1
|
Moreno T, Ribeiro S, Borges-Canha M, Silva MM, Mendonça F, Urbano Ferreira H, Gonçalves J, Guerreiro V, Meira I, Menino J, Gil-Santos S, Calheiros R, Vale C, Varela A, Souto SB, Pedro J, Rodrigues P, Lima Costa E, Freitas P, Carvalho D. COVID-19 Lockdown and Impact on 2-Year Weight Loss in a Bariatric Center. Obes Facts 2023; 17:90-97. [PMID: 38096794 PMCID: PMC10836933 DOI: 10.1159/000535729] [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: 05/30/2023] [Accepted: 12/04/2023] [Indexed: 02/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has led to a worldwide lockdown, which affected physical exercise habits, as well as having a detrimental effect on psychological health and follow-up visits of patients submitted to bariatric surgery. The aim of this study was to evaluate the impact of COVID-19 lockdown on the 2-year weight loss of patients submitted to bariatric surgery in our center. METHODS This was an observational study comparing the weight loss of patients who underwent bariatric surgery from January to March 2020 with a control group submitted to surgery between January and March 2017. Percentage of total weight loss (% TWL) and excess weight loss (% EWL) were assessed 6, 12, and 24 months after surgery. RESULTS A total number of 203 patients were included in this study, 102 had bariatric surgery during the selected period in 2020 and 101 underwent surgery during the same period in 2017. There was no statistically significant difference in weight loss between the 2017 and 2020 groups which was reported as % TWL (mean 27.08 ± 7.530 vs. 28.03 ± 7.074, 33.87 ± 8.507 vs. 34.07 ± 8.979 and 34.13 ± 9.340 vs. 33.98 ± 9.993; p = 0.371) and % EWL (mean 66.83 ± 23.004 vs. 69.71 ± 17.021, 83.37 ± 24.059 vs. 84.51 ± 21.640 and 83.47 ± 24.130 vs. 84.27 ± 23.651; p = 0.506) at 6, 12, and 24 months post-surgery. CONCLUSION Despite social limitations imposed by the COVID-19 lockdown, we found no significant difference between weight loss at 2 years postoperatively in the 2020 group when compared with a control group who underwent bariatric surgery in 2017. These results show that the outcomes of bariatric surgery during the COVID-19 lockdown were comparable with those recorded before the pandemic, supporting the efficacy of bariatric procedures' metabolic effects during the first 2 years after surgery, regardless of lifestyle habits.
Collapse
Affiliation(s)
- Telma Moreno
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Sara Ribeiro
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Marta Borges-Canha
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Maria Manuel Silva
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Fernando Mendonça
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Helena Urbano Ferreira
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Juliana Gonçalves
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Vanessa Guerreiro
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - Inês Meira
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - João Menino
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sara Gil-Santos
- Department of Endocrinology, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Raquel Calheiros
- Department of Endocrinology, Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Catarina Vale
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Department of Internal Medicine, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Ana Varela
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Selma B. Souto
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Jorge Pedro
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Pedro Rodrigues
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Eduardo Lima Costa
- Department of General Surgery, Centro Hospitalar Universitário de São João, Porto, Portugal
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Paula Freitas
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal
- Faculty of Medicine, Universidade do Porto, Porto, Portugal
| | - The CRIO Group
- Centro de Responsabilidade Integrada de Obesidade, Centro Hospitalar Universitário de São João, Porto, Portugal
| |
Collapse
|
2
|
Ebadinejad A, Ghazy F, Hosseinpanah F, Fardoost S, Rajabian Tabesh M, Khalaj A, Mahdavi M, Ebadi SA, Valizadeh M, Barzin M. A Comparative Analysis of Safety and Efficacy of Bariatric Surgery During the COVID-19 Pandemic and Pre-Pandemic Period: Insights from the Tehran Obesity Treatment Study. World J Surg 2023; 47:2949-2957. [PMID: 37838633 DOI: 10.1007/s00268-023-07214-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic has raised global health concerns and posed challenges for postoperative follow-up care for patients undergoing bariatric surgery due to social distancing rules. METHODS This was a cohort study on patients with morbid obesity who underwent bariatric surgery and had been enrolled in Tehran Obesity Treatment Study. Patients who had surgery between March 2020 and March 2021 were classified as those undergoing the procedure amid the COVID-19 pandemic, while those who had surgery between March 2017 and March 2018 were categorized as the pre-pandemic group. RESULTS The study included 982 patients in the pre-COVID-19 pandemic group and 602 patients in the COVID-19 pandemic group, with mean ages of 39.61 and 39.51 years, respectively. After adjusting for preoperative body mass index (BMI) and surgery type, the patients who underwent surgery during the COVID-19 pandemic demonstrated comparable results to the pre-COVID-19 group in terms of total weight loss %, excess weight loss %, BMI reduction, and fat mass reduction during the 12-month postoperative period. Additionally, the rate of complications with a grade≥III based on the Clavien-Dindo classification was significantly lower in patients who underwent surgery during the COVID-19 pandemic. Notably, there were no deaths reported in either group. CONCLUSION Despite social isolation and unfavorable lifestyle modifications, bariatric surgery-induced weight loss after one year was the same in patients undergoing the procedure either before or after the implementation of social distancing measures. More research is needed to analyze the influence of the COVID-19 pandemic on the long-term outcomes of bariatric surgery.
Collapse
Affiliation(s)
- Amir Ebadinejad
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Ghazy
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Hosseinpanah
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shakiba Fardoost
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Alireza Khalaj
- Department of Surgery, Faculty of Medicine, Tehran Obesity Treatment Center, Shahed University, Tehran, Iran
| | - Maryam Mahdavi
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Alireza Ebadi
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
3
|
Parsons MA, Clemens JP. Eating disorders among bariatric surgery patients: The chicken or the egg? JAAPA 2023; 36:1-5. [PMID: 37884050 DOI: 10.1097/01.jaa.0000979532.00697.1a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ABSTRACT Postoperative eating behaviors and unhealthy weight control measures are leading causes of bariatric surgery complications. Candidates for bariatric surgery and individuals with eating disorders may share common risk factors, such as a history of dieting, and/or being bullied or teased for their weight. Binge-eating disorder, night eating syndrome, and bulimia nervosa are the most common eating disorders among candidates for bariatric surgery before the operation. Malnutrition, stress, and intense fear of weight gain can lead to the development of an eating disorder after surgery as well. Plugging, grazing, loss of control eating, dumping, and food avoidance are specific disordered behaviors that may present after bariatric surgery. To improve physical and psychological outcomes for individuals under their care, clinicians can screen for these disordered behaviors and distinguish them from a healthy diet and the expected postsurgical course.
