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Şahan E, Zengin Eroğlu M, Sertçelik S. Eating behaviors, depression, and anxiety levels of pre bariatric surgery patients with obesity comorbid with or without Attention deficit and hyperactivity disorder: ADHD or Major Depression? Which is more related with eating behaviors? Brain Behav 2021; 11:e01915. [PMID: 33118314 PMCID: PMC7821566 DOI: 10.1002/brb3.1915] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 09/02/2020] [Accepted: 10/09/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE A high rate of attention deficit and hyperactivity disorder (ADHD) has been reported in patients undergoing obesity treatment. It is controversial whether ADHD solely or its comorbid disorders account for eating behaviors associated with obesity. METHODS After presurgery psychiatric assessment, 100 severely obese patients (50 with ADHD and 50 without ADHD) were administered Adult Attention Deficit Hyperactivity Disorder Self-Report Scale(ASRS), Wender Utah Rating Scale(WURS), Three-Factor Eating Questionnaire(TFEQ), and Beck Depression Inventory(BDI) and Beck Anxiety Inventory(BAI). RESULTS Patients with obesity and ADHD had significantly greater emotional eating, susceptibility to hunger, depression, and anxiety but less restraint of eating scores than those without ADHD. Disinhibition of eating scores and presence of Binge Eating Disorder(BED) did not differ significantly between ADHD and non-ADHD groups. Obese patients with major depression had significantly higher ASRS, WURS, TFEQ, BAI scores, disinhibition of eating control, emotional eating, susceptibility to hunger, and diagnosis of BED than nondepressed ones. CONCLUSIONS Major depression and anxiety disorder have associations with disinhibition of eating control, emotional eating, susceptibility to hunger and BED, ADHD. Disinhibition of eating and BED did not differ according to the presence of ADHD; thus, depression was associated with eating control on more constructs than ADHD in our study.
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Affiliation(s)
- Ebru Şahan
- Department of PsychiatryMarmara UniversityİstanbulTurkey
| | - Meliha Zengin Eroğlu
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
| | - Sencan Sertçelik
- Department of PsychiatryHaydarpaşa Numune Training and Research HospitalİstanbulTurkey
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Carmichael SP, Veasey EC, Davenport DL, Jay K, Bernard AC. Patient-Surgeon Relationship Influences Outcomes in Bariatric Patients. Am Surg 2018. [DOI: 10.1177/000313481808401227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Bariatric surgery is an important therapy in weight loss. However, adherence to follow-up is critical and may be influenced by the patient-surgeon relationship. To test this hypothesis, bariatric surgical patients were surveyed from March 2013 to March 2015 via the National Association for Weight Loss Surgery webpage and social media outlets. Surgical outcomes and adherence to follow-up were collected, and aspects of the patient-surgeon relationship were assessed via the Likert scale. Correlations between survey item responses were calculated using Fisher's exact test, Student's t test, and Spearman's rho rank correlation. Three hundred twenty patients responded (n = 287 completed in entirety and n = 33 partially completed); 48 months was the median time to survey from operation (interquartile range, 22–84 months). Eighty-six per cent (n = 276) of patients rated their relationship with their operative surgeon as “average” to “very good.” Thirteen per cent (n = 43) rated their relationship as “poor” to “very poor.” Positive relationship with the operative surgeon and lack of complication were associated with adherence to follow-up ( P = 0.0001 and P = 0.002, respectively). The presence of complication did not affect the overall patient-surgeon relationship ( P = 0.5), although aspects of the patient-surgeon relationship were correlated to complications. There was no association between weight loss at one year and patient-surgeon relationship ( P = 0.6) or presence of complication ( P = 0.1). The findings of this study support the role of a positive patient-surgeon relationship in achieving long-term follow-up in post-bariatric surgical patients.
