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Marek RJ, Ben-Porath YS, Heinberg LJ. Six-year postoperative associations between the Minnesota Multiphasic Personality Inventory - 3 (MMPI-3) and weight recurrence, eating behaviors, adherence, alcohol misuse, and quality of life. Surg Obes Relat Dis 2024; 20:391-398. [PMID: 38216363 DOI: 10.1016/j.soard.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/20/2023] [Accepted: 12/06/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) leads to beneficial and sustained outcomes. However, many patients evidence weight recurrence and psychosocial functioning may be associated with weight recurrence. The Minnesota Multiphasic Personality Inventory - 3 (MMPI-3) is validated for use in presurgical MBS evaluations and likely has clinical utility in understanding weight recurrence and other aspects of postoperative functioning. OBJECTIVE The objective of the current investigation is to understand how postoperative psychosocial functioning relates to weight recurrence and other behaviors and constructs 6 years after MBS. SETTING Cleveland Clinic Bariatric and Metabolic Institute. METHODS A sample of 163 participants consented to take a battery of self-report measures related to psychological functioning, eating behaviors, adherence, alcohol misuse, and quality of life along with their postoperative weight. MMPI-3 scale scores were prorated from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form (MMPI-2-RF) or scored from the Minnesota Multiphasic Personality Inventory - 2 - Restructured Form - Expanded (MMPI-2-RF-EX). RESULTS Weight recurrence was quite variable in this sample. Postoperative MMPI-3 scales related to emotional/internalizing dysfunction were modestly associated with higher weight recurrence. Postoperative MMPI-3 scale scores also demonstrated associations with other postoperative outcomes including measures of eating behaviors, adherence, alcohol misuse, and quality of life. CONCLUSIONS Postoperative psychosocial functioning as assessed by the MMPI-3 was associated with weight recurrence and a number of other problematic psychological outcomes beyond weight recurrence.
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Affiliation(s)
- Ryan J Marek
- Department of Psychology and Philosophy, Sam Houston State University, Huntsville, Texas.
| | | | - Leslie J Heinberg
- Department of Psychiatry and Psychology, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio
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Granero-Molina J, Jiménez-Lasserrotte MDM, Arias Hoyos C, Sánchez MJT, Fernández-Sola C, Ruiz-Fernández MD. Sexuality and self-concept of morbidly obese women who are sexually attracted to men after bariatric surgery: a phenomenological study. BMC Womens Health 2024; 24:174. [PMID: 38481251 PMCID: PMC10936016 DOI: 10.1186/s12905-024-03014-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Morbid Obesity (MO) is a public health problem that affects a person's physical, psychological and sexual well-being. Women with MO are affected by their body image and self-concept, and obesity stigma may affect women in social and sexual relationships. OBJECTIVE To describe and understand the experiences of morbidly obese heterosexual women (who are sexually attracted to men) in relation to their body image and sexuality after bariatric surgery. METHODOLOGY Qualitative study using Merleau-Ponty's hermeneutic phenomenology as a philosophical framework. Data collection took place between 2020 and 2021 in a southern Spanish province. A total of 22 in-depth interviews were conducted using open-ended questions until data saturation was reached. RESULTS Two main themes were identified: (1) "Escaping from a cruel environment": weight loss to increase self-esteem; with the sub-themes: 'I love myself now', and 'Body image and social relationships; a vicious circle; (2) "Now, I am truly me": accepting my body to reclaim my sexuality, with the sub-themes: 'The body as the focal point of sexuality', and 'When regaining your sex drive reignites your sex life and relationship'. CONCLUSION Weight loss and body acceptance radically change morbidly obese women's sex lives after bariatric surgery. They rediscover their bodies, have increased self-esteem, and see improvements in their social relationships and sexuality. These women feel seen, loved and desired, and now value their body image and femininity. As they go through continuous improvements following bariatric surgery, they gradually regain self-esteem, acceptance of their bodies and control over their sex life. Even though the women's partners benefit from these improvements, they seem to be afraid of being left.
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Affiliation(s)
- José Granero-Molina
- Physiotheraphy and Medicine Department, University of Almería, Almería, Spain
- Faculty of Health Sciences, Universidad Autónoma de Chile, Chile, Santiago, 7500000, Spain
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Hoyt T, Walter FA, Michl TM. The role of obesity severity in Minnesota multiphasic personality inventory-2-restructured form prediction of 12-month bariatric surgery outcomes. Surg Obes Relat Dis 2024; 20:267-274. [PMID: 37880030 DOI: 10.1016/j.soard.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/04/2023] [Accepted: 09/04/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) has been widely used in bariatric surgery samples. However, questions remain regarding its utility when predicting changes in body mass index over time following bariatric surgery. OBJECTIVES Examine whether MMPI-2-RF scales differentially predict 12-month changes in body mass index (BMI) following bariatric surgery when comparing patients with Class III or higher versus Class II or lower obesity. SETTING Military hospital in the Northwestern United States. METHODS This retrospective study evaluated data from 193 bariatric surgery patients who completed the MMPI-2-RF as part of presurgical evaluation requirements. Hierarchical linear modeling was used to predict body mass index over a 12-month postsurgical period based on MMPI-2-RF scales. Loss to follow-up rate was 30% during this period. RESULTS Among patients with Class II or lower obesity, the Symptom Validity, Adjustment Validity, Response Bias, Cynicism, Aggression, Stress/Worry, and Anger Proneness scales showed a significant relationship to BMI after bariatric surgery. Among patients with Class III or higher obesity, the Infrequent Psychopathology Responses, Emotional / Internalizing Dysfunction, Ideas of Persecution, Multiple Specific Fears, and Inefficacy scales showed a significant relationship to body mass index after bariatric surgery. CONCLUSIONS Certain MMPI-2-RF scales may have better utility in predicting bariatric surgery outcomes based on the patient's obesity severity. The interaction of metabolic and personality factors may play a significant role in weight change following bariatric surgery.
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Affiliation(s)
- Tim Hoyt
- Department of Behavioral Health, Madigan Army Medical Center, Tacoma, Washington.
| | - Fawn A Walter
- Department of Behavioral Health, Madigan Army Medical Center, Tacoma, Washington
| | - Tegan M Michl
- Department of Behavioral Health, Madigan Army Medical Center, Tacoma, Washington
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Ferber M, Hecht LM, Martens KM, Hamann A, Carlin AM, Miller-Matero LR. Examining differences in long-term weight loss outcomes after bariatric surgery: The role of romantic relationship status. Fam Syst Health 2024; 42:122-126. [PMID: 37616105 DOI: 10.1037/fsh0000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
INTRODUCTION This study tested for differences based on relationship status at the time of surgery in baseline body mass index (BMI), weight loss outcomes (change in BMI [ΔBMI], percent total weight loss [%TWL], percent excess weight loss [%EWL]), and rates of successful weight loss (defined as ≥ 50%EWL) up to 4-year postbariatric surgery. METHOD Data came from a secondary analysis of patients (N = 492) who were up to 4-year postsurgery and completed a presurgical psychological evaluation and postsurgical survey. RESULTS Sixty-nine percent of participants were patients in committed relationships and 31% were single/divorced/widowed patients. Single patients had higher presurgical BMIs than those who were partnered (t = 2.28, p = .02). There were no differences between those who were partnered and singles regarding ΔBMI and %TWL, although singles had smaller %EWL (t = -2.08, p = .04), which became nonsignificant after controlling for covariates. Most participants had successful weight loss (76.8%); however, this was not related to romantic relationship status. DISCUSSION The results suggest those who were partnered undergo surgery at better-starting weights than singles and maintain this advantage in the long term. Providers working with patients considering bariatric surgery could inquire about how their romantic and social relationships play a part in their decision-making process. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Megan Ferber
- Department of Family and Community Medicine, Medical Family Therapy Program, Saint Louis University
| | - Leah M Hecht
- Center for Health Policy & Health Services Research, Henry Ford Health System
| | | | - Aaron Hamann
- Department of Behavioral Health, Henry Ford Health System
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Miller-Matero LR, Haley EN, Loree AM, Braciszewski JM, Maye M, Sehgal M, Carlin AM. Post-surgical psychiatric symptoms, maladaptive eating patterns, and lifestyle behaviors associated with weight recurrence after bariatric surgery. Surg Obes Relat Dis 2024; 20:297-303. [PMID: 37923621 DOI: 10.1016/j.soard.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND A significant proportion of patients who undergo bariatric surgery experience weight recurrence; however, the most important areas to target to prevent weight recurrence remain unknown. OBJECTIVES The purpose was to examine whether psychiatric symptoms, maladaptive eating behaviors, and lifestyle factors were associated with weight recurrence. SETTING Single healthcare system. METHODS Individuals who underwent bariatric surgery were invited to complete a web-based survey in which they reported their current weight and completed measures of psychiatric symptoms, maladaptive eating behaviors, and lifestyle behaviors. Participants were included if they were at least 2 years postsurgery. Weight recurrence was measured from the 1-year follow-up to the survey date. RESULTS Participants (n = 169) were predominantly female and White or Black, with a mean age of 45 years. The rate of significant weight recurrence was 23.1%. Those who underwent sleeve gastrectomy were more likely to experience weight recurrence (odds ratio [OR] = 12.99; P = .01). In bivariate analyses, anxiety and depressive symptoms, emotional eating, loss of control eating, binge eating, and night eating were associated with weight recurrence (P < .05). Those who did not eat mindfully, take 20 minutes to eat, or get adequate sleep were also more likely to have weight recurrence (P < .05). In a multivariate model, only a lack of mindful eating (OR = 4.84; P = .03) and inadequate sleep (OR = 7.30; P = .02) remained statistically significant predictors. CONCLUSION Engaging in mindful eating and obtaining adequate sleep may protect against weight recurrence following bariatric surgery. Clinicians may want to screen and monitor these behaviors.
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Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan.
| | - Erin N Haley
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Amy M Loree
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Melissa Maye
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Monica Sehgal
- Behavioral Health, Henry Ford Health, Detroit, Michigan
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Slurink IAL, Nyklíček I, Kint R, Tak D, Schiffer AA, Langenhoff B, Ouwens MA, Soedamah-Muthu SS. Longitudinal trajectories and psychological predictors of weight loss and quality of life until 3 years after metabolic and bariatric surgery. J Psychosom Res 2024; 178:111590. [PMID: 38237524 DOI: 10.1016/j.jpsychores.2024.111590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/11/2023] [Accepted: 01/07/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE This study aimed to describe longitudinal trajectories of Total Weight Loss (%TWL), and mental and physical health related quality of life (HRQOL), as well as to identify preoperative psychological predictors of these trajectories. METHODS A prospective observational study including Dutch patients treated with metabolic and bariatric surgery (n = 420, age 44.8 ± 10.3 years, 78.6% females) was performed. Trajectories of %TWL and HRQOL from screening to 1-, 2-, and 3-years post-surgery were described using growth mixture modelling. Multivariable and lasso regression models were used to identify predictors. RESULTS Three trajectories described %TWL, varying in the degree of first-year weight loss. No pre-surgical psychological factors were associated with %TWL trajectories. We identified four physical and five mental HRQOL trajectories. Approximately 25-30% of patients exhibited patterns of initial improvements followed by decline, or persistently low levels of HRQOL. Higher depressive symptoms were associated with these unfavourable physical HRQOL trajectories (OR 1.20, 95%CI 1.04-1.39), adjusted for confounders. Unfavourable mental HRQOL trajectories were predicted by depressive and anxiety symptoms, neuroticism, insecure attachment, and maladaptive coping. In contrast, self-esteem, extraversion, and conscientiousness were associated with favourable mental HRQOL trajectories. DISCUSSION Psychological factors did not predict weight loss, but they significantly impacted patient's HRQOL after metabolic and bariatric surgery. A subgroup with unsuccessful HRQOL after surgery was identified, who would benefit from tailored preoperative counselling to optimize surgery outcomes. Metabolic and bariatric surgery may not be universally beneficial for all patients, challenging the conventional approach to surgical interventions for severe obesity and advocating for a more nuanced, individualized assessment of potential candidates.