Collapse
Affiliation(s)
- Marissa A Parsons
- Marissa A. Parsons is a certified eating disorder specialist and medical director of the Recovery and Wellness Center of Eastern Washington in Richland, Wash. Jonathan P. Clemens practices at the Emily Program in Lacey, Wash. The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | |
Collapse
|
4
|
Bauraitė K, Gudaitytė R, Maleckas A. The Impact of COVID-19 Pandemic on Weight Loss, Eating Behaviour and Quality of Life after Roux-en-Y Gastric Bypass. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1597. [PMID: 37763716 PMCID: PMC10537013 DOI: 10.3390/medicina59091597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: The global pandemic of coronavirus disease (COVID-19), declared on 11 March 2020, had an extensive impact on bariatric patients. The aim of this study was to evaluate short-term weight loss outcomes, changes in eating behaviour, and health-related quality of life (HRQoL) among patients who had Roux-en-Y gastric bypass (RYGB) before and during the COVID-19 pandemic. Materials and Methods: This cohort study included 72 patients (Group S) who underwent RYGB surgery in the Surgery Department of the Lithuanian University of Health Sciences during the COVID-19 pandemic in the years 2020-2022. Data for the control group (Group C) of 87 patients (operated on in 2010-2012) were collected from a prospective study. The data referred to the period before and a year after the RYGB. The information about patients' weight changes, hunger, satiety, fullness sensations, appetite, diet, and eating patterns was queried. Eating behaviour and HRQoL evaluation were conducted by the Three-Factor Eating Questionnaire (TFEQ-R18) and the medical outcomes study Short-Form-36 (SF-36), respectively. Results: One year after the surgery, % excess body mass index loss (%EBMIL) was 77.88 (26.33) in Group S, 76.21 (19.98) in Group C, p = 0.663. Patients in Group S tended more to choose snacks between main meals: 79.2% versus 28.7%, p < 0.0001. Cognitive restraint significantly increased in Group S from 45.93 (13.37) up to 54.48 (13.76), p = 0.001; additionally, significantly worse overall health status was found in Group S compared to Group C, 53.27 (24.61) versus 70.11 (31.63), p < 0.0001. Mental HRQoL (50.76 versus 60.52 score, p < 0.0001) and social functioning (44.79 versus 57.90, p < 0.0001) were worse in Group S. Conclusions: In this study, the COVID-19 pandemic had no impact on short-term weight loss after RYGB. However, one year after, RYGB patients tended to snack more, and mental HRQoL and social functioning were worse in the study group.
Collapse
Affiliation(s)
- Karolina Bauraitė
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Science, 44307 Kaunas, Lithuania
| | - Rita Gudaitytė
- Department of Surgery, Medical Academy, Lithuanian University of Health Science, 44307 Kaunas, Lithuania; (R.G.); (A.M.)
| | - Almantas Maleckas
- Department of Surgery, Medical Academy, Lithuanian University of Health Science, 44307 Kaunas, Lithuania; (R.G.); (A.M.)
- Department of Gastrosurgical Research and Education, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden
| |
Collapse
|
5
|
Wiśniewski OW, Czyżniewski B, Żukiewicz-Sobczak W, Gibas-Dorna M. Nutritional Behavior in European Countries during COVID-19 Pandemic-A Review. Nutrients 2023; 15:3451. [PMID: 37571387 PMCID: PMC10420667 DOI: 10.3390/nu15153451] [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: 06/18/2023] [Revised: 07/23/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
COVID-19 is highly linked with hyperinflammation and dysfunction of the immune cells. Studies have shown that adequate nutrition, a modifiable factor affecting immunity and limiting systemic inflammation, may play an adjunct role in combating the negative consequences of SARS-CoV-2 infection. Due to the global lockdown conditions, the COVID-19 pandemic has contributed, among others, to restrictions on fresh food availability and changes in lifestyle and eating behaviors. The aim of this paper was to review the data regarding eating habits in European countries within the general population of adults and some specific subpopulations, including obese, diabetic, and psychiatric patients, during the COVID-19 pandemic. The PubMed database and the official websites of medical organizations and associations were searched for the phrases "COVID" and "eating habits". Papers regarding the pediatric population, non-European countries, presenting aggregated data from different countries worldwide, and reviews were excluded. During the COVID-19 pandemic, unhealthy lifestyles and eating behaviors were commonly reported. These included increased snacking, intake of caloric foods, such as sweets, pastries, and beverages, and a decline in physical activity. Data suggest that poor eating habits that create a positive energy balance have persisted over time as an additional post-COVID negative consequence.
Collapse
Affiliation(s)
- Oskar Wojciech Wiśniewski
- Department of Cardiology-Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355 Poznan, Poland
- Department of Nutrition and Food, Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Bartłomiej Czyżniewski
- Faculty of Medicine, Collegium Medicum, University of Zielona Gora, 28 Zyty Street, 65-046 Zielona Gora, Poland;
| | - Wioletta Żukiewicz-Sobczak
- Department of Nutrition and Food, Faculty of Health Sciences, Calisia University, 62-800 Kalisz, Poland;
| | - Magdalena Gibas-Dorna
- Collegium Medicum, Institute of Health Sciences, University of Zielona Gora, 28 Zyty Street, 65-046 Zielona Gora, Poland
| |
Collapse
|
6
|
Murtha JA, Alagoz E, Breuer CR, Eierman L, Jawara D, Farrar-Edwards D, Voils CI, Funk LM. Impact of COVID-19 on the Postoperative Bariatric Surgery Patient Experience. Ann Surg 2023; 277:e745-e751. [PMID: 35794783 DOI: 10.1097/sla.0000000000005446] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To characterize patient and provider perceptions of the impact of coronavirus disease 2019 (COVID-19) on weight loss following bariatric surgery. BACKGROUND COVID-19 has disrupted routines and healthcare throughout the United States, but its impact on bariatric surgery patients' postoperative experience is unknown. METHODS Semistructured interviews with bariatric surgery patients, primary care providers, and health psychologists were conducted from April to November 2020. As part of a secondary analysis, patients and providers described how the COVID-19 pandemic affected the postoperative experience within 3 domains: dietary habits, physical activity, and follow-up care. Interview guides were created from 2 conceptual models: Torain's Surgical Disparities Model and Andersen's Behavioral Model of Health Services Use. Study team members derived codes, which were grouped into themes using conventional content analysis. RESULTS Thirty-four participants were interviewed: 24 patients (12 Roux-en-Y gastric bypass and 12 sleeve gastrectomy), 6 primary care providers, and 4 health psychologists. Patients were predominately female (83%) and White (79%). Providers were predominately female (90%) and White (100%). COVID-19 affected the postoperative bariatric surgery patient experience via 3 mechanisms: (1) it disrupted dietary and physical activity routines due to facility closures and fear of COVID-19 exposure; (2) it required patients to transition their follow-up care to telemedicine delivery; and (3) it increased stress due to financial and psychosocial challenges. CONCLUSIONS COVID-19 has exacerbated patient vulnerability. The pandemic is not over, thus bariatric surgery patients need ongoing support to access mental health professionals, develop new physical activity routines, and counteract increased food insecurity.
