undergo weight-related cosmetic procedures, however, most of the literature is based on clinic samples and focuses on young women and BED. Aims of this study were to determine the prevalence of (1) actual or intended bariatric surgery and (2) actual or intended cosmetic surgery including weight-related procedures in people with a current ED and a lifetime history of BED or bulimia nervosa (BN), and the associations with actual or intended bariatric or cosmetic surgery and demographic features. Using a general population survey, 2977 individuals were interviewed regarding sociodemographic status, ED symptoms, mental health-related quality of life (MHRQoL) and actual or intended use of bariatric and cosmetic surgery, prevalence estimates of which were 2.0% and 1.1%, respectively. People who had planned or received either type of surgery were more likely to be (1) women and (2) have a higher BMI, (3) poorer MHRQoL and (4) a current ED, lifetime BN or BED or features of EDs (all p < 0.05). Age and household income were not significantly associated with increased use of either type of surgery. Given the potential for an ED to affect outcomes of surgery, screening and treatment for EDs should be considered in such surgical candidates.
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The moderating effects of mindful eating on the relationship between emotional functioning and eating styles in overweight and obese women. Eat Weight Disord 2020; 25:841-849. [PMID: 31313253 PMCID: PMC7399674 DOI: 10.1007/s40519-019-00740-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 06/22/2019] [Indexed: 01/18/2023] Open
Abstract
PURPOSE The aim of the current study was to examine the moderating effect of mindful eating on the relationship between emotional functioning and eating styles in overweight and obese women. METHODS One hundred and eighty four overweight and obese adult women (BMI 30.12 ± 3.77 kg/m2) were assessed with the Difficulties in Emotion Regulation Scale, the Positive and Negative Affect Schedule, the Three Factor Eating Questionnaire and the Mindful Eating Scale. RESULTS Mindful eating significantly moderated several of the relationships between emotional functioning and eating styles. At all levels of mindful eating, emotion dysregulation and negative affect are both associated with greater emotional eating, but with stronger associations for high levels of mindful eating. For people low in mindful eating, both emotion dysregulation and negative affect are associated with lower restrictive eating, and neither of them are associated with uncontrolled eating. For people high in mindful eating, neither emotion dysregulation nor negative affect are associated with restrictive eating, and only negative affect is associated with greater uncontrolled eating. CONCLUSION When mindful eating techniques are included as part of an intervention for overweight or obese individuals, it is even more important that those interventions should also include techniques to reduce emotion dysregulation and negative affect. LEVEL OF EVIDENCE Level V, descriptive study.
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Williams D, Chaves E, McKnight E, Eneli I. Diagnostic and treatment challenges of eating disorders after adolescent bariatric surgery: A case report. Clin Obes 2020; 10:e12367. [PMID: 32394622 DOI: 10.1111/cob.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/27/2022]
Abstract
It is increasingly evident that bariatric surgery is an effective treatment option to manage severe obesity and its comorbidities in adolescent patients. This case report follows an adolescent who developed a restrictive eating disorder within months after bariatric surgery. Identifying and treating eating disorders after bariatric surgery can be difficult due to the conflicting goals of weight loss after surgery and weight gain in treatment of a restrictive eating disorder. Moreover, treating older adolescents can be challenging when they refuse treatment or go against medical advice. As more adolescents choose bariatric surgery, it is imperative that clinicians remain sensitive to weight-related outcomes, possible eating disorders and adolescent autonomy. Early collaboration between weight management and eating disorder programs is essential.