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Affiliation(s)
- Samuel P. Carmichael
- Graduate Medical Education, General Surgery Residency Program, University of Kentucky, Lexington, Kentucky
| | | | | | - Katie Jay
- The National Association for Weight Loss Surgery (NAWLS), Wilmington, North Carolina
| | - Andrew C. Bernard
- Section of Trauma and Acute Care Surgery, Division of General Surgery, Department of Surgery, University of Kentucky, Lexington, Kentucky
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Ruffault A, Vaugeois F, Barsamian C, Lurbe I Puerto K, Le Quentrec-Creven G, Flahault C, Naudé AJ, Ferrand M, Rives-Lange C, Czernichow S, Carette C. Associations of lifetime traumatic experience with dysfunctional eating patterns and postsurgery weight loss in adults with obesity: A retrospective study. Stress Health 2018; 34:446-456. [PMID: 29602207 DOI: 10.1002/smi.2807] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 02/14/2018] [Accepted: 02/26/2018] [Indexed: 02/02/2023]
Abstract
This study aimed to examine the associations of lifetime traumatic experience with presurgery and postsurgery eating pathology and postoperative weight loss in a sample of adult bariatric surgery patients using electronic medical record (EMR) data. Presurgery lifetime exposure to traumatic event, presurgery and postsurgery dysfunctional eating patterns, and post-operative total and excess weight losses were extracted from electronic medical records of 200 adult bariatric surgery patients in 2013 and 2014. Logistic regression analyses were conducted. During their lifetime, 60.5% of the patients (81.5% women, age = 44.4 ± 11.5 years; BMIpre = 44.9 ± 5.5 kg/m2 ) reported that they were exposed to a traumatic event. Before surgery, trauma exposure was associated with impulsive, compulsive, or restrictive eating patterns (OR = 2.40), overeating or disturbed eating (OR = 1.55), and grazing or night eating behaviours (OR = 1.72). After surgery, trauma exposure was associated with lower total weight loss at 6 (OR = 2.06) and 24 months (OR = 2.06), and to overeating or disturbed eating (OR = 1.53) 12 months after surgery. Bariatric surgery candidates with a history of trauma exposure could benefit from closer medical, dietetic, and/or psychological follow-up care to avoid insufficient postoperative weight loss as well as reappearance of dysfunctional eating patterns after surgery.
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Affiliation(s)
- Alexis Ruffault
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université Paris Descartes, Boulogne-Billancourt, France
| | - Fanny Vaugeois
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université Paris Descartes, Boulogne-Billancourt, France
| | - Charles Barsamian
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Kàtia Lurbe I Puerto
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gérane Le Quentrec-Creven
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université Paris Descartes, Boulogne-Billancourt, France
| | - Cécile Flahault
- Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université Paris Descartes, Boulogne-Billancourt, France
| | - Anne-Jeanne Naudé
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Margot Ferrand
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Claire Rives-Lange
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Sébastien Czernichow
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France.,Université Paris Descartes, Paris, France.,INSERM UMS 011, Population-based cohorts, Villejuif, France
| | - Claire Carette
- Service de Nutrition, Hôpital Européen Georges-Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
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Patients with psychiatric comorbidity can safely undergo bariatric surgery with equivalent success. Surg Endosc 2015; 30:251-8. [DOI: 10.1007/s00464-015-4196-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/26/2015] [Indexed: 12/19/2022]
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Deliopoulou K, Konsta A, Penna S, Papakostas P, Kotzampassi K. The impact of weight loss on depression status in obese individuals subjected to intragastric balloon treatment. Obes Surg 2013; 23:669-75. [PMID: 23299506 DOI: 10.1007/s11695-012-0855-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although depression is considered to be significantly related to morbid obesity disorder, no information exists on the evolution of depression status after weight loss, in particular when an intragastric balloon is used. This prospective 6-month study examines both the effect on depression status and the relation of weight loss to depression in morbidly obese patients treated by intragastric balloon. METHODS One hundred consecutive females fulfilling criteria for balloon treatment were assessed for depression and divided into two groups (65 depressed, 35 non-depressed). Obesity-related parameters were comparable. RESULTS During the treatment period, the depression status of the mildly, moderately, and severely depressed patients improved from 40, 32.3, and 27.7 % to 20, 7.7, and 1.5 %, respectively, with 70.8 % finally exhibiting no depression at all. During the same period, body weight, BMI, body fat, and excess weight loss (EWL) were comparable between all groups, the range of BMI affecting neither the depression score nor the reduction of obesity parameters. However, there was a significant [percentage of EWL >30] weight loss difference in favor of those who were less severely depressed initially. CONCLUSION The degree of weight loss observed in obese depressed females-being comparable to that achieved by non-depressed females-after intragastric balloon insertion was found to positively affect their depression status.