Collapse
Affiliation(s)
- Jacqueline A Murtha
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
| | - Esra Alagoz
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
| | - Catherine R Breuer
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
| | - Lindsey Eierman
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
| | - Dawda Jawara
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
| | - Dorothy Farrar-Edwards
- Collaborative Center for Health Equity, University of Wisconsin, Madison, WI
- Department of Medicine, University of Wisconsin Madison School of Education, Madison, WI
| | - Corrine I Voils
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
- William S. Middleton Memorial Veterans Administration Hospital, Madison, WI
| | - Luke M Funk
- Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin-Madison, Madison, WI
- William S. Middleton Memorial Veterans Administration Hospital, Madison, WI
| |
Collapse
|
7
|
Associations of COVID-19 Lockdowns on Eating Behaviors and Body Mass Index in Patients with a History of Bariatric Surgery: a Cross-Sectional Analysis. Obes Surg 2023; 33:1099-1107. [PMID: 36763309 PMCID: PMC9912237 DOI: 10.1007/s11695-023-06460-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 01/10/2023] [Accepted: 01/17/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Few studies have explored the impact of the COVID-19 pandemic on the eating behaviors, dietary quality, and changes in weight of postoperative bariatric surgery patients. METHODS A cross-sectional survey on eating behaviors and attitudes toward food was emailed or given to patients who had bariatric surgery before March 2020. Patient charts were reviewed for weight measures. RESULTS Seventy-five (71.43%) patients experienced weight recurrence with an average increase in body mass index (BMI) of 2.83 kg/m2 (SD: 2.19). The majority of patients reported no symptoms of binge eating (n = 81, 77.14%) with 16 (15.24%) qualifying for loss of control eating (LOCE). LOCE was significantly associated with grazing behavior (p = 0.04), emotional over-eating (p = 0.001), and food responsiveness (p = 0.002). LOCE was negatively associated with dietary quality (p = 0.0009) and satiety responsiveness (p = 0.01). Grazing behavior was significantly associated with emotional over-eating (p < 0.0001) and food responsiveness (p < 0.0001) as well as negatively associated with dietary quality (p < 0.0001). Slow eating was negatively associated with grazing (p = 0.01), emotional over-eating (p = 0.003), and food responsiveness (p < 0.0001). When included in a regression model controlling for age and sex, emotional over-eating was a significant predictor of weight recurrence (β = 0.25; p = 0.04). CONCLUSION Our results suggest that maladaptive eating behaviors contributed to LOCE and poor dietary quality during the COVID-19 pandemic; however, slow eating may be protective against grazing, emotional over-eating, and food responsiveness.
Collapse
|
8
|
Salituro N, Landi G, Garelli S, Balsamo F, Rottoli M, Cattivelli R, Tossani E, Grandi S, Pagotto U, Bernante P, Agostini A. The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis. J Psychosom Res 2023; 165:111144. [PMID: 36608506 PMCID: PMC9805045 DOI: 10.1016/j.jpsychores.2022.111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified. We hypothesized that compared to post-bariatric patients with low psychological distress, post-bariatric patients with high psychological distress will be more at risk of weight regain. METHODS A total of 67 patients (71.6% female, Mage = 45.9) participated in this observational retrospective cohort study. Patients' anthropometric data were gathered from medical records while the weight at the end of the lockdown through phone interviews. Psychological distress, operationalized with anxiety symptoms, depressive symptoms, and sleep disturbances, was assessed by an online self-report questionnaire. RESULTS Significant differences were highlighted in the high and low psychological distressed group in weight changes, F(1,58) = 5.2, p < 0.001, η2 = 0.3. Specifically, compared to post-bariatric patients in the low psychological distress group, those in the high psychological distressed group reported weight regained (95% CI = 1.0, 2.6). CONCLUSION Results highlight the need to target post-bariatric patients with high psychological distress who are at risk for weight regain during the COVID-19 pandemic. Interventions mitigating psychological distress and obesogenic behaviors during future pandemics or in post-COVID times are needed in vulnerable post-bariatric patients reporting high psychological distress.
Collapse
Affiliation(s)
- N. Salituro
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G. Landi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy,Corresponding author at: Department of Psychology, University of Bologna, viale Berti Pichat 5, Bologna 40127, Italy
| | - S. Garelli
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F. Balsamo
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
| | - M. Rottoli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R. Cattivelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - E. Tossani
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - S. Grandi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - U. Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P. Bernante
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - A. Agostini
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
| |
Collapse
|
9
|
Haghighat N, Foroutan H, Hesameddini I, Amini M, Hosseini B, Moeinvaziri N, Hosseini SV, Kamran H. Impact of the COVID-19 Pandemic on the Success of Bariatric Surgeries in Patients with Severe Obesity. Obes Facts 2023; 16:82-88. [PMID: 36380632 PMCID: PMC9808887 DOI: 10.1159/000528082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/09/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION SARS-CoV-2 infection (COVID-19) pandemic may influence the weight outcomes of bariatric surgeries (BS). Here, we intended to compare the weight outcome of patients who underwent BS before and during the pandemic time. METHODS In a retrospective, single-center study, the information of two groups of patients; first COVID-19 group (n = 51) consisted of those that underwent BS during the pandemic and completed a year of follow-up, second non-COVID-19 group included 50 patients who underwent BS and were followed up before the pandemic. All the patients' anthropometric and obesity-related disease data were compared between groups. RESULTS Weight loss and the decrease of body mass index 1 year after the surgery, as well as excess weight loss and total weight loss, were significantly higher in the non-COVID-19 group compared to the COVID-19 group (p < 0.05). Although the rate of remission for diabetes mellitus, hypertension, and dyslipidemia was higher in the non-COVID-19 group, the differences were not statistically significant (p > 0.05). CONCLUSION We showed a significantly poorer weight outcome at the 1-year follow-up of the BS during the pandemic compared to the pre-pandemic. These results need further investigations to determine the preventive measures and management by evaluating the associated factors.
Collapse
Affiliation(s)
- Neda Haghighat
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Foroutan
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Iman Hesameddini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoud Amini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Babak Hosseini
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Moeinvaziri
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Hooman Kamran
- Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- *Hooman Kamran,
| |
Collapse
|
10
|
Polese L, Prevedello L, Belluzzi A, Giugliano E, Albanese A, Foletto M. Endoscopic sleeve gastroplasty: results from a single surgical bariatric centre. Updates Surg 2022; 74:1971-1975. [PMID: 36168089 PMCID: PMC9514673 DOI: 10.1007/s13304-022-01385-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/13/2022] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the safety and efficacy of the endoscopic sleeve gastroplasty (ESG) procedure. Patients ineligible for bariatric surgery due to comorbidities or low Body Mass Index (BMI) were offered ESG. Gastric tubularization was carried out via multiple multi-bite sutures across the greater curvature of the stomach. The patients underwent a water-soluble swallow test on post-operative day 1 (POD-1) to assess gastric emptying and were placed on a soft diet if upper GI tract function was confirmed. From January 2019 to March 2022, 27 patients underwent ESG: 14 for severe obesity with comorbidities, including liver transplant, end-stage kidney disease, severe cardiovascular and respiratory diseases. The mean BMI before treatment was 36 ± 9 kg/m2. Two patients (7%) who developed gastric bleeding were successfully treated with packed red blood cells (PRBC) transfusions. After a mean follow-up of 18 months, the percentage of total body weight loss (%TBWL) and the percentage of excess weight (%EWL) were 11 ± 7 and 39 ± 27, respectively. The latter was significantly higher in the patients with an initial BMI < 40 kg/m2 (50 vs 22, p < 0.05). The patients whose gastric sleeve extended for more than a third of the length of the stomach (p < 0.05) had better results. ESG was found to be effective and safe in high-risk surgical patients whose initial BMI was (< 40). Studies characterized by larger number of patients and longer follow-up periods will be able to confirm these results.