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Affiliation(s)
- Dominique Williams
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Eileen Chaves
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Psychology, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Erin McKnight
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
- Division of Adolescent Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ihuoma Eneli
- Center for Healthy Weight and Nutrition, Nationwide Children's Hospital, Columbus, Ohio, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, Ohio, USA
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Kops NL, Vivan MA, de Castro MLD, Horvath JDC, Costa FS, Friedman R. Binge eating scores pre-bariatric surgery and subsequent weight loss: A prospective, 5 years follow-up study. Clin Nutr ESPEN 2020; 38:146-152. [PMID: 32690149 DOI: 10.1016/j.clnesp.2020.05.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/30/2020] [Accepted: 05/13/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS To compare groups of bariatric patients with preoperative scores of Binge Eating Scale (BES) above and below the clinical cut off value on weight outcomes up to 60 months following surgery. METHODS This is a prospective observational study involving 108 Brazilian patients (follow-up rate: 48.1%) operated by Roux-en-Y gastric bypass. In the preoperative period, they were clinically evaluated, and BES was applied. Based on the scores, patients were categorized as high or low according to established cut off 17 for binge eaters. Follow-up weight loss was obtained (3, 6, 12, 24, 36, 48, and 60 months) using data from medical records. The percentage of total weight loss (%TWL) was examined by generalized linear model. RESULTS 41.7% of patients had BES scores higher than 17 at baseline. Weight loss was significant up to 12 months. The greatest weight loss was at 24 months of follow-up, ranging from 2.7 to 110.4 kg (mean 42.9 ± 17.8 kg). In the short postoperative period (3, 24, and 36 months), %TWL was significantly different between groups. At 24 months, patients with higher scores lost more %TWL than those with lower scores (35.1 ± 0.8% vs 31.6 ± 0.7%, p = 0.029). However, this difference was not fount at 60 months postoperatively (mean 28.9 ± 9.6%). In a multivariate analysis, the presence of depression, age, and BES score were not associated with %TWL at 24 and 60 months. CONCLUSIONS The results suggest that preoperative BES scores point to a similar weight loss after bariatric surgery. Further studies with long-term follow-up are necessary to evaluate this finding.
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Affiliation(s)
- Natalia Luiza Kops
- Post-Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
| | | | - Mariana L Dias de Castro
- Post-Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Jaqueline D Correia Horvath
- Post-Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil.
| | - Fabiana Silva Costa
- Post-Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | - Rogério Friedman
- Post-Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Endocrinology Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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USTA E, AYGİN D. BARİATRİK CERRAHİDE UYGULANAN KAPSAMLI EĞİTİM VE DANIŞMANLIK HİZMETİ: YEME ÖZELLİKLERİ VE FİZİKSEL AKTİVİTE DÜZEYİNE ETKİSİ. DÜZCE ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2020. [DOI: 10.33631/duzcesbed.621996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Conceição EM, Fernandes M, de Lourdes M, Pinto-Bastos A, Vaz AR, Ramalho S. Perceived social support before and after bariatric surgery: association with depression, problematic eating behaviors, and weight outcomes. Eat Weight Disord 2020; 25:679-692. [PMID: 30859467 DOI: 10.1007/s40519-019-00671-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/05/2019] [Indexed: 01/14/2023] Open
Abstract
PURPOSE Engaging in a healthy lifestyle after bariatric surgery is essential to optimize and sustain weight loss in the long term. There is promising evidence that social support of patients who undergo bariatric surgery plays an important role in promoting a better quality of life and adherence to the required behavioral changes and medical appointments. This study sought to investigate: (a) if post-operative patients experience different levels of perceived social support compared to pre-operative patients; (b) correlations between perceived social support, depression, disordered eating, and weight outcomes; (c) if social support is a moderator between psychological distress, and disordered eating behavior and weight outcomes. METHODS A group of 65 patients assessed pre-surgery and another group of 65 patients assessed post-surgery (M = 26.12; SD 7.97 months since surgery) responded to a set of self-report measures assessing social support, eating disorder psychopathology, disordered eating, and depression. RESULTS Greater social support was associated with lower depression, emotional eating, weight and shape concerns, and greater weight loss in pre- and post-surgery groups. Social support was found to be a moderator between different psychological/weight variables but only for the post-surgery group: the relation between depression and eating disorder psychopathology or weight loss was significant for patients scoring medium to high level is social support; the relation between grazing and weight regain was significant for patients scoring medium to low levels of social support. CONCLUSIONS The associations found between perceived social support and depression, disordered eating and weight outcomes highlight the importance of considering and working with the social support network of patients undergoing bariatric surgery to optimize treatment outcomes. Level of Evidence Level III: case-control study.