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Affiliation(s)
- Kyriaki Deliopoulou
- Department of Surgery, Aristotle's University of Thessaloniki, Thessaloniki, Greece
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Bellows BK, LaFleur J, Kamauu AWC, Ginter T, Forbush TB, Agbor S, Supina D, Hodgkins P, DuVall SL. Automated identification of patients with a diagnosis of binge eating disorder from narrative electronic health records. J Am Med Inform Assoc 2013; 21:e163-8. [PMID: 24201026 DOI: 10.1136/amiajnl-2013-001859] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Binge eating disorder (BED) does not have an International Classification of Diseases, 9th or 10th edition code, but is included under 'eating disorder not otherwise specified' (EDNOS). This historical cohort study identified patients with clinician-diagnosed BED from electronic health records (EHR) in the Department of Veterans Affairs between 2000 and 2011 using natural language processing (NLP) and compared their characteristics to patients identified by EDNOS diagnosis codes. NLP identified 1487 BED patients with classification accuracy of 91.8% and sensitivity of 96.2% compared to human review. After applying study inclusion criteria, 525 patients had NLP-identified BED only, 1354 had EDNOS only, and 68 had both BED and EDNOS. Patient characteristics were similar between the groups. This is the first study to use NLP as a method to identify BED patients from EHR data and will allow further epidemiological study of patients with BED in systems with adequate clinical notes.
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Sysko R, Zandberg LJ, Devlin MJ, Annunziato RA, Zitsman JL, Walsh BT. Mental Health Evaluations for Adolescents Prior to Bariatric Surgery: A Review of Existing Practices and a Specific Example of Assessment Procedures. Clin Obes 2013; 3:62-72. [PMID: 24073019 PMCID: PMC3781169 DOI: 10.1111/cob.12019] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Best practice guidelines for adolescents considering bariatric surgery recommend a pre-operative mental health evaluation. However, only general information about these assessments appears in the literature, which makes consistency of administration challenging. This review proposes a specific empirically-derived format for pre-surgical mental health evaluations and summarizes currently available data on the psychiatric functioning of adolescents seeking bariatric surgery. DESIGN Studies of mental health evaluations for adults preparing for bariatric surgery are reviewed, as is the limited literature relevant to adolescent evaluations. A specific and detailed example of an evaluation (clinical interview, self-report questionnaires, cognitive assessment) used for younger patients at a major metropolitan hospital center is presented, followed by data from an initial group of adolescents completing this evaluation. SUBJECTS 200 adolescents (n=139 female; age: 14-18 y, BMI: 35.4-83.3 kg/m2) presenting for bariatric surgery. RESULTS A notable subset of adolescents reported current Axis I conditions (31.5%) and current mental health treatment (29.5%), but reports of current illicit drug use (1.5%) and regular alcohol use (0.5%) were relatively rare. Procedures for using the completed evaluation and post-surgery monitoring of psychosocial issues are discussed. CONCLUSIONS Adolescents considering weight loss surgery should receive comprehensive pre-surgical mental health evaluations, but additional data are needed to develop specific recommendations the use of these evaluations in post-operative care.
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Affiliation(s)
- Robyn Sysko
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
| | | | - Michael J. Devlin
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
| | | | - Jeffrey L. Zitsman
- Center for Adolescent Bariatric Surgery, Department of Surgery, Division of Pediatric Surgery, Columbia University Medical Center, New York, NY
| | - B. Timothy Walsh
- Columbia Center for Eating Disorders, Division of Clinical Therapeutics, New York State Psychiatric Institute and the Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York, New York, NY
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Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord 2011; 133:61-8. [PMID: 21501874 DOI: 10.1016/j.jad.2011.03.025] [Citation(s) in RCA: 236] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 03/14/2011] [Accepted: 03/14/2011] [Indexed: 12/30/2022]
Abstract
BACKGROUND Candidates for bariatric surgery frequently have co-morbid psychiatric problems. METHODS This study investigated the course and the prognostic significance of preoperative and postoperative anxiety and depressive disorders in 107 extremely obese bariatric surgery patients in a prospective design with face-to-face interviews (SCID) conducted prior to the surgery and postoperatively after 6-12 months and 24-36 months. RESULTS The point prevalence of depressive disorders but not of anxiety disorders decreased significantly after surgery. Preoperative depressive disorders predicted depressive disorders 24-36 months but not 6-12 months after surgery, whereas preoperative anxiety significantly predicted postoperative anxiety disorders at both follow-up time points. Preoperative lifetime and current depressive disorders were unrelated to postoperative weight loss whereas preoperative lifetime, but not current anxiety disorders were of negative prognostic value for postoperative weight loss. Patients with both depressive and anxiety disorders at baseline (current and lifetime) lost significantly less weight after surgery. Postoperative anxiety disorder was not associated with the degree of weight loss at any follow-up time-point; however postoperative depressive disorder was negatively associated with weight loss at the 24-36 month follow-up assessment point. LIMITATIONS Missing data, limited statistical power, self-reported height and weight are the limitations of this study. CONCLUSIONS As opposed to anxiety disorders, the point prevalence of depressive disorders decreased significantly after bariatric surgery. However, the presence of depressive disorders after bariatric surgery significantly predicted attenuated post-surgical improvements and may signal a need for clinical attention.