Collapse
Affiliation(s)
- Lino Polese
- 1St Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Chirurgia Generale 1, sesto piano Policlinico, Azienda Ospedale-Università Padova University of Padova, Via Giustiniani 2, 35128, Padua, Italy.
| | - Luca Prevedello
- Bariatric Unit, Week Surgery, Padova University Hospital, University of Padova, Padua, Italy
| | - Amanda Belluzzi
- Bariatric Unit, Week Surgery, Padova University Hospital, University of Padova, Padua, Italy
| | - Emilia Giugliano
- 1St Surgical Unit, Department of Surgery, Oncology and Gastroenterology, Chirurgia Generale 1, sesto piano Policlinico, Azienda Ospedale-Università Padova University of Padova, Via Giustiniani 2, 35128, Padua, Italy
| | - Alice Albanese
- Bariatric Unit, Week Surgery, Padova University Hospital, University of Padova, Padua, Italy
| | - Mirto Foletto
- Bariatric Unit, Week Surgery, Padova University Hospital, University of Padova, Padua, Italy
| |
Collapse
|
11
|
McLean CP, Utpala R, Sharp G. The impacts of COVID-19 on eating disorders and disordered eating: A mixed studies systematic review and implications. Front Psychol 2022; 13:926709. [PMID: 36148134 PMCID: PMC9487416 DOI: 10.3389/fpsyg.2022.926709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 08/02/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose The unique constraints to everyday life brought about by the COVID-19 pandemic have been suggested to negatively impact those with pre-existing mental health issues such as eating disorders. While individuals with eating disorders or disordered eating behaviors likely represent a vulnerable group to the COVID-19 pandemic, the impact of the pandemic is yet to be fully established. Methods We systematically examined the impact of the COVID-19 pandemic on eating disorders and disordered eating behaviors. We searched electronic databases MEDLINE, PsycINFO, CINAHL, and EMBASE for literature published until October 2021. Eligible studies were required to report on individuals with or without a diagnosed eating disorder or disordered eating behaviors who were exposed to the COVID-19 pandemic. Findings Seventy-two studies met eligibility criteria with the majority reporting an increase in eating disorder or disordered eating behaviors associated with the COVID-19 pandemic. Specifically, it appears children and adolescents and individuals with a diagnosed eating disorder may present vulnerable groups to the impacts of the COVID-19 pandemic. Discussion This mixed systematic review provides a timely insight into COVID-19 eating disorder literature and will assist in understanding possible future long-term impacts of the pandemic on eating disorder behaviors. It appears that the role of stress in the development and maintenance of eating disorders may have been intensified to cope with the uncertainty of the COVID-19 pandemic. Future research is needed among understudied and minority groups and to examine the long-term implications of the COVID-19 pandemic on eating disorders and disordered eating behaviors. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=284749, PROSPERO [CRD42021284749].
Collapse
Affiliation(s)
- Courtney P. McLean
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC, Australia
- *Correspondence: Courtney P. McLean
| | | | - Gemma Sharp
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Moraes CEF, Heriseanu A, Mourilhe C, Faller ALK, Hay P, Appolinario JC. Validation of the Brazilian version of the Short Inventory of Grazing (SIG). TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 46:e20220492. [PMID: 35943264 PMCID: PMC11140765 DOI: 10.47626/2237-6089-2022-0492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 07/29/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Grazing is a disturbed eating pattern that has been associated with eating disorders and obesity. One of the new measures to investigate this eating behavior is the Short Inventory of Grazing (SIG), a two-item questionnaire that assesses grazing in general and grazing associated with the feeling of loss of control over eating (LOC grazing). However, the psychometric properties of the SIG have not been assessed in the Brazilian population. The present study aimed to cross-culturally adapt and validate a Brazilian version of the SIG. METHODS The SIG was adapted to the Brazilian context following international guidelines. Then, 90 undergraduate students completed an online survey including questions from the SIG, the Binge Eating Scale (BES), the Patient Health Questionnaire-9 (PHQ9), the Generalized Anxiety Disorder-7 (GAD7), and a question related to self-reported health status. The internal consistency, test-retest reliability, and convergent validity of the questionnaire were assessed. RESULTS The prevalence rates of at least one weekly episode of grazing in general and LOC grazing were 71.1 and 54.5%, respectively. The internal consistence of the SIG was acceptable (0.81). In addition, SIG scores on both items were positively and significantly associated with BES, GAD7, and PHQ9 scores, and with poorer self-rated health. However, SIG test and retest scores differed significantly. CONCLUSION Overall, the Brazilian version of the SIG demonstrated adequate psychometric properties. The instrument had adequate internal consistency, with both items exhibiting good convergent validity with related measures.
Collapse
Affiliation(s)
- Carlos Eduardo Ferreira Moraes
- Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Andreea Heriseanu
- Department of Psychology, eCentreClinic, Macquarie University, Sydney, NSW, Australia
| | - Carla Mourilhe
- Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Ana Luisa Kremer Faller
- Departamento de Nutrição Social e Aplicada, Instituto de Nutrição Josué de Castro, UFRJ, Rio de Janeiro, RJ, Brazil
| | - Phillipa Hay
- Translational Health Research Institute, School of Medicine, Western Sydney University, Sydney, NSW, Australia
| | - Jose Carlos Appolinario
- Grupo de Obesidade e Transtornos Alimentares (GOTA), Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| |
Collapse
|
13
|
Athinarayanan SJ, Adams RN, VanTieghem M, McKenzie AL, Volk BM, Ratner RE, Phinney SD. Impact of the COVID-19 Pandemic on the Effectiveness of a Metabolic Health Telemedicine Intervention for Weight Loss: A Propensity Score Matching Analysis. Front Public Health 2022; 10:897099. [PMID: 35784202 PMCID: PMC9246258 DOI: 10.3389/fpubh.2022.897099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCoronavirus disease 2019 (COVID-19) pandemic public health measures such as stay-at-home and mandatory work-from-home orders have been associated with obesogenic lifestyle changes, increased risk of weight gain, and their metabolic sequelae. We sought to assess the impact of this pandemic on weight loss from a telemedicine-delivered very-low-carbohydrate intervention targeting nutritional ketosis (NKI).MethodsA total of 746 patients with a BMI ≥25kg/m2, enrolled between January and March 2020 and treated for at least 1 year with the NKI, were classified as pandemic cohort (PC). A separate cohort of 699 patients who received 1 year of the NKI in the preceding years, enrolled between January and March 2018, were identified as pre-pandemic cohort (Pre-PC). Demographic and clinical data were obtained from medical records to compare the cohorts and assess the outcomes. Using propensity score matching (PSM), balanced and matched groups of 407 patients in the Pre-PC and 407 patients in the PC were generated. Longitudinal change in absolute weight and percentage weight change from baseline to 1 year were assessed.ResultsWeight significantly decreased in both PC and Pre-PC at 3, 6, 9, and 12 months. The weight loss trajectory was similar in both PC and Pre-PC with no significant weight differences between the two cohorts at 3, 6, 9, and 12 months. On an average, the PC lost 7.5% body weight while the Pre-PC lost 7.9% over 1 year, and the percent weight loss did not differ between the two cohorts (p = 0.50).ConclusionA very-low-carbohydrate telemedicine intervention delivered comparable and medically significant weight loss independent of pandemic stress and lifestyle limitations.
Collapse
|
14
|
Gao Y, Bagheri N, Furuya-Kanamori L. Has the COVID-19 pandemic lockdown worsened eating disorders symptoms among patients with eating disorders? A systematic review. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2022; 30:2743-2752. [PMID: 35369670 PMCID: PMC8961480 DOI: 10.1007/s10389-022-01704-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/06/2022] [Indexed: 01/05/2023]
Abstract
Objective During the coronavirus pandemic lockdowns, general medical complications have received the most attention, and few studies have examined the association between the COVID-19 lockdown and eating disorders (ED). This study aimed to investigate the impact of the coronavirus lockdowns on ED symptoms severity and summarize factors associated with lockdowns that led to changes in eating disorders. Method PubMed, Scopus, and Cochrane Library databases were searched for studies measuring the impact of coronavirus lockdowns on ED symptoms. Results A total of 132 studies were retrieved, after abstract screening and removal of duplicates, 21 papers were full-text screened, and 11 eligible papers were identified. Factors associated with symptomatic deterioration in ED patients during COVID-19 lockdowns included disruption of lifestyle routine, social isolation, reduced access to usual support networks, limited or no access to healthcare and mental care services, and social anxiety. Discussion Overall, the pandemic lockdowns were associated with worsening of eating disorders. This triggering environment can lead to increased anxiety and depression symptoms, change in dietary habits, and eventually result in worsening eating disorder symptoms.