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Affiliation(s)
- Isabel A L Slurink
- Center of Research on Psychological disorders and Somatic diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands.
| | - Ivan Nyklíček
- Center of Research on Psychological disorders and Somatic diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands
| | - Rosanne Kint
- Elisabeth-TweeSteden Hospital, Department of Medical Psychology, dr. Deelenlaan 5, 5045 AD Tilburg, the Netherlands
| | - Danny Tak
- Catharina Ziekenhuis Eindhoven, Michelangelolaan 2, 5623EJ Eindhoven, the Netherlands
| | - Angelique A Schiffer
- Elisabeth-TweeSteden Hospital, Department of Medical Psychology, dr. Deelenlaan 5, 5045 AD Tilburg, the Netherlands
| | - Barbara Langenhoff
- Elisabeth-TweeSteden Hospital, Department of Surgery, dr. Deelenlaan 5, 5045 AD Tilburg, the Netherlands
| | - Machteld A Ouwens
- Tranzo, Scientific Centre for Care and Wellbeing of the Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
| | - Sabita S Soedamah-Muthu
- Center of Research on Psychological disorders and Somatic diseases (CORPS), Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE Tilburg, the Netherlands; Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, UK
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Koball AM, Ames GE, Fitzsimmons AJ, Kallies KJ, Bennie BA. Food cravings after bariatric surgery: comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Eat Weight Disord 2024; 29:7. [PMID: 38214807 PMCID: PMC10786997 DOI: 10.1007/s40519-023-01636-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/27/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Research suggests that food choices, preferences, and tastes change after bariatric surgery, but evidence regarding changes in food cravings is mixed. OBJECTIVES The primary aim of this cohort study was to compare food cravings during the first year following bariatric surgery in patients who had undergone sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB). SETTING Integrated multispecialty health system, United States. METHODS Patients aged ≥ 18 years seen between May 2017 and July 2019, provided informed consent, completed the Food Craving Inventory (FCI), and had ≥ 1 year of follow-up after undergoing primary SG or RYGB were included in the study. Secondary data captured included psychological and behavioral measures. Preoperative and postoperative (3, 6, 9, and 12 months) FCI scores of patients who underwent SG and RYGB were compared. RESULTS Some attrition occurred postoperatively (N = 187 at baseline, 141 at 3 months, 108 at 6 months, 89 at 9 months, and 84 at 12 months). No significant relationship between pre- or postoperative food cravings and surgery type was found except on the carbohydrate subscale. Patients with higher preoperative food addiction symptoms were not more likely to experience an earlier reoccurrence of food cravings during the first 12 months after surgery. Likewise, patients with higher levels of preoperative depression and anxiety were not more likely to have early reoccurrence of food cravings during the first 12 months after surgery; however, those with higher PHQ9 scores at baseline had uniformly higher food craving scores at all timepoints (pre-surgery, 3 m, 6 m, 9 m, and 12 m). CONCLUSIONS Results suggest that food cravings in the year after bariatric surgery are equivalent by surgery type and do not appear to be related to preoperative psychological factors or eating behaviors. LEVEL OF EVIDENCE Level III: Evidence obtained from well-designed cohort.
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Affiliation(s)
- Afton M Koball
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
| | - Gretchen E Ames
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | - Alec J Fitzsimmons
- Department of Medical Research, Gundersen Health System, La Crosse, WI, USA
| | - Kara J Kallies
- Public & Community Health, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Barb A Bennie
- Department of Medical Research, Gundersen Health System, La Crosse, WI, USA
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Kikuchi JLD, Carvalhal MMDL, de Castro MM, Vieira Lourenço-Costa V, dos Santos CAR, Cunha FS, Paracampo CCP, Gomes DL. Factors associated with grazing behavior in candidates for bariatric surgery at a hospital in the Amazon. Front Public Health 2023; 11:1227214. [PMID: 38174082 PMCID: PMC10763686 DOI: 10.3389/fpubh.2023.1227214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024] Open
Abstract
Blackground To assess grazing behavior and associated factors in candidates for bariatric surgery monitored at a public hospital that is a reference in the care of people with severe obesity. Methods Cross-sectional analytical study, with candidates for bariatric surgery of both genders, treated in a public hospital in the Amazon. To assess grazing behavior, the Repetitive Eating Questionnaire was used, and to investigate patterns of eating behavior, the Three Factor Eating Questionnaire was used, which assesses: Emotional Eating, Cognitive Restriction and Uncontrolled Eating. Sociodemographic information was obtained through self-report and the description of medication use through the medical record. Body mass index (BMI) was also calculated by measuring weight and height. The SPSS program, v. 21.0 was used. The study was approved by the Research Ethics Committee. Results A total of 205 participants were evaluated, with a mean age of 37.5 ± 8.6 years, the majority (93.7%) being women and the majority (59.5%) was not also using medication to lose weight. About 66.3% of the participants had compulsive grazing. The factor with the highest score was cognitive restriction (p < 0.001). Individuals who used weight loss drugs had higher scores in the cognitive restriction factor (p = 0.015) and lower scores for uncontrolled eating (p = 0.008), compulsive grazing (p = 0.021) and non-compulsive grazing (p = 0.034). Conclusion Linear regression showed that emotional eating and uncontrolled eating were predictors of both compulsive grazing and non-compulsive grazing behavior. It was observed that grazing behavior, cognitive restriction, emotional eating and uncontrolled eating are present and correlated in the studied patients. In addition, the use of weight loss drugs seems to help reduce dysfunctional eating behaviors in patients with severe obesity.
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Affiliation(s)
- Jeane Lorena Dias Kikuchi
- Postgraduate Program in Neurosciences and Behavior, Center for Theory and Research of Behavior, Federal University of Pará, Belém, Brazil
| | | | | | | | | | | | - Carla Cristina Paiva Paracampo
- Postgraduate Program in Neurosciences and Behavior, Center for Theory and Research of Behavior, Federal University of Pará, Belém, Brazil
| | - Daniela Lopes Gomes
- Postgraduate Program in Neurosciences and Behavior, Center for Theory and Research of Behavior, Federal University of Pará, Belém, Brazil
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Miller-Matero LR, Yeh HH, Ahmedani BK, Rossom RC, Harry ML, Daida YG, Coleman KJ. Suicide attempts after bariatric surgery: comparison to a nonsurgical cohort of individuals with severe obesity. Surg Obes Relat Dis 2023; 19:1458-1466. [PMID: 37758538 PMCID: PMC10843496 DOI: 10.1016/j.soard.2023.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND The rate of suicide is higher among individuals following bariatric surgery compared with the general population; however, it is not clear whether risk is associated with bariatric surgery beyond having severe obesity. OBJECTIVE To compare the risk of a suicide attempt among those who had bariatric surgery versus a nonsurgical cohort with severe obesity. SETTING Aggregate count data were collected from 5 healthcare systems. METHODS Individuals were identified in the surgical cohort if they underwent bariatric surgery between 2009 and 2017 (n = 35,522) and then were compared with a cohort of individuals with severe obesity who never had bariatric surgery (n = 691,752). Suicide attempts were identified after study enrollment date using International Classification of Diseases, Ninth and Tenth Editions (ICD-9 and ICD-10) diagnosis codes from 2009 to 2021. RESULTS The relative risk of a suicide attempt was 64% higher in the cohort with bariatric surgery than that of the nonsurgical cohort (2.2% versus 1.3%; relative risk = 1.64; 95% CI, 1.53-1.76). Within the cohort with bariatric surgery, suicide attempts were more common among the 18- to 39-year age group (P < .001), women (P = .002), Hawaiian-Pacific Islanders (P < .001), those with Medicaid insurance (P < .001), and those with a documented mental health condition at baseline (in the previous 2 years; P < .001). CONCLUSIONS The relative risk of suicide attempts was higher among those who underwent bariatric surgery compared with a nonsurgical cohort, though absolute risk remained low. Providers should be aware of this increased risk. Screening for suicide risk after bariatric surgery may be useful to identify high-risk individuals.
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Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan.
| | - Hsueh-Han Yeh
- Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Brian K Ahmedani
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | | | | | | | - Karen J Coleman
- Kaiser Permanente Southern California, Irvine, California; Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
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Cremonesi MDC, Duarte-Guerra L, Pajecki D, Santo MA, Lotufo F, Wang YP. VALIDITY OF THE BRAZILIAN-PORTUGUESE VERSION OF MOOREHEAD-ARDELT QUALITY OF LIFE QUESTIONNAIRE II AMONG PATIENTS WITH SEVERE OBESITY. Arq Bras Cir Dig 2023; 36:e1767. [PMID: 37851753 PMCID: PMC10578149 DOI: 10.1590/0102-672020230049e1767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/08/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Patients with obesity present multiple comorbid psychiatric conditions and experience impairments in health-related quality of life. Reliable and valid tools that evaluate health-related quality of life are essential for clinical practice. AIMS This study aimed to investigate the reliability and validity of the six-item Moorehead-Ardelt Quality of Life Questionnaire II among Brazilian patients with severe obesity. METHODS We assessed 387 patients (mean age 43 years, 78.8% women, mean body mass index of 46.5 kg/m²) on the waiting list of a bariatric surgery center. Trained research assistants concurrently applied the Moorehead-Ardelt Quality of Life-II, the Montgomery-Åsberg Depression Rating Scale, and the Global Assessment of Functioning for assessing health-related quality of life, comorbid depressive symptoms, and patient functioning level, respectively. RESULTS The internal consistency of the Moorehead-Ardelt Quality of Life-II was considered acceptable. The total score was correlated with the severity of depressive symptoms and functioning level. The more body mass index increases, the more health-related quality of life worsens. The Moorehead-Ardelt Quality of Life-II presented a unidimensional structure. CONCLUSIONS The unidimensional Moorehead-Ardelt Quality of Life-II is a reliable and valid measure for evaluating health-related quality of life in Brazilian patients with severe obesity. The questionnaire allows to quickly assess the health-related quality of life of patients in different bariatric contexts, considering depression and functional level.
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Affiliation(s)
| | | | - Denis Pajecki
- Universidade de São Paulo, Department of Gastroenterology – São Paulo (SP), Brazil
| | - Marco Aurelio Santo
- Universidade de São Paulo, Department of Gastroenterology – São Paulo (SP), Brazil
| | - Francisco Lotufo
- Universidade de São Paulo, Department of Psychiatry – São Paulo (SP), Brazil
| | - Yuan-Pang Wang
- Universidade de São Paulo, Department of Psychiatry – São Paulo (SP), Brazil
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Abstract
OBJECTIVE In a large multisite cohort of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy, we compared the 5-year suicidal ideation and attempt rates with matched nonsurgical controls. BACKGROUND Bariatric surgery has significant health benefits but has also been associated with adverse mental health outcomes. METHODS Five-year rates of suicidal ideation and suicide attempts of Veterans who underwent Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy from the fiscal year 2000-2016 to matched nonsurgical controls using sequential stratification using cumulative incidence functions (ideation cohort: n=38,199; attempt cohort: n=38,661 after excluding patients with past-year outcome events). Adjusted differences in suicidal ideation and suicide attempts were estimated using a Cox regression with a robust sandwich variance estimator. RESULTS In the matched cohorts for suicidal ideation analyses, the mean age was 53.47 years and the majority were males (78.7%) and White (77.7%). Over 40% were treated for depression (41.8%), had a nonrecent depression diagnosis (40.9%), and 4.1% had past suicidal ideation or suicide attempts >1 year before index. Characteristics of the suicide attempt cohort were similar. Regression results found that risk of suicidal ideation was significantly higher for surgical patients (adjusted hazard ratio=1.21, 95% CI: 1.03-1.41), as was risk of suicide attempt (adjusted hazard ratio=1.62, 95% CI: 1.22-2.15). CONCLUSIONS Bariatric surgery appears to be associated with a greater risk of suicidal ideation and attempts than nonsurgical treatment of patients with severe obesity, suggesting that patients need careful monitoring for suicidal ideation and additional psychological support after bariatric surgery.
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Affiliation(s)
- Anna Hung
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
| | - Matthew L. Maciejewski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
| | - Theodore S. Z. Berkowitz
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
| | - David E. Arterburn
- Department of Medicine, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Seattle
| | - James E. Mitchell
- University of North Dakota School of Medicine and Health Sciences, Fargo, ND Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Katharine A. Bradley
- Department of Medicine, University of Washington, Seattle, WA
- Kaiser Permanente Washington Health Research Institute, Seattle
- Department of Health Services, University of Washington, Seattle, WA
| | - Nathan A. Kimbrel
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Durham Veterans Affairs (VA) Health Care System, Durham, NC, USA
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Valerie A. Smith
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC
- Department of Population Health Sciences, Duke University, Durham, NC
- Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC
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12
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Benítez T, Caixàs A, Rebasa P, Luna A, Crivillés S, Gutiérrez T, Deus J. Psychopathological profile before and after bariatric surgery. Sci Rep 2023; 13:16172. [PMID: 37758783 PMCID: PMC10533840 DOI: 10.1038/s41598-023-43170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Presurgical psychopathological assessment usually focuses on detecting severe mental disorders. However, mild intensity psychopathology and eating behaviour pattern may also influence postsurgical outcomes. The aim was to identify psychopathology and eating behaviour pattern in candidates prepared for bariatric surgery compared to a normative population before and after surgery. A cohort of 32 patients seeking bariatric surgery in a university hospital between March 2016 and March 2017 were evaluated with Personality Assessment Inventory (PAI), 36-item EDE-Q and BES before and after surgery. Thirty-two patients before and 26 one year after surgery were included. The PAI presurgical psychometric profile suggested a mild mixed adjustment disorder focused on somatic complaints. After surgery, patients improved in somatic complaints (p < 0.001), and depression (p = 0.04). Related eating disorders were more common than those of the normative group and improved significantly after surgery in scores for compulsive intake (BES p < 0.001) and overall key behaviours of eating disorders and related cognitive symptoms (EDE-Q/G p < 0.001). In our cohort ready for bariatric surgery a mild psychopathological profile is still present and becomes closer to that of the normative group after surgery. Further studies are needed to evaluate the effects of mild psychopathology on outcomes after bariatric surgery.