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Tayyem R, Ali A, Atkinson J, Martin CR. Analysis of Health-Related Quality-of-Life Instruments Measuring the Impact of Bariatric Surgery. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2011; 4:73-87. [DOI: 10.2165/11584660-000000000-00000] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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10
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Kinzl JF. Morbid obesity: significance of psychological treatment after bariatric surgery. Eat Weight Disord 2010; 15:e275-80. [PMID: 20513999 DOI: 10.3275/7080] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Conservative interventions for weight reduction are not very effective in many cases of morbid obesity. For this reason, bariatric surgery plays an increasing role in the treatment of these patients. Bariatric surgery, however, is not the solution but an important precondition for successful management of morbid obesity. Psychological evaluation of the weight loss surgery patients is recommended because of the prevalence of psychiatric comorbidities and of eating disorders in individuals with morbid obesity. Morbid obese eating disordered patients with co-morbid psychiatric disorders, especially with personality disorders, show greater difficulties in adapting to the new demands, including the need to cope with stress and other problems in a new way, to relearn how to eat, distress over weight loss plateaus, failure to achieve a normal-looking body etc. Therefore, psychological and/or psychiatric treatment seem to be needed in some obese patients to gain an early postoperative understanding of possible psychological or eating problems. Various kinds of psychological support are available at Innsbruck Medical University Hospital before and after bariatric surgery, such as pharmacotherapy, individual psychotherapy, small-group psychotherapy, and the "Obesity Club". The reasons for the relatively low degree of willingness to take part in psychological treatment programs are demonstrated.
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Affiliation(s)
- J F Kinzl
- Department of Psychiatry and Psychotherapy, University Hospital, Medical University Innsbruck, Austria.
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Botella Romero F, Alfaro Martínez JJ, Molina Pacheco E, Lomas Meneses A, Salas Saiz MA, García Gómez A, García Arce L. [Influence of previous psychiatric disorders on postoperative course in patients undergoing bariatric surgery]. ACTA ACUST UNITED AC 2010; 57:9-15. [PMID: 20172481 DOI: 10.1016/s1575-0922(10)70003-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 11/24/2009] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Presurgical evaluation of patients undergoing bariatric surgery includes, among others, a psychological/psychiatric evaluation. Psychiatric disorders that did not contraindicate surgery may persist and influence on weight loss and postoperative clinical course, hindering the success of the procedure. The aim of our study was to analyze the postoperative evolution of our series of patients with and without psychiatric symptoms before surgery. PATIENTS AND METHODS Retrospective analysis of 109 patients undergoing bariatric surgery with duodenal switch from 2003 to 2008 (follow up > 6 months). We studied weight changes, immediate and delayed complications of surgery and nutritional deficiencies in post-surgical follow-up in patients with previous psychiatric disorders (group 1, n = 17) compared with patients without psychiatric disorders (group 2, n = 92). RESULTS Patients in group 1 showed a greater tendency for weight gain. They regained a 9.4% of the initial excess weight lost between 18 months after surgery and 36 months after surgery, while patients in group 2 regained only 0.2% in the same period (p < 0.05). There was no difference in immediate surgical complications (5/17 vs 25/92 patients). The mean incidence of late surgical complications was 0.71 per patient in group 1 and 0.22 complications per patient in group 2 (p = 0.02). 52.9% of patients in group 1 had at least one late complication compared to 19.6% of patients in group 2 (p = 0.003). The three most common complications in patients with previous psychiatric disorders were chronic diarrhea, vomits and malnutrition. The presence of nutritional deficiencies were common in both groups, mainly soluble vitamins, iron and zinc. During postoperative follow-up, we found 3.1 +/- 1.6 nutritional deficiencies per patient in group 1 and 2.5 +/- 1.7 in group 2 (p = 0.04). More than three nutritional deficiencies were found in 8 patients in group 1 (52.9%) compared to 23 patients in group 2 (25%) (p = 0.03). CONCLUSIONS The presence of previous psychiatric disorders may be a predictor of a less positive outcome in morbidly obese patients who undergo bariatric surgery.