Collapse
Affiliation(s)
- Yunqi Gao
- Centre for Research on Ageing, Health & Wellbeing, Australian National University, Acton, ACT 2601 Australia
| | - Nasser Bagheri
- Centre for Mental Health Research, Australian National University, Acton, ACT 2601 Australia.,The Visual and Decision Analytics (VIDEA) Lab, Health Research Institute, The University of Canberra, Bruce, Australia
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, The University of Queensland, Herston, QLD 4029 Australia
| |
Collapse
|
15
|
Schneider J, Pegram G, Gibson B, Talamonti D, Tinoco A, Craddock N, Matheson E, Forshaw M. A mixed-studies systematic review of the experiences of body image, disordered eating, and eating disorders during the COVID-19 pandemic. Int J Eat Disord 2022; 56:26-67. [PMID: 35322449 PMCID: PMC9087368 DOI: 10.1002/eat.23706] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/05/2022] [Accepted: 03/05/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This systematic review assessed the influence of the COVID-19 pandemic and associated restrictions on body image, disordered eating (DE), and eating disorder outcomes. METHODS After registration on PROSPERO, a search was conducted for papers published between December 1, 2019 and August 1, 2021, using the databases PsycINFO, PsycARTICLES, CINAHL Plus, AMED, MEDLINE, ERIC, EMBASE, Wiley, and ProQuest (dissertations and theses). RESULTS Data from 75 qualitative, quantitative, and mixed-methods studies were synthesized using a convergent integrated approach and presented narratively within four themes: (1) disruptions due to the COVID-19 pandemic; (2) variability in the improvement or exacerbation of symptoms; (3) factors associated with body image and DE outcomes; (4) unique challenges for marginalized and underrepresented groups. Disruptions due to the pandemic included social and functional restrictions. Although most studies reported a worsening of concerns, some participants also reported symptom improvement or no change as a result of the pandemic. Factors associated with worse outcomes included psychological, individual, social, and eating disorder-related variables. Individuals identifying as LGBTQ+ reported unique concerns during COVID-19. DISCUSSION There is large variability in individuals' responses to COVID-19 and limited research exploring the effect of the pandemic on body image, DE, and eating disorder outcomes using longitudinal and experimental study designs. In addition, further research is required to investigate the effect of the COVID-19 pandemic on body image and eating concerns among minoritized, racialized, underrepresented, or otherwise marginalized participants. Based on the findings of this review, we make recommendations for individuals, researchers, clinicians, and public health messaging. PUBLIC SIGNIFICANCE This review of 75 studies highlights the widespread negative impacts that the COVID-19 pandemic and associated restrictions have had on body image and disordered eating outcomes. It also identifies considerable variations in both the improvement and exacerbation of said outcomes that individuals, researchers, clinicians, and other public health professionals should be mindful of if we are to ensure that vulnerable people get the tailored support they require.
Collapse
Affiliation(s)
- Jekaterina Schneider
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Georgina Pegram
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Benjamin Gibson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Deborah Talamonti
- Research Centre and Centre EPICMontreal Heart InstituteMontrealQuebecCanada
| | - Aline Tinoco
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Nadia Craddock
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Emily Matheson
- Centre for Appearance Research, Department of Health and Social SciencesUniversity of the West of EnglandBristolUK
| | - Mark Forshaw
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| |
Collapse
|
16
|
Sockalingam S, Leung SE, Ma C, Hawa R, Wnuk S, Dash S, Jackson T, Cassin SE. The Impact of Telephone-Based Cognitive Behavioral Therapy on Mental Health Distress and Disordered Eating Among Bariatric Surgery Patients During COVID-19: Preliminary Results from a Multisite Randomized Controlled Trial. Obes Surg 2022; 32:1884-1894. [PMID: 35218006 PMCID: PMC8880302 DOI: 10.1007/s11695-022-05981-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/30/2022]
Abstract
Background Patients undergoing bariatric surgery have high rates of psychiatric comorbidity, which may increase their vulnerability to COVID-19-related mental health distress. Exacerbation of mental health distress and disordered eating could have significant negative effects on long-term weight management and quality of life for these patients if untreated. Objective To determine the efficacy of a telephone-based cognitive behavioral therapy (Tele-CBT) intervention in improving depressive, anxiety, and disordered eating symptoms during COVID-19. Methods Participants were recruited as part of a larger randomized controlled trial study (clinicaltrials.gov ID: NCT03315247) between March 2020 and March 2021 and randomized 1:1 to receive Tele-CBT or standard bariatric care. Outcomes of Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Emotional Eating Scale (EES), and Binge Eating Scale (BES) were measured at baseline, immediately post-intervention, and 3 months post-intervention. Linear mixed models were used to test the effect of intervention group, time, and group-by-time interaction for each outcome. Results Eighty-one patients were included in the intention-to-treat analysis. Mean (SD) age of participants was 47.68 (9.36) years and 80.2% were female. There were significant group-by-time interactions for all outcomes and significant differences between groups across time. There were significant decreases in mean GAD-7 (p = 0.001), PHQ-9 (p < 0.001), EES-Total (p = 0.001), EES-Anger (p = 0.003), EES-Anxiety (p < 0.001), EES-Depression (p < 0.001), and BES (p = 0.002) scores for the Tele-CBT group at post-intervention and follow-up when compared to baseline and the control group. Conclusion Tele-CBT is a feasible and effective treatment for improving psychological distress and disordered eating among post-operative bariatric surgery patients during the COVID-19 pandemic. Graphical abstract ![]()
Collapse
Affiliation(s)
- Sanjeev Sockalingam
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada. .,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. .,Centre for Addiction and Mental Health, ON, M6J 1H4, Toronto, Canada. .,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada.
| | - Samantha E Leung
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada
| | - Clement Ma
- Centre for Addiction and Mental Health, ON, M6J 1H4, Toronto, Canada.,Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada
| | - Raed Hawa
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Susan Wnuk
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada
| | - Satya Dash
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Department of Medicine, University of Toronto, Toronto, ON, M5S 3H2, Canada
| | - Timothy Jackson
- Bariatric Surgery Program, University Health Network, Toronto, ON, M5T 2S8, Canada.,Division of General Surgery, University Health Network, University of Toronto, Toronto, ON, M5T 2S8, Canada
| | - Stephanie E Cassin
- Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada.,Centre for Mental Health, University Health Network, Toronto, ON, M5G 2C4, Canada.,Department of Psychology, Ryerson University, Toronto, ON, M5B 2K3, Canada
| |
Collapse
|
17
|
Caldwell AE, Thomas EA, Rynders C, Holliman BD, Perreira C, Ostendorf DM, Catenacci VA. Improving lifestyle obesity treatment during the COVID-19 pandemic and beyond: New challenges for weight management. Obes Sci Pract 2022; 8:32-44. [PMID: 34540266 PMCID: PMC8441901 DOI: 10.1002/osp4.540] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/12/2022] Open
Abstract
Objective The COVID-19 pandemic has resulted in significant changes to daily life and many health-related behaviors. The objective of this study was to examine how the stay-at-home/safer-at-home mandates issued in Colorado (March 2020-May 2020) impacted lifestyle behaviors and mental health among individuals with overweight or obesity participating in two separate behavioral weight loss trials (n = 82). Methods Questionnaires were used to collect qualitative and quantitative data on challenges to weight loss presented by the COVID-19 pandemic, including changes in dietary intake, physical activity, sedentary behavior, and mental health during the stay-at-home/safer-at-home mandates. Results Using a convergent mixed method approach integrating qualitative and quantitative data, the greatest challenge experienced by participants was increased stress and anxiety, which led to more unhealthy behaviors. The majority perceived it to be harder to adhere to the prescribed diet (81%) and recommended physical activity (68%); however, self-reported exercise on weekdays increased significantly and 92% of participants lost weight or maintained weight within ±1% 5-6 weeks following the stay-at-home mandate. Conclusion Study results suggest that obesity treatment programs should consider and attempt to address the burden of stress and anxiety stemming from the COVID-19 pandemic and other sources due to the negative effects they can have on weight management and associated behaviors.