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Affiliation(s)
- Tura Benítez
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
| | - Assumpta Caixàs
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain.
| | - Pere Rebasa
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Alexis Luna
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Sara Crivillés
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Teresa Gutiérrez
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003, Barcelona, Spain
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13
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Schankweiler P, Raddatz D, Ellrott T, Hauck Cirkel C. Correlates of Food Addiction and Eating Behaviours in Patients with Morbid Obesity. Obes Facts 2023; 16:465-474. [PMID: 37544305 PMCID: PMC10601678 DOI: 10.1159/000531528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/31/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Food addiction (FA) is a promising construct regarding the multifactorial aetiology of obesity and the search for therapeutic approaches. However, there is an ongoing debate regarding the overlap/differentiation with eating disorders and the classification as a substance- or behaviour-related addiction. Energy-dense foods, especially those combining carbohydrates and fat, are associated with addictive eating and suspected of playing a role in the genesis of FA. This study aims to further understand the clinical significance of FA and to identify possible therapeutic targets. A special focus is set on potentially addictive foods (combination of carbohydrates and fat). METHODS Based on the Yale Food Addiction Scale 2.0, a cohort of 112 German adults with morbid obesity was divided into two sub-samples (patients with and without FA), which were examined for differences in the variables listed below. RESULTS The prevalence of FA was 25%. Patients meeting criteria for FA showed higher degrees of hunger, emotional, binge, and night eating than patients without FA. In addition, hunger and disinhibition were found to be significant predictors of FA. FA was not associated with sex, age, body mass index (BMI), cognitive restraint, rigid and flexible control, prevalence of substance use, age of onset of obesity, stress level, level of social support, reduction of BMI during a weight loss programme, or programme withdrawal rate. There was no significant difference in the consumption of foods rich in both carbohydrates and fat, nor of fat or carbohydrates alone. CONCLUSION FA can be considered as a sub-phenotype of obesity, occurring in approximately 25% of obesity cases. Dysfunctional emotional coping mechanisms associated with low distress tolerance showed to be significantly related to FA and should be targeted therapeutically. Behavioural interventions should include a bio-psycho-social model. Binge eating episodes were found to be characteristic for FA and the already stated overlap between FA and binge eating behaviour can be confirmed. The results do not support a decisive difference due to a substance-related component of FA. Despite this, the existence of FA as a distinct entity cannot be excluded, as not all patients with FA exhibit binges.
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Affiliation(s)
- Pia Schankweiler
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Dirk Raddatz
- Clinic for Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Ellrott
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
| | - Carolin Hauck Cirkel
- Institute for Nutrition and Psychology at the Georg-August-University Göttingen, University Medical Center Göttingen, Göttingen, Germany
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14
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Dijkhorst PJ, Makarawung DJS, Vanhommerig JW, Kleipool SC, Dalaei F, de Vries CEE, van der Molen AB, Poulsen L, Sorensen JA, Bonjer HJ, de Castro SMM, van Veen RN. Predictors of improved psychological function after bariatric surgery. Surg Obes Relat Dis 2023; 19:872-881. [PMID: 36842930 DOI: 10.1016/j.soard.2023.01.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Negative psychological sequelae have been reported after bariatric surgery. It is unclear which factors affect psychological function in the first postoperative years. OBJECTIVE Evaluation of significant predictors of improved psychological function following bariatric surgery by analyzing data from the BODY-Q questionnaire. SETTING Multicenter prospective cohort in 3 centers located in The Netherlands and Denmark. METHODS The BODY-Q questionnaire was used to assess 6 domains of health-related quality of life. The domain of interest, psychological function, consists of 10 questions from which a converted score of 0 (low) to 100 (high) can be calculated. Linear mixed models were used to analyze which patient characteristics were most predictive of the psychological function score. Secondary outcomes of interest were cross-sectional scores of psychological function and the impact of weight loss, and the effect of major short-term complications on psychological function. RESULTS Data were analyzed from 836 patients who underwent bariatric surgery from 2015 to 2020. Patients with lower expectations concerning weight loss (<40% desired total weight loss), higher educational level, no history of psychiatric illness, and employment before bariatric surgery demonstrated the highest psychological function scores after bariatric surgery. At 1 and 2 years after bariatric surgery, more weight loss was associated with significantly higher psychological function scores. Experiencing a major short-term complication did not significantly impact psychological function. CONCLUSIONS Several relevant predictors of improved postoperative psychological function have been identified. This knowledge can be used to enhance patient education preoperatively and identify patients at risk for poor psychological functioning postoperatively.
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Affiliation(s)
- Phillip J Dijkhorst
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands.
| | | | | | - Suzanne C Kleipool
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | - Farima Dalaei
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - Claire E E de Vries
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | | | - Lotte Poulsen
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - Jens A Sorensen
- Research Unit for Plastic Surgery, Odense University Hospital and University of Southern Denmark, Odense, Denmark; Odense Explorative Patient Network (OPEN), Odense, Denmark
| | - H Jaap Bonjer
- Department of Surgery, Amsterdam Medical University Center, Amsterdam, The Netherlands
| | - Steve M M de Castro
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
| | - Ruben N van Veen
- Department of Surgery, OLVG & Dutch Obesity Clinic, Amsterdam, The Netherlands
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15
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Kerver GA, Engel SG, Gunstad J, Crosby RD, Steffen KJ. Deficits in cognitive control during alcohol consumption after bariatric surgery. Surg Obes Relat Dis 2023; 19:344-349. [PMID: 36443210 PMCID: PMC10040420 DOI: 10.1016/j.soard.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/21/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND While bariatric surgery results in substantial weight loss, one negative side effect of surgery is that patients often experience more rapid and intense intoxication effects after consuming alcohol. OBJECTIVES Given that alcohol use has been associated with impaired cognitive functioning in the general population, this study examined whether acute alcohol consumption after bariatric surgery immediately led to impaired cognitive control, and whether this effect was impacted by baseline levels of cognitive control. SETTING Nonprofit teaching hospital, United States. METHODS Participants were 34 adults who attended a laboratory visit before and 1 year after Roux-en-Y gastric bypass surgery, wherein they consumed a weight-based dose of alcohol and completed cognitive testing over the course of 3 hours. RESULTS A series of generalized mixed-effect models demonstrated that performance on the cognitive task generally improved over time, likely due to practice effects. However, following bariatric surgery, individuals with impaired cognitive control before consuming alcohol experienced greater commission errors immediately afterward. CONCLUSIONS These findings suggest that alcohol use after bariatric surgery may produce immediate deficits in inhibitory control among individuals who are already vulnerable to impaired cognitive control. Clinicians should seek to educate bariatric surgery candidates on this possible effect, as deficits in inhibitory control may ultimately lead to risky behaviors and poor adherence with postsurgical medical recommendations.
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Affiliation(s)
- Gail A Kerver
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota.
| | - Scott G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
| | - John Gunstad
- Department of Psychological Sciences, Kent State University, Kent, Ohio
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, Fargo, North Dakota
| | - Kristine J Steffen
- Sanford Center for Biobehavioral Research, Fargo, North Dakota; Department of Pharmaceutical Sciences, North Dakota State University, Fargo, North Dakota
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16
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Smith KR, Steele KE, Papantoni A, Harris C, Speck CL, Bakker A, Moran TH, Carnell S, Kamath V. The relationship between weight loss and cognitive function in bariatric surgery. Surg Endosc 2023; 37:1976-1984. [PMID: 36271060 PMCID: PMC10023412 DOI: 10.1007/s00464-022-09581-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 08/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Previously, we reported short-term improvements in auditory attention, oromotor processing speed, and executive function during the active weight loss phase following bariatric surgery that persisted out to 3 months. In this study, our aims were to investigate the relationship between weight loss and cognitive performance in these patients 1 year following vertical sleeve gastrectomy (VSG) and Roux-en Y gastric bypass (RYGB) surgery and to determine whether preoperative cognitive performance predicted weight loss. METHODS Adult women ages 18-55 approved for bariatric surgery completed a cognitive battery prior to and at 2, 12, 24, and 52 weeks following VSG (N = 17) or RYGB (N = 18). Scores from each task were assigned to one of the following cognitive domains: auditory attention, processing speed, memory, and executive functioning. Weight loss and cognitive scores for each domain were calculated and compared between cohorts. RESULTS RYGB surgery resulted in greater weight loss at 1-year follow-up relative to VSG. Both VSG and RYGB procedures resulted in improved performance on different measures of auditory attention and both surgery groups improved across all processing speed tasks. Within the executive function domain, both groups showed improvements, but only the RYGB procedure resulted in improved performance in the Trail Making Test. Baseline auditory attention and memory performance predicted weight loss at 1 year following RYGB but not VSG surgery. Controlling for baseline cognitive performance, percent total weight loss predicted auditory attention at 1 year following RYGB but not VSG surgery. CONCLUSIONS Bariatric surgery type may result in selective improvements in cognition during the first year following surgery. Presurgical cognitive performance as well as surgery type appears to influence weight loss outcomes.
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Affiliation(s)
- Kimberly R Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA.
| | - Kimberley E Steele
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Afroditi Papantoni
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Civonnia Harris
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Caroline L Speck
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Arnold Bakker
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Timothy H Moran
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Susan Carnell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Phipps 316, Baltimore, MD, 21287, USA
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17
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Aguiar PV, Dionisio WÁDS, Souza EADC, Vantini D, Campanholi R, Pinto TCC, Ximenes RCC. Binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. Eat Weight Disord 2023; 28:12. [PMID: 36800040 PMCID: PMC9938051 DOI: 10.1007/s40519-023-01533-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/17/2022] [Indexed: 02/18/2023] Open
Abstract
PURPOSE The aim of the present study was to determine possible associations between binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. METHODS A cross-sectional study was conducted with 254 obese patients recruited from the general surgery service for bariatric procedures at the hospital affiliated with the Federal University of Pernambuco, Brazil. Evaluations were performed using the Binge Eating Scale (BES), Beck Depression Inventory, Beck Scale for Suicidal Ideation (BSSI) and a questionnaire addressing sociodemographic characteristics. RESULTS Most patients were women (82%), 48% had a moderate binge eating disorder, 42% a severe binge eating disorder, 32% had symptoms suggestive of mild, moderate or severe depression and 6% had suicidal ideation. Severe binge eating was positively associated with depressive symptoms (p < 0.001) and suicidal ideation (p < 0.05). Cases of severe binge eating were more frequent in young adults, but not necessarily associated with symptoms of depression or suicidal ideation in this portion of the sample. CONCLUSIONS The present findings underscore the need for psychological and psychiatric follow-up of obese candidates for bariatric surgery using appropriate assessment scales to guide therapeutic approaches. LEVEL III Evidence obtained from cross-sectional study.
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Affiliation(s)
- Priscilla Vasconcelos Aguiar
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Weslley Álex da Silva Dionisio
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil.
| | | | - Davi Vantini
- Clinical Analysis Laboratory, Faculdade de Medicina Do ABC, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Raphael Campanholi
- Clinical Analysis Laboratory, Faculdade de Medicina Do ABC, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Tiago Coimbra Costa Pinto
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Reiter-Purtill J, Decker KM, Jenkins TM, Zeller MH. Self-worth and developmental outcomes in young adults after pediatric bariatric surgery. Health Psychol 2023; 42:92-102. [PMID: 36633990 PMCID: PMC9976787 DOI: 10.1037/hea0001257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Bariatric surgery has emerged as a safe/effective treatment for adolescents with severe obesity; therefore, understanding its impact over the life course is imperative. This study examined self-worth and developmental outcomes during the transition to adulthood (19-24 years old) for youth who underwent surgery as adolescents (13-18 years old) and a nonsurgical group with severe obesity. METHOD As part of a prospective and multisite observational study series, adolescents (139 surgical, 83 nonsurgical) were followed for 6 years postsurgery/baseline when they completed height/weight measurements and measures of global self-worth, maturity, and occupational, educational, and social functioning as young adults. Growth curve analysis examined global self-worth change, while regressions were used to compare groups and examine adolescent-reported familial predictors and weight-related correlates for outcomes. RESULTS Relative to the nonsurgical group, the surgical group experienced a significant quadratic improvement in self-worth and higher year 6 romantic self-perceptions. For the surgical group only, greater family dysfunction predicted lower young adult self-worth and perceptions of maturity, while higher family connectedness predicted higher self-worth and perceptions of maturity. Greater percent weight loss was associated with higher perceptions of maturity for the surgical group. CONCLUSIONS Group difference findings suggest that the impact of surgery was on self-worth and romantic self-perceptions, outcomes linked in the developmental literature to body image. For both groups, functioning appeared similar to population-based findings, suggesting they are meeting "expected" age-salient developmental outcomes. The impact of earlier positive family functioning on self-worth and self-perceptions of maturity may place adolescents on pathways to success. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Kimura Y, Fujishima Y, Nishizawa H, Saito T, Miyazaki Y, Shirahase K, Tokuzawa C, Nagai N, Fukuda S, Maeda K, Maeda N, Doki Y, Shimomura I. Changes in Eating Behaviors and Their Associations with Weight Loss in Japanese Patients Who Underwent Laparoscopic Sleeve Gastrectomy. Nutrients 2023; 15:nu15020353. [PMID: 36678222 PMCID: PMC9866351 DOI: 10.3390/nu15020353] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Metabolic and bariatric surgery (MBS) has been established to provide long-term weight loss in severe obesity. In this study, we investigated the factors that affect post-operative weight loss, with a particular focus on changes in eating behaviors. METHODS Time-course changes in body weight and eating behaviors were examined in 49 Japanese patients who underwent laparoscopic sleeve gastrectomy from the first visit to 12 months after surgery. Each eating behavior was evaluated via the questionnaire of the Japan Society for the Study of Obesity. RESULTS Pre-operative weight reduction mediated by dietary and lifestyle interventions showed significant positive correlations with weight loss outcomes at 12 months after surgery. We observed significant decreases in scores for most of the eating behaviors 12 months after surgery. However, "emotional eating behavior" scores declined temporarily in the early post-operative period of one month but thereafter returned to the pre-operative level at 12 months. Furthermore, increases in the scores for "emotional eating behavior" and "sense of hunger" from 1 to 12 months post-operatively were significantly associated with poor weight loss. CONCLUSIONS Our results demonstrate the beneficial effects of MBS on obesity-related eating behaviors, as well as highlighting "emotional eating behavior" as requiring particular attention.