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Affiliation(s)
- Francisco Botella Romero
- Sección de Endocrinología y Nutrición, Complejo Hospitalario Universitario de Albacete, Albacete, España.
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Semanscin-Doerr DA, Windover A, Ashton K, Heinberg LJ. Mood disorders in laparoscopic sleeve gastrectomy patients: does it affect early weight loss? Surg Obes Relat Dis 2010; 6:191-6. [PMID: 20189470 DOI: 10.1016/j.soard.2009.11.017] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 11/22/2009] [Accepted: 11/29/2009] [Indexed: 01/07/2023]
Abstract
BACKGROUND Research has demonstrated that laparoscopic Roux-en-Y gastric bypass patients with a lifetime history of a mood disorder have a lower percentage of excess weight loss (%EWL) compared with patients without this lifetime history. No studies have examined the effect of psychiatric history on postoperative outcomes among laparoscopic sleeve gastrectomy (LSG) patients. The objectives of the present study were to determine whether mood disorders relate to the first year of weight loss for patients undergoing LSG at an academic medical center. METHODS A total of 104 patients (78.6% white and 71.2% women), with a median body mass index of 60.35 kg/m(2) (range 31.37-129.14) underwent LSG. The patients were prospectively followed up at 1, 3, 6, 9, and 12 months. The semistructured preoperative psychiatric evaluations demonstrated that 43.1% had a current, and 62.5% a lifetime, diagnosis of a mood disorder. RESULTS LSG patients with current mood disorders had a significantly lower %EWL than patients without a psychiatric diagnosis at the 1-, 3-, 6-, and 9-month follow-up visits. LSG patients with a lifetime history of a mood disorder had a significantly lower %EWL than patients without psychiatric diagnosis at the 1-, 9-, and 12-month follow-up examinations. However, after removing patients with bipolar disorder from the analyses, no significant differences were found in the %EWL between patients with and without a lifetime history of depressive disorders. CONCLUSION Consistent with the laparoscopic Roux-en-Y gastric bypass findings, a lifetime history of mood disorders appears to be associated with significantly less weight loss in LSG patients. These findings highlight the importance of the psychiatric assessment in bariatric patients. Additionally, patients with a current or lifetime history of mood disorders might need additional pre- and postoperative care to improve their outcomes.
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Love RJ, Love AS, Bower S, Carlos Poston WS. Impact of antidepressant use on gastric bypass surgery patients' weight loss and health-related quality-of-life outcomes. PSYCHOSOMATICS 2009; 49:478-86. [PMID: 19122124 DOI: 10.1176/appi.psy.49.6.478] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND Psychological factors may be predictive of post-surgical adjustment and successful outcomes in obesity-surgery populations. OBJECTIVE The authors compared post-gastric bypass surgery (GBS) outcomes of patients being given active psychotropic treatment for depression, with those of patients without treatment or identifiable need for treatment at enrollment. METHOD Outcome measures included weight and repeated administration of the Medical Outcome Survey Short Form-36 (SF-36). RESULTS There was no impact of antidepressant treatment on GBS patients' weight loss or SF-36 outcomes. CONCLUSION Therefore, patients with actively treated depression should be expected to have GBS outcomes equivalent to those of patients without identifiable psychiatric illness or treatment.
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Affiliation(s)
- Robert J Love
- Department of Psychiatry, Wilford Hall Medical Center, University of Texas Health Science Center at San Antonio, San Antonio, TX 78249, USA.