Collapse
Affiliation(s)
- Ann E. Caldwell
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Elizabeth A. Thomas
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Rocky Mountain Regional Veterans Affairs Medical CenterAuroraCOUSA
| | - Corey Rynders
- Division of Geriatric MedicineDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Eastern Colorado Veterans Affairs Geriatric Research, Educationand Clinical CenterDenverCOUSA
| | - Brooke Dorsey Holliman
- Department of Family MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)Children's Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Cathryn Perreira
- Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS)Children's Hospital ColoradoUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Danielle M. Ostendorf
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | - Victoria A. Catenacci
- Department of MedicineAnschutz Health and Wellness CenterUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
- Division of EndocrinologyMetabolism, and DiabetesDepartment of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| |
Collapse
|
18
|
In Response to: Impact of COVID-19 Lockdown on Short-Term Weight Loss in a Single Italian Institution-1-Year Updated Data. Obes Surg 2022; 32:952-953. [PMID: 35040022 PMCID: PMC8763430 DOI: 10.1007/s11695-021-05832-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/19/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022]
|
19
|
Vitiello A, Berardi G, Musella M. Reply to the Response to: Impact of COVID-19 Lockdown on Short-Term Weight Loss in a Single Italian Institution: 1-Year Updated Data. Obes Surg 2022; 32:954. [PMID: 35034273 PMCID: PMC8761100 DOI: 10.1007/s11695-021-05833-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/02/2021] [Accepted: 12/13/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Antonio Vitiello
- Advanced Biomedical Sciences Department, Naples "Federico II" University, AOU "Federico II" - Via S. Pansini 5, 80131, Napoli, Italy.
| | - Giovanna Berardi
- Advanced Biomedical Sciences Department, Naples "Federico II" University, AOU "Federico II" - Via S. Pansini 5, 80131, Napoli, Italy
| | - Mario Musella
- Advanced Biomedical Sciences Department, Naples "Federico II" University, AOU "Federico II" - Via S. Pansini 5, 80131, Napoli, Italy
| |
Collapse
|
20
|
Strong H, Reiter-Purtill J, Howarth T, West-Smith L, Zeller MH. Early COVID-19 Vaccine Hesitancy Characteristics in Mothers Following Bariatric Surgery. Obes Surg 2022; 32:852-860. [PMID: 34997432 PMCID: PMC8741570 DOI: 10.1007/s11695-021-05872-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Obesity has played a central role in heightened coronavirus disease 2019 (COVID-19) risk and vaccine response. COVID-19 vaccine intention among those with a history of severe obesity, specifically those who have undergone bariatric surgery, has not been described. This study aims to examine early COVID-19 vaccine intention among mothers with a history of severe obesity who underwent bariatric surgery. METHODS Sixty-four mothers (Mage = 39.3 years) who underwent bariatric surgery (Mtime since surgery = 19.6 months) completed surveys online (November 2020-February 2021). Information obtained included their COVID-19 vaccine intention (vaccine ready, undecided, vaccine opposed). Analyses examined group differences in demographics, body mass index (BMI = kg/m2), knowledge of obesity-related COVID-19 risk, flu vaccination history, general beliefs about vaccine safety/effectiveness, and factors increasing confidence/motivation to obtain a COVID-19 vaccine. RESULTS Thirty-six (56.3%) mothers had severe obesity (≥ Class II [BMI = ≥ 35 kg/m2]). The majority were vaccine hesitant (undecided [n = 28; 43.8%]; vaccine opposed [n = 15; 23.4%]). Compared to the vaccine-ready group, vaccine-hesitant groups were younger (p < .05). For the vaccine opposed, recent flu vaccination rates (p = .012) and general belief that vaccines are safe (p = .028) were lower than expected. Among hesitant participants, no reported side effects and the health of self and others were endorsed as top factors increasing vaccine confidence and motivation respectively. CONCLUSIONS While preliminary, the prominence of early vaccine hesitancy in this sample of mothers who have undergone bariatric surgery, with most persisting with severe obesity, indicates a subgroup at high risk. Factors to address through targeted messaging and intervention were identified.
Collapse
Affiliation(s)
- Heather Strong
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Taylor Howarth
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
| | - Lisa West-Smith
- Department of Psychiatry and Behavioral Neuroscience & Department of Surgery, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA
| | - Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH, 45267, USA
| |
Collapse
|
21
|
Andreu A, Flores L, Molero J, Mestre C, Obach A, Torres F, Moizé V, Vidal J, Navinés R, Peri JM, Cañizares S. Patients Undergoing Bariatric Surgery: a Special Risk Group for Lifestyle, Emotional and Behavioral Adaptations During the COVID-19 Lockdown. Lessons from the First Wave. Obes Surg 2021; 32:441-449. [PMID: 34791617 PMCID: PMC8598099 DOI: 10.1007/s11695-021-05792-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/07/2023]
Abstract
Objectives
To determine how the COVID-19 lockdown influenced the lifestyle, eating behavior, use of substances, mental health, and weight in patients who had undergone bariatric surgery (BS) and explore the self-perception of one’s own health and fears related to COVID-19. Methods We performed a cross-sectional exploratory study in obesity patients who had undergone BS surgery > 1 year previously in a university hospital. Assessment was performed 40 days after initiating lockdown and included 2 periods: from April 24 until May 8 and during the initial de-escalation period: from May 9 until 22, 2020. A structured telephone interview and an online survey were administered. Results
One hundred eighty-eight patients were interviewed; 156 also responded to the online survey (77% females, mean age 53.46 ± 10.48 years, mean follow-up 5.71 ± 4.30 years). Dietary habits were affected in 72% of the participants, with 15% reporting better diet planning; 83.5% reported having more sedentary behaviors; 27% and 36% showed depression and anxiety, respectively; and 45% of participants reported bad sleep quality. In relation to changes in the use of any substance, the use increased in the majority of patients who were previously users. Self-perception of one’s own health and fears related to COVID-19 were only moderate. Finally, emotional eating and time since BS were statistically significant risk factors for predicting weight gain. Conclusions Lockdown during COVID-19 pandemic negatively influenced the lifestyle, mental health, substance use, and weight in BS patients. These alterations were somewhat similar to those observed in the general population but more severe and with important clinical implications. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05792-1.