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Affiliation(s)
- Yu Kimura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yuya Fujishima
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Correspondence: ; Tel.: +81-(66)-8793732; Fax: +81-(66)-8793739
| | - Takuro Saito
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Yasuhiro Miyazaki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Department of Surgery, Osaka General Medical Center, Osaka 558-8558, Japan
| | - Keiko Shirahase
- Division of Nutrition Management, Osaka University Hospital, Osaka 565-0871, Japan
| | - Chie Tokuzawa
- Division of Nutrition Management, Osaka University Hospital, Osaka 565-0871, Japan
| | - Naoko Nagai
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Division of Nutrition Management, Osaka University Hospital, Osaka 565-0871, Japan
| | - Shiro Fukuda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Kazuhisa Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Norikazu Maeda
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Department of Metabolism and Atherosclerosis, Graduate School of Medicine Osaka University, Osaka 565-0871, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Division of Nutrition Management, Osaka University Hospital, Osaka 565-0871, Japan
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20
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Pekin C, McHale M, Seymour M, Strodl E, Hopkins G, Mitchell D, Byrne GJ. Psychopathology and eating behaviour in people with type 2 diabetes referred for bariatric surgery. Eat Weight Disord 2022; 27:3627-3635. [PMID: 36495463 PMCID: PMC9803743 DOI: 10.1007/s40519-022-01502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Psychopathology and disordered eating behaviours are putative pre-operative risk factors for suboptimal outcomes post-bariatric surgery. Documented psychopathology prevalence rates vary in bariatric candidate samples. Further, less attention has been paid to vulnerable subgroups such as people with diabetes who might be at an elevated risk. For these reasons, this study aimed to investigate the rates of psychopathology and disordered eating in pre-surgical candidates with type 2 diabetes mellitus (T2DM). METHODS Participants were 401 consecutive patients from a state-wide bariatric surgery service for people with T2DM. Psychopathology was measured using multi-modal assessment including diagnostic interview and battery of validated questionnaires. The mean age of the sample was 51 years with a mean BMI of 46 kg/m2. The majority of the sample was female (60.6%), born in Australia (87%) and 18.2% identified as Aboriginal and/or Torres Strait Islander. RESULTS Rates of current psychopathology in this sample included: major depressive disorder (MDD; 16.75%), generalised anxiety disorder (GAD; 20.25%), insomnia (17.75%) and binge eating disorder (BED; 10.75%). There were no significant differences on measures between people who endorsed Aboriginal and/or Torres Strait Islander status compared to those who did not endorse. The mean total score on the BES was 21.82 ± 10.40 (range 0-39), with 8.2% of participants meeting criteria for severe binge eating. Presence of an eating disorder was not significantly associated with degree of glycemic compensation. Average emotional eating scores were significantly higher in this study, compared to reference samples. Significantly increased binge eating severity and emotional eating severity was revealed for people with T2DM and comorbid MDD, social anxiety and eating disorders. Binge eating severity was associated with GAD, food addiction, substance use disorders, and history of suicide attempt but not emotional eating severity. CONCLUSION Amongst people with T2DM seeking bariatric surgery, MDD, GAD and emotional eating were common. Psychopathology in a sample of people with T2DM seeking bariatric surgery was significantly associated with severity of disordered eating. These findings suggest people with T2DM seeking bariatric surgery may be vulnerable to psychopathology and disordered eating with implications for early identification and intervention. LEVEL OF EVIDENCE Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- C Pekin
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia.
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia.
| | - M McHale
- Department of Psychology, Royal Brisbane & Women's Hospital and School of Psychology, University of Queensland, Brisbane, QLD, Australia
| | - M Seymour
- Faculty of Medicine, Department of Endocrinology and Diabetes, Royal Brisbane & Women's Hospital, University of Queensland, Brisbane, QLD, Australia
| | - E Strodl
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - G Hopkins
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - D Mitchell
- Division of Surgery Metro North Hospital and Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
| | - G J Byrne
- Faculty of Medicine, Academy of Psychiatry, University of Queensland, Brisbane, QLD, Australia
- Mental Health Service, Royal Brisbane & Women's Hospital, Brisbane, Australia
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
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21
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Chao AM, Abene J, Allison KC, Pearl RL, Wadden TA, Williams NN, Tronieri JS. Binge eating disorder and eating self-efficacy in adults seeking bariatric surgery. Clin Obes 2022; 12:e12531. [PMID: 35606940 PMCID: PMC9624241 DOI: 10.1111/cob.12531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 11/30/2022]
Abstract
This study assessed the relationships between binge eating disorder (BED) and eating self-efficacy in a sample of patients prior to bariatric surgery. The study also examined the extent that BED status accounted for variance in self-efficacy after controlling for demographic factors (age, sex and race), physical variables (comorbidities and body mass index [BMI]) and depressive symptoms. This was a cross-sectional study of pre-surgical data from patients seeking bariatric surgery at a university-based healthcare system (N = 98; mean ± SD age of 46.2 ± 12.5 years; BMI of 45.4 ± 7.2 kg/m2 ; 86.7% female; and 60.2% of patients self-identified as White). Patients completed the Weight and Lifestyle Inventory (WALI), Beck Depression Inventory-II (BDI-II) and Weight Efficacy Lifestyle Questionnaire. Of the total sample, 15.3% met criteria for BED, 33.7% had subthreshold BED and 51.0% were free of this disorder. In adjusted analyses, total self-efficacy was significantly lower in patients with subthreshold BED (B ± SE = -15.88 ± 7.23, p = .03) and individuals with BED (B ± SE = -35.07 ± 10.23, p = .001) than in those without BED. Patients with BED, compared to those without, had significantly worse scores (in adjusted analyses) on the self-efficacy subscales of negative emotions (p = .003), availability of food (p < .001), social pressure (p = .004) and positive activities (p = .03). In patients seeking bariatric surgery, total self-efficacy scores were significantly lower in patients with BED and subthreshold BED than those without BED. The results suggest that eating self-efficacy may be an important factor to target in patients with BED who seek bariatric surgery.
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Affiliation(s)
- Ariana M Chao
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jessica Abene
- Department of Biobehavioral Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jena S Tronieri
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Hoffmann K, Paczkowska A, Bryl W, Marzec K, Raakow J, Pross M, Berghaus R, Nowakowska E, Kus K, Michalak M. Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study. Nutrients 2022; 14:nu14132775. [PMID: 35807955 PMCID: PMC9268827 DOI: 10.3390/nu14132775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.
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Affiliation(s)
- Karolina Hoffmann
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
- Correspondence: ; Tel.: +48-61-8549-377; Fax: +48-61-8478-529
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Wiesław Bryl
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Kinga Marzec
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Jonas Raakow
- Department of Surgery, Campus Charité Mitte, Campus Virchow Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Matthias Pross
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Rafael Berghaus
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Elżbieta Nowakowska
- Department of Pharmacology and Toxicology, Institute of Health Sciences, Collegium Medicum, University of Zielona Góra, 65-516 Zielona Góra, Poland;
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
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King WC, White GE, Belle SH, Yanovski SZ, Pomp A, Pories WJ, Wolfe BM, Ahmed B, Courcoulas AP. Changes in Smoking Behavior Before and After Gastric Bypass: A 7-year Study. Ann Surg 2022; 275:131-139. [PMID: 32084036 DOI: 10.1097/sla.0000000000003828] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate smoking history and change in smoking behavior, from 1 year before through 7 years after Roux-en-Y gastric bypass (RYGB) surgery, and to identify risk factors for post-surgery smoking. BACKGROUND Smoking behavior in the context of bariatric surgery is poorly described. METHODS Adults undergoing RYGB surgery entered a prospective cohort study between 2006 and 2009 and were followed up to 7 years until ≤2015. Participants (N = 1770; 80% female, median age 45 years, median body mass index 47 kg/m2) self-reported smoking history pre-surgery, and current smoking behavior annually. RESULTS Almost half of participants (45.2%) reported a pre-surgery history of smoking. Modeled prevalence of current smoking decreased in the year before surgery from 13.7% [95% confidence interval (CI) = 12.1-15.4] to 2.2% (95% CI = 1.5-2.9) at surgery, then increased to 9.6% (95% CI = 8.1-11.2) 1-year post-surgery and continued to increase to 14.0% (95% CI = 11.8-16.0) 7-years post-surgery. Among smokers, mean packs/day was 0.60 (95% CI = 0.44-0.77) at surgery, 0.70 (95% CI = 0.62-0.78) 1-year post-surgery and 0.77 (95% CI = 0.68-0.88) 7-years post-surgery. At 7-years, smoking was reported by 61.7% (95% CI = 51.9-70.8) of participants who smoked 1-year pre-surgery (n = 221), 12.3% (95% CI = 8.5-15.7) of participants who formerly smoked but quit >1 year pre-surgery (n = 507), and 3.8% (95% CI = 2.1-4.9) of participants who reported no smoking history (n = 887). Along with smoking history (ie, less time since smoked), younger age, household income <$25,000, being married or living as married, and illicit drug use were independently associated with increased risk of post-surgery smoking. CONCLUSION Although most adults who smoked 1-year before RYGB quit pre-surgery, smoking prevalence rebounded across 7-years, primarily due to relapse.
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Affiliation(s)
- Wendy C King
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Gretchen E White
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Steven H Belle
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Susan Z Yanovski
- Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Alfons Pomp
- Department of Surgery, Weill Cornell Medical College, New York, New York
| | - Walter J Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina
| | - Bruce M Wolfe
- Department of Surgery, Oregon Health & Sciences University, Portland, Oregon
| | - Bestoun Ahmed
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anita P Courcoulas
- Department of Surgery, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Köhler H, Markov V, Watschke A, Gruner-Labitzke K, Böker C, Kröger C. Changes in Work Ability after Weight-Loss Surgery: Results of a Longitudinal Study of Persons with Morbid Obesity before and after Bariatric Surgery. Obes Facts 2022; 15:36-45. [PMID: 34749355 PMCID: PMC8820149 DOI: 10.1159/000519269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/17/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in work ability is still limited. We hypothesized that self-reported work ability improves in response to surgery-induced weight loss and sociodemographical variables (e.g., age, sex, and marital status), and that psychosocial characteristics (e.g., depressive symptoms and dysfunctional eating) may have predictive value as to patients' work ability. METHODS A total of 200 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. They completed several self-report measures at the preoperative examination (t1) and at 6- (t2) and 12 months (t3) after bariatric surgery. A repeated-measures analysis of variance was calculated to detect any changes in the work ability and body mass index (BMI) among the 3 time points. Further, a hierarchical multiple regression analysis was used to determine whether any demographical and psychosocial characteristics at (t1) would predict work ability at (t3). RESULTS Participants (82% of whom were women) were middle-aged and showed a BMI of nearly 46 at the preoperative medical examination. Excess weight loss at (t2) and at (t3) was 49 and 66%, respectively. Work ability increased toward a moderate level after weight-loss surgery. Work ability and dysfunctional eating at (t1) showed significant predictive value with respect to work ability at (t3). DISCUSSION The results suggest that weight-loss surgery has a positive impact on work ability, and indicate a predictive value for the extent of weight loss and dysfunctional eating behavior. Against our hypothesis and in contrast to former research, a predictive value for depressive symptoms and age was not revealed. Further research must show how interventions can support and maintain improvements in work ability after bariatric surgery, in order to reduce sick leave and unemployment in patients with preoperative morbid obesity.