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Affiliation(s)
- Eva M Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal.
| | - Marta Fernandes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
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Conceição EM, de Lourdes M, Peixoto AP, Pinto-Bastos A, Goldschmidt AB, Vaz AR. The utility of DSM-5 indicators of loss of control eating for the bariatric surgery population. EUROPEAN EATING DISORDERS REVIEW 2020; 28:423-432. [PMID: 32246543 DOI: 10.1002/erv.2737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/27/2020] [Accepted: 03/16/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This study investigated the utility of DSM-5 indicators of loss of control (LOC) eating in adult bariatric surgery patients who presented with binge-eating episodes. METHODS Participants (all women) were 40 preoperative and 28 postoperative bariatric surgery patients reporting objective binge eating (OBE), 46 preoperative and 52 postoperative with subjective binge-eating (SBE), 53 bulimia nervosa (BN) controls, and 34 binge-eating disorder (BED) controls. Face-to-face Eating Disorder Examination interviews and questionnaires were administered. ANOVA, T-test, χ 2 , and regressions compared the groups in terms of LOC indicators endorsed and to explain disordered eating psychopathology. RESULTS The indicator most commonly reported by bariatric patients with OBE was "feeling disgusted" (90% and 75% of pre- and postoperative groups), and the least endorsed was "eating alone" (40 and 28.6%). These indicators were reported by >84.9% of the BN and BED. Bariatric patients (pre- or post-surgery) with OBE only reported a higher number of indicators than patients with SBE only (t(150) = 2.34, p = .021). A higher number of indicators reported were associated with increased eating-related psychopathology (F(1,134) = 31.06, p < .001), but only for the post-surgery patients. CONCLUSIONS The LOC indicators proposed by DSM-5 need to be refined or revised for the bariatric population. Highlights Bariatric patients endorse fewer LOC indicators than BN or BED during a binge-eating episode. Some of the DSM-5 LOC indicators may not be suited to assess episodes of loss of control eating among bariatric patients. The Higher the number of LOC indicators reported, the higher the eating-related psychopathology.
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Affiliation(s)
| | | | - Ana P Peixoto
- School of Psychology, University of Minho, Braga, Portugal
| | | | - Andrea B Goldschmidt
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School of Brown University/The Miriam Hospital, Providence, RI, USA
| | - Ana R Vaz
- School of Psychology, University of Minho, Braga, Portugal
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Imperatori C, Bianciardi E, Niolu C, Fabbricatore M, Gentileschi P, Di Lorenzo G, Siracusano A, Innamorati M. The Symptom-Checklist-K-9 (SCL-K-9) Discriminates between Overweight/Obese Patients with and without Significant Binge Eating Pathology: Psychometric Properties of an Italian Version. Nutrients 2020; 12:nu12030674. [PMID: 32121618 PMCID: PMC7146623 DOI: 10.3390/nu12030674] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/23/2020] [Accepted: 02/28/2020] [Indexed: 02/06/2023] Open
Abstract
A general personality and psychopathology evaluation is considered to be crucial part of the multidisciplinary assessment for weight-related problems. The Symptom Checklist-90-Revised (SCL-90-R) is commonly used to assess general psychopathology in both overweight and obese patients seeking weight-loss treatment. The main purpose of the present research was to investigate the psychometric properties of the brief form of the SCL-90-R (i.e., the SCL-K-9) in a clinical sample (N = 397) of patients seeking weight-loss treatment (i.e., bariatric surgery and a nutritional weight-loss program). The results of the confirmatory factor analysis supported a one-factor solution of the SCL-K-9, with all nine items loading significantly on the common latent factor (lambdas ≥ 0.587). The ordinal α (= 0.91), the inter-item mean indices of correlation (rii = 0.53), and the convergent validity were also satisfactory. A receiver operating characteristic curves procedure showed that both SCL-90-R and SCL-K-9 were able to classify patients with and without significant binge eating pathology according to the Binge Eating Scale (BES) total score. Overall, our results suggest that the SCL-K-9 has adequate psychometric properties and can be applied as a short screening tool to assess general psychopathology in overweight/obese individuals seeking weight-loss treatment and at follow-up interviews when time restraints preclude the use of the full-length form.
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Affiliation(s)
- Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
- Correspondence: ; Tel.: +06-66-54-38-73
| | - Emanuela Bianciardi
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Cinzia Niolu
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Mariantonietta Fabbricatore
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
| | - Paolo Gentileschi
- Bariatric Surgery Unit, Department of Experimental Medicine and Surgery, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy;
| | - Giorgio Di Lorenzo
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
- IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Roma, Italy
| | - Alberto Siracusano
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133 Roma, Italy; (E.B.); (C.N.); (G.D.L.); (A.S.)
| | - Marco Innamorati
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Via degli Aldobrandeschi 190, 00163 Roma, Italy; (M.F.); (M.I.)