Collapse
Affiliation(s)
- Alba Andreu
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain.,CIBER Obesity and Nutrition (CIBEROBN), Barcelona, Spain
| | - Lilliam Flores
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain.,CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - Judit Molero
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain
| | - Carla Mestre
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain
| | - Amadeu Obach
- Section of Clinical Health Psychology, Psychiatry and Psychology Department, Hospital Clinic, 140 Rosellón Street, 08036, Barcelona, Spain
| | - Ferran Torres
- Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona; Medical Statistics Core Facility, IDIBAPS, Hospital Clinic Barcelona, Barcelona, Spain
| | - Violeta Moizé
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain.,CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - Josep Vidal
- Endocrinology and Nutrition Department, Obesity Unit, Hospital Clinic, 170, Villarroel Street, Helios office 9, 08036, Barcelona, Spain.,CIBER Diabetes and Associated Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - Ricard Navinés
- Section of Clinical Health Psychology, Psychiatry and Psychology Department, Hospital Clinic, 140 Rosellón Street, 08036, Barcelona, Spain
| | - Josep M Peri
- Section of Clinical Health Psychology, Psychiatry and Psychology Department, Hospital Clinic, 140 Rosellón Street, 08036, Barcelona, Spain
| | - Silvia Cañizares
- Section of Clinical Health Psychology, Psychiatry and Psychology Department, Hospital Clinic, 140 Rosellón Street, 08036, Barcelona, Spain. .,Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Spain.
| |
Collapse
|
22
|
Meleo-Erwin ZC, Basch CH, Fera J, Smith B. Discussion of Weight Loss Surgery in Instagram Posts: Successive Sampling Study. JMIR Perioper Med 2021; 4:e29390. [PMID: 34723828 PMCID: PMC8593803 DOI: 10.2196/29390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/14/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The majority of American adults search for health and illness information on the internet. However, the quality and accuracy of this information are notoriously variable. With the advent of social media, US individuals have increasingly shared their own health and illness experiences, including those related to bariatric surgery, on social media platforms. Previous research has found that peer-to-peer requesting and giving of advice related to bariatric surgery on social media is common, that such advice is often presented in stark terms, and that the advice may not reflect patient standards of care. These previous investigations have helped to map bariatric surgery content on Facebook and YouTube. OBJECTIVE This objective of this study was to document and compare weight loss surgery (WLS)-related content on Instagram in the months leading up to the COVID-19 pandemic and 1 year later. METHODS We analyzed a total of 300 Instagram posts (50 posts per week for 3 consecutive weeks in late February and early March in both 2020 and 2021) uploaded using the hashtag #wls. Descriptive statistics were reported, and independent 1-tailed chi-square tests were used to determine if a post's publication year statistically affected its inclusion of a particular type of content. RESULTS Overall, advice giving and personal responsibility for outcomes were emphasized by WLS posters on Instagram. However, social support was less emphasized. The safety, challenges, and risks associated with WLS were rarely discussed. The majority of posts did not contain references to facts from reputable medical sources. Posts published in 2021 were more likely to mention stress/hardships of living with WLS (45/150, 30%, vs 29/150, 19.3%; P=.03); however, those published in 2020 more often identified the importance of ongoing support for WLS success (35/150, 23.3%, vs 16/150, 10.7%; P=.004). CONCLUSIONS Given that bariatric patients have low rates of postoperative follow-up, yet post-operative care and yet support are associated with improved health and weight loss outcomes, and given that health content on the web is of mixed accuracy, bariatric professionals may wish to consider including an online support forum moderated by a professional as a routine part of postoperative care. Doing so may not only improve follow-up rates but may offer providers the opportunity to counter inaccuracies encountered on social media.
Collapse
Affiliation(s)
- Zoe C Meleo-Erwin
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, United States
| | - Corey H Basch
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, United States
| | - Joseph Fera
- Department of Mathematics, Lehman College, City University of New York, Bronx, NY, United States
| | - Bonnie Smith
- Department of Public Health, William Paterson University of New Jersey, Wayne, NJ, United States
| |
Collapse
|
23
|
Impact of COVID-19 Lockdown on Short-Term Weight Loss in a Single Italian Institution: 1-Year Updated Data. Obes Surg 2021; 32:924-925. [PMID: 34677756 PMCID: PMC8531909 DOI: 10.1007/s11695-021-05759-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 10/09/2021] [Accepted: 10/12/2021] [Indexed: 02/04/2023]
|
24
|
Wright C, Mutsekwa RN, Hamilton K, Campbell KL, Kelly J. Are eHealth interventions for adults who are scheduled for or have undergone bariatric surgery as effective as usual care? A systematic review. Surg Obes Relat Dis 2021; 17:2065-2080. [PMID: 34474983 DOI: 10.1016/j.soard.2021.07.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 11/18/2022]
Abstract
This systematic review aimed to evaluate the effect of eHealth-delivered interventions for adults who undergo bariatric surgery on postoperative weight loss, weight loss maintenance, eating psychopathology, quality of life, depression screening, and self-efficacy. Six electronic databases were searched, with 14 studies (across 17 reports) included, involving 1633 participants. With substantial heterogeneity, qualitative descriptions have been provided. Interventions were delivered via an online program or internet modules (n = 2), telephone (n = 2), text messages (n = 2), videoconferencing (n = 3), mobile application (n = 1), and audiovisual media (n = 1). Three studies included a combination, including internet modules and telephone (n = 1), wireless fidelity scales, emails, and telephone (n = 1), and a combination of online treatment, weekly emails, and access to a private Facebook group (n = 1). All the eHealth interventions, except for one, implemented behavior change techniques, including self-monitoring, problem solving, social support, goal setting, and shaping knowledge. Both eHealth intervention and control groups lost weight across the included studies, and eHealth was found to be as effective as or more effective than the control for weight loss. Two studies measured weight loss maintenance; both eHealth and control groups regained weight in the longer term. The interventions showed significant improvement on assessment measures for eating psychopathology. In conclusion, when bariatric surgery patients have limited or no access to healthcare teams or require additional support, eHealth may be a suitable option. Future studies implementing eHealth interventions would benefit from reporting intervention components as per the behavior change techniques taxonomy and further consideration of delivering eHealth in a stepped care approach would be beneficial.
Collapse
Affiliation(s)
- Charlene Wright
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Australia.