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Affiliation(s)
- Hinrich Köhler
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany
- *Hinrich Köhler,
| | - Valentin Markov
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
| | - Anna Watschke
- Department of Psychology, University of Braunschweig, Braunschweig, Germany
| | - Kerstin Gruner-Labitzke
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany
| | - Clara Böker
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hannover, Germany
| | - Christoph Kröger
- Department of Psychology, University of Hildesheim, Hildesheim, Germany
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Enaud R, Cambos S, Viaud E, Guichoux E, Chancerel E, Marighetto A, Etchamendy N, Clark S, Mohammedi K, Cota D, Delhaes L, Gatta-Cherifi B. Gut Microbiota and Mycobiota Evolution Is Linked to Memory Improvement after Bariatric Surgery in Obese Patients: A Pilot Study. Nutrients 2021; 13:nu13114061. [PMID: 34836316 PMCID: PMC8620125 DOI: 10.3390/nu13114061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/07/2021] [Accepted: 11/11/2021] [Indexed: 12/23/2022] Open
Abstract
Patients with obesity are known to exhibit gut microbiota dysbiosis and memory deficits. Bariatric surgery (BS) is currently the most efficient anti-obesity treatment and may improve both gut dysbiosis and cognition. However, no study has investigated association between changes of gut microbiota and cognitive function after BS. We prospectively evaluated 13 obese patients on anthropometric data, memory functions, and gut microbiota-mycobiota before and six months after BS. The Rey Auditory Verbal Learning Test (AVLT) and the symbol span (SS) of the Weschler Memory Scale were used to assess verbal and working memory, respectively. Fecal microbiota and mycobiota were longitudinally analyzed by 16S and ITS2 rRNA sequencing respectively. AVLT and SS scores were significantly improved after BS (AVLT scores: 9.7 ± 1.7 vs. 11.2 ± 1.9, p = 0.02, and SS scores: 9.7 ± 23.0 vs. 11.6 ± 2.9, p = 0.05). An increase in bacterial alpha-diversity, and Ruminococcaceae, Prevotella, Agaricus, Rhodotorula, Dipodascus, Malassezia, and Mucor were significantly associated with AVLT score improvement after BS, while an increase in Prevotella and a decrease in Clostridium, Akkermansia, Dipodascus and Candida were linked to SS scores improvement. We identified several changes in the microbial communities that differ according to the improvement of either the verbal or working memories, suggesting a complex gut-brain-axis that evolves after BS.
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Affiliation(s)
- Raphaël Enaud
- Centre Hospitalier de Bordeaux, CRCM Pédiatrique, CIC 1401, 33000 Bordeaux, France;
- Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Hôpital Xavier Arnozan, University of Bordeaux, Avenue du Haut Lévêque, 33604 Pessac, France;
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
| | - Sophie Cambos
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Esther Viaud
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Erwan Guichoux
- BIOGECO, INRAE, University of Bordeaux, 69 route d’Arcachon, 33610 Cestas, France; (E.G.); (E.C.)
| | - Emilie Chancerel
- BIOGECO, INRAE, University of Bordeaux, 69 route d’Arcachon, 33610 Cestas, France; (E.G.); (E.C.)
| | - Aline Marighetto
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Nicole Etchamendy
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Samantha Clark
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
| | - Kamel Mohammedi
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
| | - Daniela Cota
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU TALISMENT, 33000 Bordeaux, France
| | - Laurence Delhaes
- Centre de Recherche Cardio-Thoracique de Bordeaux, U1045, Hôpital Xavier Arnozan, University of Bordeaux, Avenue du Haut Lévêque, 33604 Pessac, France;
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU ACRONIM, 33000 Bordeaux, France;
| | - Blandine Gatta-Cherifi
- Centre Hospitalier de Bordeaux, Department of Endocrinology, Diabetes and Nutrition, University Hospital of Bordeaux, 33604 Pessac, France;
- Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, INSERM, 146 rue Léo Saignat, 33076 Bordeaux, France; (E.V.); (A.M.); (N.E.); (S.C.); (D.C.)
- Centre Hospitalier de Bordeaux, University of Bordeaux, FHU TALISMENT, 33000 Bordeaux, France
- Correspondence:
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Muraca E, Oltolini A, Binda A, Pizzi M, Ciardullo S, Manzoni G, Zerbini F, Bianconi E, Cannistraci R, Perra S, Pizzi P, Lattuada G, Perseghin G, Villa M. Metabolic and Psychological Features are Associated with Weight Loss 12 Months After Sleeve Gastrectomy. J Clin Endocrinol Metab 2021; 106:e3087-e3097. [PMID: 33705552 DOI: 10.1210/clinem/dgab161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Laparoscopic sleeve gastrectomy (LSG) is a recognized effective procedure of bariatric surgery, but a poor response in weight loss may still represent a clinical problem. To date there are no validated predictors useful to better perform patient selection. OBJECTIVE To establish the association of baseline anthropometric, metabolic, and psychologic features with the percent total weight loss (%TWL) and percent excess weight loss (%EWL) 12 months after surgery. DESIGN Retrospective longitudinal analysis of a set of data about obese patients attending the outpatient service of a single obesity center from June 2016 to June 2019. PATIENTS A total of 106 obese patients underwent LSG with presurgery evaluation and follow-up at 12 months after surgery. MAIN OUTCOME Weight loss 12 months after LSG. RESULTS Patients who achieved a %TWL higher than the observed median (≥34%) were younger, with a lower fasting plasma glucose and glycated hemoglobin, with a lower prevalence of hypertension and with a lower score in the impulsiveness scale, compared with patients with a %TWL < 34%. Similar findings were found when %EWL was considered. Multivariable stepwise regression analysis showed that younger age, lower impulsiveness, higher-than-normal urinary free cortisol, and lower HbA1c were associated with higher %TWL, explaining about 31.5% of the weight loss. CONCLUSION Metabolic and psychologic features at baseline were independently associated with weight loss and explained a non-negligible effect on the response to LSG. These data suggest that careful metabolic and psychologic profiling could help in sharper indications and personalized pre- and postsurgical follow-up protocols in candidates for LSG.
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Affiliation(s)
- Emanuele Muraca
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Alice Oltolini
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Alberto Binda
- Clinical Psychology; Policlinico di Monza, 20900 Monza, Italy
| | - Mattia Pizzi
- Centro per lo Studio, la Ricerca e la terapia dell'Obesità, Policlinico di Monza, 20900 Monza, Italy
| | - Stefano Ciardullo
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca; 20900 Monza, Italy
| | - Giuseppina Manzoni
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Francesca Zerbini
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Eleonora Bianconi
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Rosa Cannistraci
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca; 20900 Monza, Italy
| | - Silvia Perra
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Pietro Pizzi
- Centro per lo Studio, la Ricerca e la terapia dell'Obesità, Policlinico di Monza, 20900 Monza, Italy
| | - Guido Lattuada
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
| | - Gianluca Perseghin
- Department of Medicine and Rehabilitation; Policlinico di Monza, 20900 Monza, Italy
- Department of Medicine and Surgery, Università degli Studi di Milano Bicocca; 20900 Monza, Italy
| | - Matteo Villa
- Clinical Psychology; Policlinico di Monza, 20900 Monza, Italy
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Almby KE, Lundqvist MH, Abrahamsson N, Kvernby S, Fahlström M, Pereira MJ, Gingnell M, Karlsson FA, Fanni G, Sundbom M, Wiklund U, Haller S, Lubberink M, Wikström J, Eriksson JW. Effects of Gastric Bypass Surgery on the Brain: Simultaneous Assessment of Glucose Uptake, Blood Flow, Neural Activity, and Cognitive Function During Normo- and Hypoglycemia. Diabetes 2021; 70:1265-1277. [PMID: 33674408 PMCID: PMC8275889 DOI: 10.2337/db20-1172] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 02/25/2021] [Indexed: 12/15/2022]
Abstract
While Roux-en-Y gastric bypass (RYGB) surgery in obese individuals typically improves glycemic control and prevents diabetes, it also frequently causes asymptomatic hypoglycemia. Previous work showed attenuated counterregulatory responses following RYGB. The underlying mechanisms as well as the clinical consequences are unclear. In this study, 11 subjects without diabetes with severe obesity were investigated pre- and post-RYGB during hyperinsulinemic normo-hypoglycemic clamps. Assessments were made of hormones, cognitive function, cerebral blood flow by arterial spin labeling, brain glucose metabolism by 18F-fluorodeoxyglucose (FDG) positron emission tomography, and activation of brain networks by functional MRI. Post- versus presurgery, we found a general increase of cerebral blood flow but a decrease of total brain FDG uptake during normoglycemia. During hypoglycemia, there was a marked increase in total brain FDG uptake, and this was similar for post- and presurgery, whereas hypothalamic FDG uptake was reduced during hypoglycemia. During hypoglycemia, attenuated responses of counterregulatory hormones and improvements in cognitive function were seen postsurgery. In early hypoglycemia, there was increased activation post- versus presurgery of neural networks in brain regions implicated in glucose regulation, such as the thalamus and hypothalamus. The results suggest adaptive responses of the brain that contribute to lowering of glycemia following RYGB, and the underlying mechanisms should be further elucidated.
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Affiliation(s)
- Kristina E Almby
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Martin H Lundqvist
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Niclas Abrahamsson
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Sofia Kvernby
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Markus Fahlström
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Maria J Pereira
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Malin Gingnell
- Department of Neurosciences and Department of Psychology, Uppsala University, Uppsala, Sweden
| | - F Anders Karlsson
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Giovanni Fanni
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Urban Wiklund
- Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Sven Haller
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Mark Lubberink
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Wikström
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Jan W Eriksson
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
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Lester ELW, Padwal RS, Birch DW, Sharma AM, So H, Ye F, Klarenbach SW. The real-world cost-effectiveness of bariatric surgery for the treatment of severe obesity: a cost-utility analysis. CMAJ Open 2021; 9:E673-E679. [PMID: 34145050 PMCID: PMC8248561 DOI: 10.9778/cmajo.20200188] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Severe obesity is associated with adverse health outcomes and increased risk of death. This study evaluates the real-world cost-utility of therapy for severe obesity, from the publicly funded health care system and societal perspectives. METHODS We conducted a cost-utility analysis using primary data from a prospective observational cohort of adults living with severe obesity (BMI ≥ 35 kg/m2 and a major medical comorbidity or BMI ≥ 40 kg/m2) who were enrolled in a regional obesity program over 2 years. We extrapolated 10-year and lifetime Markov models, validated and supplemented with literature sources, to compare medical, surgical and standard care therapies. We performed deterministic and probabilistic sensitivity analyses. RESULTS The cohort included 500 adults living with severe obesity, 150 of whom received laparoscopic surgical therapy. From a publicly funded health system perspective, at 2 years, surgical therapy had an incremental cost-effectiveness ratio (ICER) of $54 456 per quality-adjusted life-year (QALY) compared with standard care therapy. Over a lifetime, it had an ICER of $14 056 per QALY. From the societal perspective, at 2 years, surgical therapy had an ICER of $340 per QALY; over a lifetime, it was the dominant option. The results were robust to sensitivity analysis. INTERPRETATION From a public health care perspective, surgery for severe obesity is cost effective, and when approached from a societal perspective, it becomes cost saving. Real-world data support using surgical therapy for severe obesity, and our results contribute to the health economic and clinical literature with regard to a robust analysis from a societal perspective.
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Affiliation(s)
- Erica L W Lester
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta.
| | - Raj S Padwal
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
| | - Daniel W Birch
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
| | - Arya M Sharma
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
| | - Helen So
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
| | - Feng Ye
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
| | - Scott W Klarenbach
- Departments of Surgery (Lester, Birch) and Medicine (Padwal, Sharma, So, Ye, Klarenbach), University of Alberta, Edmonton, Alta
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Abstract
PURPOSE OF REVIEW This review describes clinical management of early-onset severe obesity, defined here as severe obesity in children ≤ 5 years old. It summarizes current information regarding (1) assessment, specifically growth, genetics, cardiometabolic risk, health behaviors, developmental considerations, and psychosocial factors, and (2) treatment, focusing on lifestyle modification including parent training and a brief summary of pharmacotherapy. RECENT FINDINGS Prevalence of severe obesity in young children has remained stable yet most of these children will become adults with obesity. Interventions that address multiple health domains, such as eating habits, physical activity, and parenting skills, are necessary for addressing early-onset severe obesity. Research into pharmacotherapy remains limited but may provide future strategies for management. Early-onset severe obesity significantly influences children's long-term health and management should focus on intervention to promote BMI reduction. Further research into effective strategies is necessary to address the needs of this high-risk population.
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Affiliation(s)
- Sarah Raatz
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, USA
| | - Amy C Gross
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, USA.
- Center for Pediatric Obesity Medicine, University of Minnesota, Minneapolis, USA.
- , Minneapolis, USA.