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Abstract
Over the past 30 years, the understanding of eating behaviour has been dominated by the concept of dietary restraint. However, the development of the Three Factor Eating Questionnaire introduced two other factors, Disinhibition and Hunger, which have not received as much recognition in the literature. The objective of this review was to explore the relationship of the Disinhibition factor with weight regulation, food choice and eating disorders, and to consider its aetiology. The review indicates that Disinhibition is an important eating behaviour trait. It is associated not only with a higher body mass index and obesity, but also with mediating variables, such as less healthful food choices, which contribute to overweight/obesity and poorer health. Disinhibition is also implicated in eating disorders and contributes to eating disorder severity. It has been demonstrated that Disinhibition is predictive of poorer success at weight loss, and of weight regain after weight loss regimes and is associated with lower self-esteem, low physical activity and poor psychological health. Disinhibition therefore emerges as an important and dynamic trait, with influences that go beyond eating behaviour and incorporate other behaviours which contribute to weight regulation and obesity. The characteristics of Disinhibition itself therefore reflect many components representative of a thrifty type of physiology. We propose that the trait of Disinhibition be more appropriately renamed as 'opportunistic eating' or 'thrifty behaviour'.
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Affiliation(s)
- E J Bryant
- Institute of Psychological Sciences, University of Leeds, Leeds, UK.
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Langer FB, Bohdjalian A, Shakeri-Manesch S, Zacherl J, Riener R, Schindler K, Ludvik B, Prager G. Eating behavior in laparoscopic sleeve gastrectomy: Correlation between plasma ghrelin levels and hunger. Eur Surg 2008. [DOI: 10.1007/s10353-008-0406-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Post-surgery Adherence to Scheduled Visits and Compliance, More than Personality Disorders, Predict Outcome of Bariatric Restrictive Surgery in Morbidly Obese Patients. Obes Surg 2008; 17:1492-7. [DOI: 10.1007/s11695-008-9428-8] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Scholtz S, Bidlake L, Morgan J, Fiennes A, El-Etar A, Lacey JH, McCluskey S. Long-term outcomes following laparoscopic adjustable gastric banding: postoperative psychological sequelae predict outcome at 5-year follow-up. Obes Surg 2008; 17:1220-5. [PMID: 18074498 DOI: 10.1007/s11695-007-9212-1] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND NICE guidelines state that patients with psychological contra-indications should not be considered for bariatric surgery, including Laparoscopic Adjustable Gastric Banding (LAGB) surgery as treatment of morbid obesity, although no consistent correlation between psychiatric illness and long-term outcome in LAGB has been established. This is to our knowledge the first study to evaluate long-term outcomes in LAGB for a full range of DSM-IV defined psychiatric and eating disorders, and forms part of a research portfolio developed by the authors aimed at defining psychological predictors of bariatric surgery in the short-, medium- and long-term. METHODS Case notes of 37 subjects operated on between April 1997 and June 2000, who had undergone structured clinical interview during pre-surgical assessment to yield diagnoses of mental and eating disorders according to DSM-IV criteria were analyzed according to a set of operationally defined criteria. Statistical analysis was carried out to compare those with a poor outcome and those considered to have a good outcome in terms of psychiatric profile. RESULTS In this group of mainly female, Caucasian subjects, ranging in age from 27 to 60 years, one-third were diagnosed with a mental disorder according to DSM-IV criteria. The development of postoperative DSM-IV defined binge eating disorder (BED) or depression strongly predicted poor surgical outcome, but pre-surgical psychiatric factors alone did not. CONCLUSION Although pre-surgical psychiatric assessment alone cannot predict outcome, an absence of preoperative psychiatric illness should not reassure surgeons who should be mindful of postoperative psychiatric sequelae, particularly BED. The importance of providing an integrated biopsychosocial model of care in bariatric teams is highlighted.
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Affiliation(s)
- Samantha Scholtz
- Department of Psychiatry, St. Georges Medical School, University of London, UK.