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Hindle A, De la Piedad Garcia X, Hayden M, O'Brien PE, Brennan L. Pre-operative Restraint and Post-operative Hunger, Disinhibition and Emotional Eating Predict Weight Loss at 2 Years Post-laparoscopic Adjustable Gastric Banding. Obes Surg 2020; 30:1347-1359. [PMID: 32006239 DOI: 10.1007/s11695-019-04274-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION A principal mechanism of action in bariatric surgery is reduction in calorie consumption due to decreased hunger and increased satiety. Patients' ability to perceive post-operative changes to their hunger is therefore central to optimal results. This study examined factors that may impact how patients perceive post-operative hunger and how perception of hunger impacts eating and subsequent weight loss after laparoscopic adjustable gastric banding (LAGB). METHODS Patients undertaking LAGB (n = 147) provided pre-surgery and 2-year weight loss data and pre-surgery and 12-month psychological data (perception of hunger, disinhibition related to eating, emotional eating). RESULTS Path analysis demonstrated that patients with lower levels of pre-surgery cognitive restraint over eating experienced significantly greater reduction in perception of hunger at 12 months post-surgery. Perceived reduction in hunger was significantly associated with lower levels of both emotional eating and disinhibited eating. Finally, reduced emotional eating at 12 months significantly predicted 9% of the variance in percentage of total weight loss (%TWL) at 2 years after surgery. CONCLUSION These initial findings suggest that preparation for bariatric surgery may be enhanced by psychoeducation regarding cognitive restraint over eating and its effect on hunger perception. In addition, psychological treatment that focuses on identifying and responding to changes in hunger may contribute to improved outcomes for those who have difficulty adjusting to post-operative eating behaviours.
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Affiliation(s)
- Annemarie Hindle
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia. .,Centre for Eating, Weight, and Body Image, Suite 215, 100 Victoria Parade, East, Melbourne, Victoria, 3002, Australia.
| | - Xochitl De la Piedad Garcia
- School of Behavioural and Health Sciences, Australian Catholic University, 115 Victoria Parade, Fitzroy, Victoria, 3065, Australia
| | - Melissa Hayden
- Faculty of Health, Deakin University Burwood Melbourne Campus, 221 Burwood Highway, Burwood, 3125, Australia
| | - Paul E O'Brien
- Centre for Obesity Research and Education, The Alfred Centre, Monash University Clinical School, 99 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Leah Brennan
- Centre for Eating, Weight, and Body Image, Suite 215, 100 Victoria Parade, East, Melbourne, Victoria, 3002, Australia.,School of Psychology and Public Health, La Trobe University, Albury-Wodonga Campus, 133 McKoy Street, 3689, Wodonga, Victoria, Australia
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Raman J, Spirou D, Jahren L, Eik-Nes TT. The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology. Front Endocrinol (Lausanne) 2020; 11:563. [PMID: 32903696 PMCID: PMC7438835 DOI: 10.3389/fendo.2020.00563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Ranked highly in its association with serious medical comorbidities, obesity, a rapidly growing epidemic worldwide, poses a significant socio-economic burden. While bariatric procedures offer the most efficacious treatment for weight loss, a subset of patients risk weight recidivism. Due to the heterogeneity of obesity, it is likely that there are phenotypes or sub-groups of patients that require evidence-based psychological support to produce more sustainable outcomes. So far, however, characteristics of patients have not led to a personalized treatment algorithm for bariatric surgery. Maintenance of weight loss following bariatric surgery requires long-term modification of eating behaviors and physical activity. A recent Clinical Obesity Maintenance Model (COMM) proposed a conceptual framework of salient constructs, including the role of habit, behavioral clusters, emotion dysregulation, mood, health literacy, and executive function as interconnected drivers of obesity maintaining behaviors relevant to the field of bariatric psychology. The primary aim of this concise review is to bring together emerging findings from experimental and epidemiological studies relating to the COMM constructs that may inform the assessment and follow up of bariatric surgery. We also aim to explain the phenotypes that need to be understood and screened prior to bariatric surgery to enable better pre-surgery intervention and optimum post-surgery response.