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Zeller MH, Kidwell KM, Reiter-Purtill J, Jenkins TM, Michalsky MP, Mitchell JE, Courcoulas AP, Inge TH. Cigarette Use and Adolescent Metabolic and Bariatric Surgery. Obesity (Silver Spring) 2021; 29:579-586. [PMID: 33528876 PMCID: PMC8023426 DOI: 10.1002/oby.23084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/04/2020] [Accepted: 11/10/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This study aimed to track conventional cigarette smoking behaviors and associated correlates in adolescents with severe obesity who did or did not undergo metabolic and bariatric surgery to 4 years after surgery/baseline. METHODS Utilizing a prospective controlled design, surgical (n = 153; mean BMI = 52) and nonsurgical (n = 70; mean BMI = 47) groups that completed assessments before surgery/at baseline and at Years 2 and 4 post surgery (Year 4: n = 117 surgical [mean BMI = 38]; n = 56 nonsurgical [mean BMI = 48]) were compared. Separate logistic regression models tested correlates of Year 4 current smoking. RESULTS More than half of participants (surgical: 55%; nonsurgical: 60%) had ever smoked a cigarette, with current smoking increasing with time. Groups did not differ in Year 4 current smoking (surgical: 23%; nonsurgical: 33%), with ≈ 50% meeting criteria for "heavy" smoking (≥ half pack/day) and ≈ 40% smoking their first cigarette before ninth grade. Factors associated with higher odds of Year 4 current smoking included dysregulation (P < 0.001), internalizing symptoms (P = 0.01), alcohol use (P = 0.04), caregiver smoking (P < 0.001), friend smoking (P = 0.001), and perceiving low harm (P = 0.02), plus greater percent weight loss (P = 0.03) in the surgical group. CONCLUSIONS Smoking is a clinical health challenge for adolescents and young adults with severe obesity, including those who have undergone metabolic and bariatric surgery. Upstream identification, monitoring, and intervention to prevent smoking uptake and escalation in youth with obesity across settings should be prioritized.
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Affiliation(s)
- Meg H Zeller
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Katherine M Kidwell
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Todd M Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Marc P Michalsky
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - James E Mitchell
- Department of Psychiatry and Behavioral Science, University of North Dakota, Fargo, North Dakota, USA
| | - Anita P Courcoulas
- Division of Minimally Invasive General and Bariatric Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Thomas H Inge
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
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Melis M, Pintus S, Mastinu M, Fantola G, Moroni R, Pepino MY, Tomassini Barbarossa I. Changes of Taste, Smell and Eating Behavior in Patients Undergoing Bariatric Surgery: Associations with PROP Phenotypes and Polymorphisms in the Odorant-Binding Protein OBPIIa and CD36 Receptor Genes. Nutrients 2021; 13:nu13010250. [PMID: 33467165 PMCID: PMC7830302 DOI: 10.3390/nu13010250] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/08/2021] [Accepted: 01/13/2021] [Indexed: 02/08/2023] Open
Abstract
Bariatric surgery is the most effective long-term treatment for severe obesity and related comorbidities. Although patients who underwent bariatric surgery report changes of taste and smell perception, results from sensory studies are discrepant and limited. Here, we assessed taste and smell functions in 51 patients before, one month, and six months after undergoing bariatric surgery. We used taste strip tests to assess gustatory function (including sweetness, saltiness, sourness, umaminess, bitterness and oleic acid, a fatty stimulus), the “Sniffin’ Sticks” test to assess olfactory identification and the 3-Factor Eating Questionnaire to assess eating behavior. We also explored associations between these phenotypes and flavor-related genes. Results showed an overall improvement in taste function (including increased sensitivity to oleic acid and the bitterness of 6-n-propylthiouracil (PROP)) and in olfactory function (which could be related to the increase in PROP and oleic acid sensitivity), an increase in cognitive restraint, and a decrease in disinhibition and hunger after bariatric surgery. These findings indicate that bariatric surgery can have a positive impact on olfactory and gustatory functions and eating behavior (with an important role of genetic factors, such PROP tasting), which in turn might contribute to the success of the intervention.
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Affiliation(s)
- Melania Melis
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
- Correspondence: ; Tel.: +39-070-675-4142
| | - Stefano Pintus
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Mariano Mastinu
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
| | - Giovanni Fantola
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Roberto Moroni
- Obesity Surgical Unit ARNAS G. Brotzu, 09121 Cagliari, Italy; (S.P.); (G.F.); (R.M.)
| | - Marta Yanina Pepino
- Department of Food Science and Human Nutrition, University of Illinois, Urbana Champaign, Urbana, IL 61801, USA;
| | - Iole Tomassini Barbarossa
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (M.M.); (I.T.B.)
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Al-Qahtani AM. Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia. Based on diabetes self-management questionnaire. Saudi Med J 2021; 41:955-964. [PMID: 32893277 PMCID: PMC7557543 DOI: 10.15537/smj.2020.9.25339] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To investigate the frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional study was conducted on a sample of 355 patients with T2DM, using multistage cluster sampling, attending the Najran University Hospital and Primary health care centres in Najran, Saudi Arabia, from January to May 2019. The assessment of self-care behaviors was conducted using the 16-item diabetes self-management questionnaire (DSMQ). Results: The majority (85.1%) of the patients with T2DM were uncontrolled, 42% were obese, and 5.9% were morbidly obese. Based on DSMQ criteria, the majority of patients (90.1%) had poor self-care behaviors. The mean sum of DSMQ was 5.04 out of 10. Among the DSMQ subscales, health care use had the highest mean score of 5.63, followed by glucose management with a score of 5.12, while dietary control had lower mean scores of 4.96 and physical activity had 4.46, all were inadequate. Being married (OR=2.178, p=0.035) and having DM for more than 5 years (OR=2.711, p less than 0.006) were the significant independent factors associated with poor self-care behavior. CONCLUSION Inadequate self-care behavior is widely prevalent in Najran city, Saudi Arabia. All the DSMQ subscales were poorly managed by most of the diabetic patients. Furthermore, being married and having a longer DM duration are the significant independent factors associated with poor self-care behaviors.
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Affiliation(s)
- Awad Mohammed Al-Qahtani
- Department of Family and Community Medicine, College of Medicine, Najran University, Najran, Kingdom of Saudi Arabia. E-mail.
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Reinmann A, Gafner SC, Hilfiker R, Bruyneel AV, Pataky Z, Allet L. Bariatric Surgery: Consequences on Functional Capacities in Patients With Obesity. Front Endocrinol (Lausanne) 2021; 12:646283. [PMID: 33868175 PMCID: PMC8049139 DOI: 10.3389/fendo.2021.646283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/02/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Bariatric surgery leads to loss of fat and fat-free mass (FFM). To preserve FFM it is recommended that weight loss interventions are accompanied by physical activity. However, it remains unknown if functional capacities spontaneously improve after a substantial weight loss. Study's aim was to assess the effect of bariatric surgery on strength, functional capacities and quality of life of participants with a body mass index (BMI) ≥ 35 kg/m2. METHOD Anthropometric parameters (weight, BMI, waist circumference), physical functions (quadriceps strength, walking capacity, spatio-temporal gait parameters, dynamic balance, lower limb power) and quality of life were assessed before and at three months after the bariatric surgery in 33 individuals who did not follow any physical activity program. RESULTS The anthropometric parameters, quality of life and three functional abilities (walking capacity, normal gait speed and lower limb power) improved significantly three months post-surgery. In contrast, fast gait speed, absolute strength, normalized strength, and dynamic balance did not improve. DISCUSSION A massive weight loss should be accompanied by an exercise program aiming to maintain FFM and to enhance muscle strength and balance. Such a program might also enhance functional capacities and help to sustain the weight loss over time.
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Affiliation(s)
- Aline Reinmann
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
- *Correspondence: Aline Reinmann,
| | - Simone Chantal Gafner
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Roger Hilfiker
- Valais-Wallis School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Valais, Switzerland
| | - Anne-Violette Bruyneel
- Geneva School of Health Sciences, Haute Ecole Spécialisée de Suisse Occidentale (HES-SO) University of Applied Sciences and Arts Western Switzerland, Geneva, Switzerland
| | - Zoltan Pataky
- Department of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - Lara Allet
- Valais-Wallis School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Valais, Switzerland
- Department of Medicine, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
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Matthews KN, Psihogios M, Dettmer E, Steinegger C, Toulany A. "I am the embodiment of an anorexic patient's worst fear": Severe obesity and binge eating disorder on a restrictive eating disorder ward. Clin Obes 2020; 10:e12398. [PMID: 32911574 PMCID: PMC7685105 DOI: 10.1111/cob.12398] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 12/05/2022]
Abstract
Adolescents who have been diagnosed with an eating disorder commonly have comorbid mental health conditions which have a significant impact on illness trajectory and may even limit access to effective treatment. Current models of eating disorder care focus mainly on treatment for patients diagnosed with restrictive eating disorders with fewer options available for those with binge eating disorder. We describe a case of an adolescent living with severe, complex obesity and binge eating disorder, presenting in a mental health crisis, admitted to an in-patient unit primarily for patients being treated for restrictive eating disorders such as anorexia nervosa. This case report describes multiple challenges that arose in admitting such a patient on a ward specializing in the treatment of restrictive eating disorders and highlights the need for equitable and more accessible care for patients living with all types of eating disorders.
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Affiliation(s)
| | - Maria Psihogios
- Department of PaediatricsMichael Garron HospitalTorontoOntarioCanada
| | | | - Cathleen Steinegger
- Department of PaediatricsUniversity of TorontoTorontoOntarioCanada
- Division of Adolescent MedicineHospital for Sick ChildrenTorontoOntarioCanada
| | - Alene Toulany
- Department of PaediatricsUniversity of TorontoTorontoOntarioCanada
- Division of Adolescent MedicineHospital for Sick ChildrenTorontoOntarioCanada
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36
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Chan JKY, King M, Vartanian LR. Patient perspectives on psychological care after bariatric surgery: A qualitative study. Clin Obes 2020; 10:e12399. [PMID: 32830441 DOI: 10.1111/cob.12399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 11/29/2022]
Abstract
Psychological interventions may be effective in improving adherence after bariatric surgery; however, there is limited research on patients' willingness to engage with psychological aftercare. This study aimed to qualitatively explore patient perspectives on psychological services in the bariatric setting. Participants reported believing that psychological care is essential for treatment success and indicated that they wanted support with adjusting to changes in lifestyle, self-identity, and relationships after surgery. Participants suggested that psychological aftercare should be recommended by their medical team and incorporated into standard management after bariatric surgery. These findings can be used to inform the design of services for bariatric surgery patients.
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Affiliation(s)
- Jade K Y Chan
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Marlee King
- School of Psychology, Western Sydney University, Bankstown, New South Wales, Australia
| | - Lenny R Vartanian
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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Björkman S, Wallengren O, Laurenius A, Eliasson B, Larsson I. Nocturnal eating but not binge eating disorder is related to less 12 months' weight loss in men and women with severe obesity: A retrospective cohort study. Clin Obes 2020; 10:e12408. [PMID: 32851796 PMCID: PMC7685102 DOI: 10.1111/cob.12408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 07/28/2020] [Accepted: 08/07/2020] [Indexed: 12/24/2022]
Abstract
There is a paucity of studies on the frequency of binge-eating disorder (BED) and nocturnal eating (NE) and their potential role as barriers in non-surgical weight loss treatment in subjects with severe obesity (body mass index [BMI] ≥35 kg m2 ). The aim was to identify BED and NE, and their effect on weight loss treatment. In total, 1132 (727 women, 405 men), BMI ~41 kg/m2 were patients in a 12-month weight loss programme at a specialist clinic. The questionnaire for eating and weight patterns-revised was completed by the patients before start of treatment. BED was diagnosed in 5.1% of men and 12.4% of women. NE prevalence was 13.5% and 12.7%, respectively. Mean (±SEM) 12-month weight loss was less in patients with NE compared to those without (-11.0 ± 1.5 vs -14.6 ± 0.7 kg, P = .008) but did not differ in patients with and without BED, (-12.3 ± 1.9 vs -14.2 ± 0.6 kg, P = .24). Factors associated with dropout were BED (odds ratio, OR 1.57, 95% confidence interval (CI) 1.14-2.17; P = .006) and previous weight loss attempts (OR 1.35, 95% CI 1.0-1.7; P = .02). BED did not seem to hinder weight loss whereas NE resulted in less weight loss in patients with severe obesity who completed a 12-month treatment programme. Previous weight loss attempts affect both dropout and ability to lose weight.
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Affiliation(s)
- Sofia Björkman
- Department of Gastroenterology and Hepatology, Unit of Clinical Nutrition and the Regional Obesity CenterSahlgrenska University HospitalGothenburgSweden
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Ola Wallengren
- Department of Gastroenterology and Hepatology, Unit of Clinical NutritionSahlgrenska University HospitalGothenburgSweden
| | - Anna Laurenius
- Department of Gastroenterology and Hepatology, Unit of Clinical NutritionSahlgrenska University HospitalGothenburgSweden
- Department of Surgery, Institute of Clinical SciencesSahlgrenska Academy at the University of GothenburgGothenburgSweden
| | - Björn Eliasson
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
| | - Ingrid Larsson
- Department of Gastroenterology and Hepatology, Unit of Clinical Nutrition and the Regional Obesity CenterSahlgrenska University HospitalGothenburgSweden
- Institute of Medicine, Sahlgrenska Academy at the University of GothenburgSahlgrenska University HospitalGothenburgSweden
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Abawi O, Welling MS, van den Eynde E, van Rossum EFC, Halberstadt J, van den Akker ELT, van der Voorn B. COVID-19 related anxiety in children and adolescents with severe obesity: A mixed-methods study. Clin Obes 2020; 10:e12412. [PMID: 32920993 PMCID: PMC7685119 DOI: 10.1111/cob.12412] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 08/26/2020] [Accepted: 08/30/2020] [Indexed: 12/11/2022]
Abstract
Recent studies report negative mental health effects of the COVID-19 related lockdown measures in general paediatric cohorts. Since obesity is a risk factor for COVID-19 in adults, children (including adolescents) with obesity might perceive themselves to be vulnerable. Using a combined quantitative and qualitative approach, we explored COVID-19 related anxiety in paediatric patients with severe obesity in the Netherlands using semi-structured telephone interviews and the Paediatric Quality of Life Inventory (PedsQL) questionnaire, which had also been completed by the study population at baseline in the year prior to the COVID-19 outbreak. In total, 75 families participated in the semi-structured telephone interviews during the lockdown, April 2020. Characteristics of included patients were: median age 10.5 years (interquartile range = 7.6-15.2); 52% female; mean BMI standard deviation score 3.8 (SD = 1.0). COVID-19 related anxiety was reported for 24/75 (32%) children. The mean decrease in PedsQL score between baseline visit and COVID-19 outbreak did not differ between children for whom anxiety was reported vs those for whom it was not (mean change -10.3 ± 36.5 vs -3.3 ± 24.4, P = .54). Self-imposed strict quarantine measures were taken by 19/75 (25%) families. During follow-up, several families reported that the previous contact alleviated their anxiety. In conclusion, healthcare professionals should address possible COVID-19 related anxiety in children with severe obesity. Addressing COVID-19 related anxiety could mitigate its potential negative effects.