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Examination of the MMPI-2 Restructured Clinical (RC) Scales in a Sample of Bariatric Surgery Candidates. J Clin Psychol Med Settings 2007. [DOI: 10.1007/s10880-007-9073-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Ritz SJ. The Bariatric Psychological Evaluation: A Heuristic for Determining the Suitability of the Morbidly Obese Patient for Weight Loss Surgery. ACTA ACUST UNITED AC 2006. [DOI: 10.1089/bar.2006.1.97] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Thirlby RC, Bahiraei F, Randall J, Drewnoski A. Effect of Roux-en-Y gastric bypass on satiety and food likes: the role of genetics. J Gastrointest Surg 2006; 10:270-7. [PMID: 16455461 DOI: 10.1016/j.gassur.2005.06.012] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2004] [Accepted: 06/15/2005] [Indexed: 01/31/2023]
Abstract
Among factors influencing the outcome of bariatric surgery may be genetics and familial risk. The purpose of this study was to assess the etiology of obesity and its impact on hunger, satiety, and food likes in obese patients undergoing Roux-en-Y gastric bypass (RYGB). This study was based on 76 patients undergoing RYGB procedures performed by a single surgeon. A previously described 100-point obesity risk index (ORI) was used to assess familial obesity risk. Hunger and satiety were assessed using a standardized Visual Analog Scale "Snickers" test, and food preferences for regular vs. low-fat potato chips were measured preoperatively and postoperatively. Patients were stratified preoperatively into high ORI (n = 34) and low ORI (n = 42) groups. Before operation, high-ORI patients preferred high-fat (regular) potato chips to low-fat (baked) potato chips, whereas the low-ORI patients liked both food types equivalently (P < 0.05). After operation (n = 43), both groups showed lower preferences for high-fat potato chips (P < 0.05 for high-ORI group). As anticipated, hunger was dramatically suppressed after RYGB. However, there was more satiety in the high-ORI group (P < 0.05, ANOVA). Most patients undergoing bariatric surgery had a strong familial or genetic component to their disease. RYGB in high-ORI patients was associated with a significant decline in preference of fatty food and a significantly prolonged drop in hunger ratings after a fast and after a standard 282 kcal meal. The success of bariatric surgery may be influenced by the etiology of obesity.
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Affiliation(s)
- Richard C Thirlby
- Department of Surgery, Virginia Mason Medical Center, 1100 Ninth Avenue, PO Box 900, Seattle, WA 98101-0900, USA.
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Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. ACTA ACUST UNITED AC 2005; 13:639-48. [PMID: 15897471 DOI: 10.1038/oby.2005.71] [Citation(s) in RCA: 256] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Bariatric surgery has become an increasingly popular treatment option for individuals with extreme obesity (defined as a BMI > or = 40 kg/m2) or those with less severe obesity accompanied by significant comorbidities. Sustained postoperative weight loss and improvements in obesity-related health problems make bariatric surgery the most effective treatment for this population. Nevertheless, most experts agree that psychosocial and behavioral factors contribute to successful postoperative outcomes. This paper reviews the literature on the preoperative psychosocial status, eating behaviors, and quality of life of patients who seek bariatric surgery. In addition, the paper examines studies that investigated changes in these factors postoperatively. The review concludes with an agenda for future research in this area.
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Affiliation(s)
- David B Sarwer
- Weight and Eating Disorders Program, 3535 Market Street, Suite 3022, Philadelphia, PA 19104-3309, USA.
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Affiliation(s)
- Daniel Rigaud
- Service d'Endocrinologie et Nutrition, CHU Le Bocage, 21079 Dijon.
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Schlienger JL, Meyer L, Rohr S, Pradignac A, Perrin AE, Meyer C, Simon C. [Gastroplasty: complications and their prevention]. DIABETES & METABOLISM 2003; 29:88-93. [PMID: 12629455 DOI: 10.1016/s1262-3636(07)70014-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Bariatric surgery is now frequently proposed for the treatment of morbid or complicated obesity since the introduction of minimally invasive laparoscopic anti-obesity operations such as the adjustable silicone gastric binding gastroplasty. However this reversible procedure in not always as safe as presumed and the results in weight loss may be sometimes disappointing. Side effects are common and early or late complications occured in more than 20% out of the patients. They are favoured by post operative eating disorders. Nutritional consequences are probably underestimated and are not limited to uncomfortable digestive symptoms. Some deficiencies in micronutriments have been described. The worsening of previous eating disorders or psychosocial abnormalities are not seldom. Gastroplasty is not an harmless procedure. A good selection in patients, a regular follow up, nutritional advices and psychosocial management by a multidisciplinar team are required to reduce complications after gastroplasty.
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Affiliation(s)
- J L Schlienger
- Service de Médecine Interne et Nutrition, Hôpital de Hautepierre, Strasbourg, France.
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Guisado Macías J, Alarcón Domingo J, Vaz Leal F. Factores asociados a mala respuesta tras cirugía en obesidad mórbida. Rev Clin Esp 2003. [DOI: 10.1016/s0014-2565(03)71364-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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