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Affiliation(s)
- Jayanthi Raman
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Lisbeth Jahren
- Library Section for Medicine and Health Sciences, NTNU University Library, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine Tetlie Eik-Nes
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
- *Correspondence: Trine Tetlie Eik-Nes
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Smith CE, Hawkins MAW, Williams-Kerver GA, Duncan J. Depression subtypes, binge eating, and weight loss in bariatric surgery candidates. Surg Obes Relat Dis 2019; 16:690-697. [PMID: 32044238 DOI: 10.1016/j.soard.2019.12.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 12/04/2019] [Accepted: 12/12/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Depression and binge eating disorder (BED) are prevalent among bariatric surgery candidates. Depression subtypes may be differentially related to obesity, such that the atypical subtype predicts poorer outcomes. However, no research has examined depression subtypes, BED, and weight loss in bariatric candidates. OBJECTIVE To examine whether presurgical atypical depressive symptoms, compared with no depressive and melancholic depressive symptoms, were associated with higher rates of presurgical BED, binge eating severity, and poorer postsurgical weight loss trajectories among bariatric candidates. SETTING An outpatient Midwest bariatric clinic. METHODS Participants were 345 adults (aged 46.27 ± 12.78 yr, 76% female; body mass index = 49.84 ± 8.51 kg/m2) who received a presurgical evaluation. Depression subtypes (melancholic, atypical, and no depressive symptoms) were categorized using the Beck Depression Inventory-II. BED diagnosis and severity were evaluated using the Eating Disorder Diagnostic Scale and Binge Eating Scale, respectively. Weight loss trajectories were calculated as percent total weight loss postsurgery. RESULTS Using no depression as the referent, participants reporting melancholic symptoms (odds ratio = 7.60, P < .001 confidence interval95 [2.59-22.28]) and atypical symptoms (odds ratio = 10.11, P < .01 confidence interval95 [2.69-37.94]) were more likely to meet criteria for BED. Patients with atypical depressive symptoms exhibited the highest binge eating severity scores (mean = 23.03). Depression subtypes did not predict percent total weight loss trajectories within 18-months postbariatric surgery. CONCLUSIONS Patients reporting preoperative atypical depressive symptoms were more likely to meet criteria for co-morbid BED diagnosis and have greater binge eating severity but did not have poorer weight loss within 18 months postsurgery. Future studies with longer-term follow-up and corresponding measures of postsurgical depression and binge eating pathology are warranted.
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Affiliation(s)
- Caitlin E Smith
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma.
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Martin-Fernandez KW, Heinberg LJ, Ben-Porath YS. Using the preoperative psychological evaluation to determine psychosocial risk factors for CPAP nonadherence among bariatric surgery candidates. Surg Obes Relat Dis 2019; 15:2115-2120. [PMID: 31711951 DOI: 10.1016/j.soard.2019.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 07/10/2019] [Accepted: 07/11/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is prevalent among bariatric surgery candidates and is associated with numerous adverse health conditions, both pre- and postoperatively. Continuous positive airway pressure therapy (CPAP) is the first-line treatment for OSA, but it requires significant behavioral changes. As such, CPAP adherence is a significant problem in OSA treatment. Information from the preoperative psychological evaluation may be used to identify psychosocial risk factors associated with CPAP nonadherence and inform the implementation of more specific and appropriate interventions. OBJECTIVES Examine the utility of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) behavioral/externalizing dysfunction scale scores to determine personality and psychopathology associations with, and risk for, CPAP nonadherence. SETTING Academic medical center. METHODS Patients who underwent a preoperative psychological evaluation and were diagnosed with OSA (n = 358) were divided into 2 groups: CPAP adherent (n = 271) and CPAP nonadherent (n = 87). Independent samples t tests were computed to examine differences in average MMPI-2-RF scale scores between these groups. Relative risk ratios were computed using multiple MMPI-2-RF substantive scale score cut-offs to determine which MMPI-2-RF scales were associated with increased risk of CPAP nonadherence. RESULTS Higher scores on scales measuring behavioral/externalizing dysfunction and family problems were associated with and indicative of risk for CPAP nonadherence. CONCLUSIONS CPAP nonadherence is related to and may be affected by generally higher levels of behavioral/externalizing dysfunction. Using a broadband measure of personality and psychopathology, like the MMPI-2-RF, during the preoperative evaluation can provide important information about co-morbid symptoms that may interfere with CPAP adherence. Considering this information during preoperative treatment planning could increase the likelihood of preoperative CPAP adherence and reduce the likelihood of adverse postoperative outcomes.
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