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Affiliation(s)
- Ozair Abawi
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Pediatrics, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Mila S. Welling
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Pediatrics, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Emma van den Eynde
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Elisabeth F. C. van Rossum
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Internal Medicine, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Jutka Halberstadt
- Department of Health SciencesFaculty of Science, Vrije Universiteit AmsterdamAmsterdamThe Netherlands
| | - Erica L. T. van den Akker
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Pediatrics, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
| | - Bibian van der Voorn
- Obesity Center CGG, Erasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Pediatrics, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
- Department of Internal Medicine, Division of EndocrinologyErasmus MC, University Medical Center RotterdamRotterdamThe Netherlands
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Athanasiadis DI, Hernandez E, Hilgendorf W, Roper A, Embry M, Selzer D, Stefanidis D. How are bariatric patients coping during the coronavirus disease 2019 (COVID-19) pandemic? Analysis of factors known to cause weight regain among postoperative bariatric patients. Surg Obes Relat Dis 2020; 17:756-764. [PMID: 33390351 PMCID: PMC7699156 DOI: 10.1016/j.soard.2020.11.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 10/28/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022]
Abstract
Background The global coronavirus disease 2019 (COVID-19) pandemic is wreaking havoc on society. Bariatric patients are more prone to severe infection due to their high body mass index (BMI) and are more vulnerable to the effects of isolation, such as depression or disruption of their health habits. Objectives To quantify the impact of self-quarantine on bariatric patients and self-quarantine’s relationship with weight gain. Setting Academic hospital, United States. Methods A 30-item survey examining several known contributors to weight regain was distributed among the postoperative bariatric patients of our clinic. Changes in eating habits, exercise, depression, social support, loneliness, and anxiety were studied, among others. Results A total of 208 patients completed the survey (29.3% response rate). A large percentage of patients reported increases in their depression (44.2%), loneliness (36.2%), nervousness (54.7%), snacking (62.6%), loss of control when eating (48.2%), and binge eating (19.5%) and decreases in their social support (23.2%), healthy food eating (45.5%), and activity (55.2%). Difficulty in accessing vitamins was reported by 13%. Patients more than 18 months out of surgery regained more than 2 kg during an average of 47 days. Risk factors for weight regain were found to be loss of control when eating, increases in snacking and binge eating, reduced consumption of healthy food, and reduced physical activity. Conclusion Bariatric patients are negatively affected by the COVID-19 pandemic and subsequent social isolation on many levels. This patient population is vulnerable to crisis situations; thus, additional intervention is needed to address behaviors that lead to weight regain.
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Affiliation(s)
| | - Edward Hernandez
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - William Hilgendorf
- Department of Surgery, Indiana University Health North Hospital, Indianapolis, Indiana; Indiana University School of Medicine, Indianapolis, Indiana
| | - Alexandra Roper
- Indiana University School of Medicine, Indianapolis, Indiana
| | - Marisa Embry
- Department of Surgery, Indiana University Health North Hospital, Indianapolis, Indiana
| | - Don Selzer
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; Department of Surgery, Indiana University Health North Hospital, Indianapolis, Indiana
| | - Dimitrios Stefanidis
- Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana; Department of Surgery, Indiana University Health North Hospital, Indianapolis, Indiana.
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Bianciardi E, Imperatori C, Niolu C, Campanelli M, Franceschilli M, Petagna L, Zerbin F, Siracusano A, Gentileschi P. Bariatric Surgery Closure During COVID-19 Lockdown in Italy: The Perspective of Waiting List Candidates. Front Public Health 2020; 8:582699. [PMID: 33313038 PMCID: PMC7706656 DOI: 10.3389/fpubh.2020.582699] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 10/12/2020] [Indexed: 12/27/2022] Open
Abstract
Background: From the beginning of March 2020, lockdown regimens prevented patients with obesity from receiving bariatric surgery. Surgical emergencies and oncological procedures were the only operations allowed in public hospitals. Consequently, patients with morbid obesity were put in a standby situation. With the aim at exploring the viewpoint of our future bariatric surgery patients, we built a questionnaire concerning obesity and COVID-19. Method: A total of 116 bariatric surgery candidates were approached using a telephonic interview during the Italian lockdown. Results: Of the total sample, 73.8% were favorable to regular bariatric surgery execution. Forty percent were concerned about their own health status due to the COVID-19 emergency, and 61.1% were troubled by the temporary closure of the bariatric unit. The majority of the sample were eating more. Forty-five percent and the 27.5% of patients reported a worsening of the emotional state and physical health, respectively. Most of the patients (52.2%) considered themselves more vulnerable to COVID-19, especially individuals with class III obesity. Patients who reported an increased consumption of food were younger (43.44 ± 12.16 vs. 49.18 ± 12.66; F = 4.28, p = 0.042). No gender difference emerged. Conclusion: The lockdown had a negative result on Italian patients' psychological well-being and eating habits. The majority of patients would have proceeded with the surgery even during the COVID-19 emergency. Effective management and bariatric surgery should be restarted as soon as possible.
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Affiliation(s)
- Emanuela Bianciardi
- Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Cinzia Niolu
- Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Michela Campanelli
- Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy
| | - Marzia Franceschilli
- Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy
| | - Lorenzo Petagna
- Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy
| | - Francesca Zerbin
- Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Alberto Siracusano
- Chair of Psychiatry, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Paolo Gentileschi
- Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy
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Kourounis G, Kong CY, Logue J, Gibson S. Weight loss in adults following bariatric surgery, a systematic review of preoperative behavioural predictors. Clin Obes 2020; 10:e12392. [PMID: 32691530 DOI: 10.1111/cob.12392] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/02/2020] [Accepted: 07/04/2020] [Indexed: 12/23/2022]
Abstract
Bariatric surgery is effective in treating obesity in many cases, yet as many as 50% of patients may not achieve the desired weight reduction. Preoperative modifiable behavioural factors could help patient selection and intervention design to improve outcomes. Medline, EMBASE, Cochrane Library and PsychINFO were searched to identify studies published between 1 January 2008 and 14 February 2019 reporting on preoperative modifiable behavioural factors associated with postoperative weight loss, with minimum 2 years follow-up. A total of 6888 articles were screened, 34 met the inclusion criteria. Maladaptive eating behaviours (MEB), preoperative weight loss (PWL), and tobacco use were reported 21, 18, and 3 times respectively. Physical activity and substance abuse were each reported once. Most articles on PWL (72.2%) and MEB (52.4%) reported no association. Positive associations were reported in 22.2% and 14.3% of articles for PWL and MEB respectively. Negative associations were reported in 5.6% and 33.3% of articles for PWL and MEB, respectively. Marked heterogeneity in outcome reporting hindered quantitative synthesis. The current paucity of evidence amenable to synthesis leads to ongoing uncertainty regarding the size and direction of association between PWL and MEB with outcomes following bariatric surgery. Long-term studies with common reporting of outcomes are needed.
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Affiliation(s)
- Georgios Kourounis
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK
| | - Chia Yew Kong
- College of Medicine & Veterinary Medicine, University of Edinburgh, Edinburgh, UK
- College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- Department of General Surgery, Monklands Hospital, Airdrie, UK
| | - Jennifer Logue
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Simon Gibson
- Department of General Surgery, Queen Elizabeth University Hospital, Glasgow, UK
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Baskaran C, Bose A, Plessow F, Flores LT, Toth AT, Eddy KT, Bredella MA, Misra M. Depressive and anxiety symptoms and suicidality in adolescent and young adult females with moderate to severe obesity before and after weight loss surgery. Clin Obes 2020; 10:e12381. [PMID: 32558297 PMCID: PMC8678933 DOI: 10.1111/cob.12381] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 05/06/2020] [Accepted: 05/07/2020] [Indexed: 11/29/2022]
Abstract
Data are conflicting regarding the impact of weight loss on mood and anxiety in adolescent and young adult females with moderate to severe obesity (OB), who are at increased risk for mood dysfunction compared with normal-weight females (NW). We examined depressive and anxiety symptoms in 94 females 13-21 years old: 39 in the NW group (body mass index [BMI]: 5th -85th percentiles) and 55 in the OB group (BMI >40 kg/m2 or >35 kg/m2 with comorbidities). Fifteen participants in the OB group who underwent bariatric surgery (gastric bypass or sleeve gastrectomy) and 15 getting routine care were re-assessed after 6 months. The Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory (STAI) assessed depressive and anxiety symptoms, respectively. The OB group had higher BDI-II and STAI T-scores (P < .0001), a higher prevalence of clinical depression and anxiety (P < .001), and reported greater suicidal ideation (P = .02) vs the NW group. The bariatric surgery and non-surgical groups did not differ for changes in BDI-II and STAI T-Scores and suicidality over 6-month follow-up, despite greater weight loss in the former. Depressive and anxiety symptoms and suicidality were more frequently observed in the OB vs NW group. These symptoms did not improve following bariatric surgery despite significant weight loss, underscoring the need to investigate determinants of emergence and resolution of these symptoms in the OB group.
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Affiliation(s)
- Charumathi Baskaran
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Endocrinology, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Amita Bose
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Landy Torre Flores
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Alexander T. Toth
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kamryn T. Eddy
- Eating Disorders Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Miriam A. Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Madhusmita Misra
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Abstract
PURPOSE OF REVIEW This review describes the latest evidence for the impact of bariatric surgery on health-related quality of life (HRQL). RECENT FINDINGS The impact of bariatric surgery on HRQL is less well-understood than its clinical effectiveness on weight and co-morbidities. Poor-quality study design and different HRQL measures challenge systematic reviews and meta-analyses. Available limited evidence suggests that physical aspects of HRQL may improve more than mental health aspects of HRQL after bariatric surgery, reaching maximal benefits 1-2 years post-surgery. Comparative HRQL analyses between bariatric procedures cannot be made due to a lack of randomised data. Qualitative research highlights the tensions patients experience after bariatric surgery, which provides insights to observed changes in HRQL. Standardized HRQL measures are being developed and agreed to improve future evidence synthesis. Two multi-centre randomised trials of bariatric surgical procedures including detailed HRQL assessment are in progress. It is hoped that the combination of comparative high-quality HRQL data and information from qualitative studies will provide new insights into patient well-being and health after bariatric surgery.
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Affiliation(s)
- Karen D Coulman
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
- Obesity and Bariatric Surgery Service, North Bristol NHS Trust, Bristol, UK.
| | - Jane M Blazeby
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK
- Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre Surgical Innovation Theme, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
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Abstract
PURPOSE OF REVIEW Bariatric surgery is today the most effective therapy for weight loss and reduction of comorbidity burden in patients with severe obesity. However, bariatric surgery does not benefit equally all the patients. A consistent variability in outcomes has been observed. Predicting responses to bariatric surgery could be an important tool in clinical practice, by improving patients' selection or by identifying patients in which more aggressive follow-up and post-operative intervention should be applied. Predictive factors for weight loss, weight regain, diabetes remission and recurrence are briefly reviewed in this paper. RECENT FINDINGS Many pre-operative factors have been proposed as negative or positive predictors of body weight reduction after surgery. However, none of these factors has been consistently demonstrated to have a sufficiently strong predictive power to influence eligibility to bariatric surgery itself. Weight regain can occur after bariatric surgery and its probability seems to be more influenced by post-operative behavioral factors than by pre-operative predictors. Several effective scores have been developed to predict diabetes remission after surgery, however long-term maintenance and diabetes recurrence after surgery seem again more influenced by post-operative behaviors and weight loss maintenance. In general, more attention and active interventions to pre-operative and post-operative eating behaviors and lifestyle modifications are probably more important at the clinical level than the search of pre-operative predictors of long-term outcomes.