| | - Rumbidzai N Mutsekwa
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Australia; Gold Coast Hospital and Health Service, Nutrition and Food Service Department, Queensland, Australia; School of Allied Health Sciences, Griffith University, Queensland, Australia
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Queensland, Australia
| | - Katrina L Campbell
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Australia; Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Queensland, Australia
| | - Jaimon Kelly
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Australia; Centre for Online Health, Faculty of Medicine, University of Queensland, Queensland, Australia
| |
Collapse
|
25
|
Barranquero AG, Cimpean S, Raglione D, Cadière B, Maréchal MT, Pau L, Bez M, Cadière GB. Impact of the COVID-19 Pandemic and Lockdown on Gastric Bypass Results at 1-Year Follow-up. Obes Surg 2021; 31:4511-4518. [PMID: 34374929 PMCID: PMC8352749 DOI: 10.1007/s11695-021-05640-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/30/2022]
Abstract
Purpose The COVID-19 pandemic caused a lockdown in many countries, which induced negative dietary habits and sedentary behavior. Studies suggest that weight loss of patients undergoing bariatric surgery was equally affected. The aim was to evaluate the impact of COVID-19 on weight loss, obesity-related comorbidities, and nutritional status at 1-year follow-up after gastric bypass (GB). Methods Retrospective observational case–control study of patients undergoing primary GB in a tertiary referral Belgian center. COVID-19 period group was composed by those whose 1-year postoperative period was affected by the COVID-19 pandemic and lockdown: from October 1, 2019, to March 31, 2020. The control group was composed of patients operated from October 1, 2018, to March 31, 2019. Electronic clinical records were reviewed searching: baseline characteristics, weight and comorbidities evolution, and biochemical values. Results A total of 47 patients in the COVID-19 period group and 66 in the non-COVID-19 period group were analyzed. There were no significant differences in baseline characteristics. A reduced weight loss was observed at 1-year follow-up, in terms of percentage of excess weight loss (%EWL) (82.4% [SD: 21.6] vs. 82.4% [SD: 21.6]; p: 0.043) and body mass index (BMI) (27.8 kg/m2 [IQR: 25.8–30.0] vs. 26.2 kg/m2 [IQR: 24.6–28.6]; p: 0.029) for COVID-19 period group vs. non-COVID-19 period group, respectively. There was a similar reduction of obesity-related comorbidities, without clinically significant differences in the nutritional follow-up. Conclusion The COVID-19 pandemic and lockdown had an impact on weight loss at 1-year follow-up after gastric bypass. Graphical abstract ![]()
Collapse
Affiliation(s)
| | | | - Dario Raglione
- Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Benjamin Cadière
- Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | | | - Luca Pau
- Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Mattia Bez
- Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | | |
Collapse
|
26
|
Messiah SE, Uppuluri M, Xie L, Schellinger JN, Mathew MS, Ofori A, Kukreja S, Schneider B, Dunn SH, Tavakkoli A, Almandoz JP. Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients. Obes Surg 2021; 31:3738-3748. [PMID: 34041701 PMCID: PMC8154548 DOI: 10.1007/s11695-021-05488-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 02/06/2023]
Abstract
Purpose The impact of the COVID-19 pandemic on behavioral issues among those who have completed bariatric surgery (BS) is not well described in ethnically diverse populations. The aim of this study was to compare the impact of COVID-19 lockdown orders and after lockdown orders were lifted on substance use, mental health, and weight-related behaviors among a sample of post-BS adults. Materials and Methods A retrospective medical chart review identified BS patients from one university-based obesity medicine clinic and two BS practices. An online non-anonymous survey was implemented in two phases: during lockdown (April 1–May 31, 2020) and after lockdown orders were lifted (June 1, 2020–September 30, 2020) to obtain information about the COVID-19 pandemic’s impact on BS patients. Results A total of 189 (during lockdown=39, post-lockdown=150) participants (90.4% female, mean age 52.4 years, SD 11.1, 49.8% non-Hispanic White, 30.6% non-Hispanic Black, 16.1% Hispanic) participated. Lockdown participants were more likely to have sleep problems (74.3% vs. 56.1%, P=.039) and feel anxious (82.0% vs. 63.0%, P=.024) versus post-lockdown participants. A majority (83.4%) reported depression in both lockdown/post-lockdown. Post-lockdown participants were more than 20 times more likely to report substance use compared those in lockdown (aOR 20.56, 95% CI 2.66–158.4). Conclusions and Relevance The COVID-19 pandemic is having a substantial negative impact on substance use, mental health, and weight-related health behaviors in diverse BS patients. These findings have important implications for post-BS patient care teams and may suggest the integration of screening tools to identify those at high risk for behavioral health issues. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s11695-021-05488-6.
Collapse
Affiliation(s)
- Sarah E Messiah
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA.
- Center for Pediatric Population Health, Children's Health System of Texas and UT Health School of Public Health, Dallas, TX, USA.
| | - Maduri Uppuluri
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and UT Health School of Public Health, Dallas, TX, USA
| | - Luyu Xie
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and UT Health School of Public Health, Dallas, TX, USA
| | - Jeffrey N Schellinger
- Division of Endocrinology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - M Sunil Mathew
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and UT Health School of Public Health, Dallas, TX, USA
| | - Ashley Ofori
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
- Center for Pediatric Population Health, Children's Health System of Texas and UT Health School of Public Health, Dallas, TX, USA
| | | | - Benjamin Schneider
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Samuel H Dunn
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Anna Tavakkoli
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Jaime P Almandoz
- School of Public Health, University of Texas Health Science Center, Dallas, TX, USA
| |
Collapse
|
27
|
Félix S, de Lourdes M, Ribeiro I, Cunha B, Ramalho S, Vaz AR, Machado PPP, Conceição E. A preliminary study on the psychosocial impact of COVID-19 lockdown in post-bariatric surgery women: the importance of eating behavior, health care access, and social support. CURRENT PSYCHOLOGY 2021; 40:6275-6281. [PMID: 33679113 PMCID: PMC7914114 DOI: 10.1007/s12144-021-01529-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 12/11/2022]
Abstract
This study aims to characterize the psychosocial impact of COVID-19 lockdown for post-bariatric surgery (≥ 36 months) women and its association with disordered eating and psychological distress. The medium to long-time follow up is a period of increased susceptibility for poorer weight outcomes which might be triggered by the lockdown. Twenty-four participants responded to an online questionnaire and a telephone interview. About half (n = 14; 58.3%) reported perceived weight gain during the lockdown, 13 (54.1%) limited access to social support, and 12 (50%) limited access to medical care. Co-habiting with a higher number of persons during lockdown was associated with fewer difficulties in dealing with emotionally activating situations, less fear of gaining weight, less fear of losing control over eating, and less disordered eating. The global perceived psychosocial impact of lockdown was significantly correlated with difficulties in dealing with emotionally activating situations and stress symptoms. Results highlight the need to monitor post-bariatric patients, facilitate health care access, and promote social support during the lockdown period.
Collapse
Affiliation(s)
- Sílvia Félix
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Inês Ribeiro
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Bruna Cunha
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Paulo P P Machado
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Eva Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| |
Collapse
|
28
|
The COVID-19 Pandemic Did Not Affect Target Weight Loss 1 Year Post Bariatric Surgery. Obes Surg 2021; 31:4926-4932. [PMID: 34417939 PMCID: PMC8380004 DOI: 10.1007/s11695-021-05672-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/12/2021] [Accepted: 08/12/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Bariatric surgery is one of the most effective treatments for patients with severe and complex obesity. Lifestyle modifications in diet and exercise habits have long been important adjunct to the long-term success after bariatric surgery. The effect of the COVID-19 pandemic on the postoperative bariatric patient is not well understood. We sought to evaluate the impact the COVID-19 pandemic on postoperative weight loss at 1 year in a bariatric cohort. METHODS All patients who underwent bariatric surgery from January 1, 2020, to March 12, 2020, were included. Patients who underwent bariatric surgery during the same period of the two preceding years (2018 and 2019) were included as control groups. Primary end point was %EBMIL at 1 year. A telephone survey was administered to all patients from 2020 to assess for their perception on the effects of the COVID-19 pandemic on weight loss. RESULTS A total of 596 patients were included: 181 from 2020, 199 from 2019, and 216 from 2018. The response rate was 97% and 53.4% of patients reported that the lockdown affected their ability to lose weight. The %EBMIL at 1 year was 64.1%, 63.7%, and 68.1% for 2020, 2019, and 2018, respectively. There was no difference in weight loss at 1 year (p = 0.77) despite a decrease in exercise activity in those who had surgery just before the pandemic. CONCLUSION There was no difference in target weight loss at 1 year in a cohort who underwent bariatric surgery before the pandemic.
Collapse
|