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Affiliation(s)
- Anna Belligoli
- Center for the Study and the Integrated Treatment of Obesity, Padova University Hospital, Padova, Italy
| | - Silvia Bettini
- Center for the Study and the Integrated Treatment of Obesity, Padova University Hospital, Padova, Italy
| | - Gianni Segato
- Department of Surgery, "San Bortolo" Hospital, Vicenza, Italy
| | - Luca Busetto
- Center for the Study and the Integrated Treatment of Obesity, Padova University Hospital, Padova, Italy.
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Cook J, Lehne C, Weiland A, Archid R, Ritze Y, Bauer K, Zipfel S, Penders J, Enck P, Mack I. Gut Microbiota, Probiotics and Psychological States and Behaviors after Bariatric Surgery-A Systematic Review of Their Interrelation. Nutrients 2020; 12:nu12082396. [PMID: 32785153 PMCID: PMC7468806 DOI: 10.3390/nu12082396] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/01/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023] Open
Abstract
The gastrointestinal (GI) microbiota plays an important role in health and disease, including brain function and behavior. Bariatric surgery (BS) has been reported to result in various changes in the GI microbiota, therefore demanding the investigation of the impact of GI microbiota on treatment success. The goal of this systematic review was to assess the effects of BS on the microbiota composition in humans and other vertebrates, whether probiotics influence postoperative health, and whether microbiota and psychological and behavioral factors interact. A search was conducted using PubMed and Web of Science to find relevant studies with respect to the GI microbiota and probiotics after BS, and later screened for psychological and behavioral parameters. Studies were classified into groups and subgroups to provide a clear overview of the outcomes. Microbiota changes were further assessed for whether they were specific to BS in humans through the comparison to sham operated controls in other vertebrate studies. Changes in alpha diversity appear not to be specific, whereas dissimilarity in overall microbial community structure, and increases in the abundance of the phylum Proteobacteria and Akkermansia spp. within the phylum Verrucomicrobia after surgery were observed in both human and other vertebrates studies and may be specific to BS in humans. Human probiotic studies differed regarding probiotic strains and dosages, however it appeared that probiotic interventions were not superior to a placebo for quality of life scores or weight loss after BS. The relationship between GI microbiota and psychological diseases in this context is unclear due to insufficient available data.
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Affiliation(s)
- Jessica Cook
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - Christine Lehne
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - Alisa Weiland
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - Rami Archid
- Department of General, Visceral and Transplant Surgery, University Hospital, 72072 Tübingen, Germany;
| | - Yvonne Ritze
- Institute for Medical Psychology and Behavioral Neurobiology, University Hospital, 72072 Tübingen, Germany;
| | - Kerstin Bauer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - John Penders
- Department of Medical Microbiology, School of Nutrition and Translational Research in Metabolism (NUTRIM) and Care and Public Health Research Institute(Caphri), Maastricht University Medical Centre, 6211 Maastricht, The Netherlands;
| | - Paul Enck
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Hospital, 72072 Tübingen, Germany; (J.C.); (C.L.); (A.W.); (K.B.); (S.Z.); (P.E.)
- Correspondence: ; Tel.: +49-7071-2985614; Fax: +49-7071-294382
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Farup PG. Are the Results of a Combined Behavioural and Surgical Treatment of Morbid Obesity Satisfactory and Predictable? Nutrients 2020; 12:nu12071997. [PMID: 32635628 PMCID: PMC7400840 DOI: 10.3390/nu12071997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/30/2020] [Accepted: 06/30/2020] [Indexed: 01/08/2023] Open
Abstract
Treatment of subjects with morbid obesity (Body Mass Index (BMI) > 40 kg/m2 or > 35 kg/m2 with obesity-related complications) often fails. This study explored the biopsychosocial predictors of dropout and weight loss during a combined behavioural and surgical weight-reduction program. Behavioural treatment for six months was followed by bariatric surgery and a visit six months after surgery. The success criterion was the loss of ≥50% of excess BMI above 25 kg/m2 (%EBMIL). Thirty-one men and 113 women with BMI 43.5 kg/m2 (SD 4.3) and 41.8 kg/m2 (SD 3.6), respectively, were included; 115 underwent bariatric surgery (Gastric sleeve: 23; Roux-en-Y gastric bypass: 92), and 98 had a follow-up visit six months after surgery. The mean %EBMIL at follow-up was 71.2% (SD 18.5). Treatment success was achieved in 86 subjects. Assuming success in 17 subjects who did not attend the follow-up visit (best possible outcome), 103 out of 144 subjects (72%) achieved successful weight reduction. Cohabitation was the only predictor of accomplishing surgery. Neither weight loss during behavioural therapy nor biopsychosocial factors were found to be clinically significant predictors of weight loss after surgery. The success rate of less than three in four subjects was unsatisfactory. There is a need to improve the regimen and to determine effective alternative interventions.
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Affiliation(s)
- Per G Farup
- Department of Research, Innlandet Hospital Trust, N-2381 Brumunddal, Norway
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Gryth K, Persson C, Näslund I, Sundbom M, Näslund E, Stenberg E. The Influence of Socioeconomic Factors on Quality-of-Life After Laparoscopic Gastric Bypass Surgery. Obes Surg 2020; 29:3569-3576. [PMID: 31190262 DOI: 10.1007/s11695-019-04028-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear. MATERIALS AND METHODS Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden. RESULTS A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30-60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72-17.93, p < 0.0001). CONCLUSION At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
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Affiliation(s)
- Karin Gryth
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Carina Persson
- Department of Community Medicine and Public Health, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department for Sustainable Development, Region Örebro County, Örebro, Sweden
| | - Ingmar Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Erik Näslund
- Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Erik Stenberg
- Department of Surgery, Faculty of Medicine and Health, Örebro University Hospital, SE-701 85, Örebro, Sweden.
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Baillot A, Black M, Brunet J, Romain AJ. Biopsychosocial correlates of physical activity and sedentary time in adults with severe obesity. Clin Obes 2020; 10:e12355. [PMID: 31965721 DOI: 10.1111/cob.12355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
Abstract
Adults with severe obesity have poorer health, are less active and spend more time sedentary compared to people with a lower body mass index (BMI). There is a pressing need to understand the factors associated with low physical activity (PA) and excessive sedentary time to develop more effective behaviour change interventions for this population. The purpose of this study was to identify biopsychosocial correlates of PA and sedentary time in adults living with severe obesity. Forty-four adults living with severe obesity (age = 50.5 ± 13.3 years; BMI = 44.3 ± 7.8 kg/m2 ) completed a survey including questions on sociodemographic characteristics, comorbidities, psychosocial factors (eg, social physique anxiety [SPA], social support for PA, PA level self-perception), quality of life, daily pain and self-reported moderate-to-vigorous intensity PA (MVPA). Participants also completed the 6-minute walk test (6MWT) to assess physical fitness and wore an accelerometer to assess objective PA and sedentary time. In stepwise linear multivariate analyses, higher objective MVPA was associated with higher 6MWT distance, being single and lower SPA (R2 = 0.46, P < .001), whereas higher self-reported MVPA was associated with greater PA level self-perceptions (R2 = 0.47, P < .001). Greater objective light intensity PA was associated with greater quality of life and self-efficacy for PA (R2 = 0.26, P = .001). Greater sedentary time was associated with having more comorbidities (R2 = 0.25, P < .001). This study shows that adults living with severe obesity who have more comorbidities, poorer quality of life and/or lower self-efficacy perception for PA are more likely to be sedentary and to practice less light intensity PA. Additionally, those who were in a relationship, had higher SPA and/or had lower physical fitness practiced less MVPA. Future research is needed to determine causal effects.
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Affiliation(s)
- Aurélie Baillot
- Université du Québec en Outaouais, Gatineau, Québec, Canada
- Centre de recherche du Centre Intégré de Santé et Services Sociaux de l'Outaouais, Gatineau, Québec, Canada
- Institut du savoir Montfort-Recherche, Ottawa, Ontario, Canada
| | - Melissa Black
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Brunet
- Institut du savoir Montfort-Recherche, Ottawa, Ontario, Canada
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ahmed J Romain
- Faculty of Medicine, School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montreal, Québec, Canada
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Nandrino JL, Grynberg D, Gandolphe MC, Willem C, Benaisa K, Van de Maele J, Taccoen A, Verkindt H, Pattou F. Decreased emotional eating behavior is associated with greater excess weight loss five years after gastric banding. Appetite 2020; 149:104620. [PMID: 32070712 DOI: 10.1016/j.appet.2020.104620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/03/2023]
Abstract
While significant weight loss has been observed in the first two years following adjustable gastric banding (AGB), research on the long-term effectiveness of gastric restriction (e.g., 5 years) both on weight loss and eating behavior changes is scarce. The present study examined obese patients' changes in eating behavior preoperatively and 5 years after AGB and examined their associations with excess weight loss (EWL). Specifically, we focused on the association between the modification of three eating behavior profiles (i.e., restrained eating, emotional eating and external eating) and %EWL at 5 years. Among the 197 participants who underwent AGB, 136 completed the clinical assessments (weight, depression with the BDI, eating behavior with the DEBQ) before surgery, and after 5 years. Resultsshowed that the mean percentage of EWL was 47% after 5 years. Moreover, patients reported lower emotional eating and external eating after 5 years in comparison to the baseline, whereas there were no differences concerning restrained eating. Importantly, patients who presented higher %EWL at 5 years also reported a greater decrease in emotional eating between the two sessions than those with low %EWL. Our study underlines that eating behaviors are major variables involved in weight loss after gastric restriction. Results showed that emotional and external eating decreased significantly at 5 years whereas restrained eating behaviors did not vary between the pre- and postoperative stages. Moreover, the data suggest that a decrease in emotional eating accounts for the extent of EWL.
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Affiliation(s)
- Jean-Louis Nandrino
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France; Fondation Santé des étudiants de France, Clinique des 4 Cantons, Villeneuve d'Ascq, France.
| | - Delphine Grynberg
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Marie-Charlotte Gandolphe
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Clémence Willem
- UMR CNRS 9193, SCALab, Laboratoire de Sciences Cognitives et Affectives, Université de Lille, France.
| | - Karima Benaisa
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Justine Van de Maele
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Aurore Taccoen
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - Hélène Verkindt
- Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
| | - François Pattou
- UMR INSERM 1190, Recherche Translationnelle sur le Diabète, Université de Lille, France; Department of Endocrine Surgery, Centre Hospitalier Universitaire, Lille, France.
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50
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Santonicola A, Gagliardi M, Asparago G, Carpinelli L, Angrisani L, Iovino P. Anhedonia and functional dyspepsia in obese patients: Relationship with binge eating behaviour. World J Gastroenterol 2020; 26:2632-2644. [PMID: 32523316 PMCID: PMC7265144 DOI: 10.3748/wjg.v26.i20.2632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 05/09/2020] [Accepted: 05/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Obese patients (Ob) with a binge eating disorders (BED) behavior pattern have a higher prevalence of postprandial distress syndrome (PDS) compared to Ob without a BED behavior pattern, while an increase of PDS has been described in Ob after sleeve gastrectomy (SG). Hedonic response to a meal is dissociable from satiation in healthy subjects. Anhedonia is the lowered ability to experience pleasure. There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.
AIM To assess the relationship among anhedonia, BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.
METHODS Eighty-one Ob without SG, 45 Ob with SG and 55 healthy controls (HC) were studied. All subjects fulfilled the binge eating scale (BES) to investigate BED, the validated 14 items Snaith-Hamilton pleasure scale (SHAPS) to assess Anhedonia as well as the Beck Depression Inventory-II (BDI II) and State Trait Anxiety Inventory (STAI) questionnaires to screen for depression and anxiety. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (0-6) of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia (FD) and its subtypes according to ROME IV criteria.
RESULTS Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED (OR: 4.7; 95.0%CI 1.23-18.24; P = 0.02). STAI-Y2 scores were significantly higher in Ob without SG positive for BED (42.2 ± 1.5 vs Ob negative for BED: 39.6 ± 1 .0, P = 0.04), while SHAPS scores and BDI II did not differ in the two groups (1.16 ± 1.30 vs 0.89 ± 1.02, P = 0.49). A lower prevalence of BED (BES > 17: 11.4% vs 40.7%, P = 0.001) and BDI-II (6.8 ± 1.2 vs 13.8 ± 1.9, P = 0.005) was reported in Ob with SG than Ob without SG, on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG. Thirty-five percent of Ob with SG fulfilled the diagnosis of FD. SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups (18.2 vs 8.1%, P = 0.2). Fifty-four percent of Ob with SG achieved surgical success excess weight loss > 50%. Excess weight loss was negatively related to SHAPS total mean scores [adjusted B: -7. 099 (95%CI: -13.91 to -0.29), P = 0.04].
CONCLUSION Ob without SG showed a higher prevalence of PDS, mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior, whereas no differences were found in SHAPS score. Ob with SG showed a higher prevalence of PDS compared to Ob without SG. Concerning psychological aspect, BED and depression are less frequent in the Ob with SG, while both state and trait anxiety are significantly higher. Moreover, the more an Ob with SG is anhedonic, less surgical success was achieved.
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Affiliation(s)
- Antonella Santonicola
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Mario Gagliardi
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Giovanni Asparago
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Luna Carpinelli
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
| | - Luigi Angrisani
- General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples 80100, Italy
| | - Paola Iovino
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy
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