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Suliman O, Esailan MM, Alraddadi AM, Shaker AS, Alsharif LA, Aljohani MS, Alharbi RF, Almohammadi FA, Alahmadi GA, Osailan S. The Prevalence and Consequence of Depression After Bariatric Surgery Among Adults in Saudi Arabia. Cureus 2024; 16:e59945. [PMID: 38854250 PMCID: PMC11161855 DOI: 10.7759/cureus.59945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
BACKGROUND Bariatric surgery is a commonly performed group of procedures for individuals with severe obesity, and its impact on mental health, particularly depression, has gained significant attention. In Saudi Arabia, the prevalence and consequences of depression following bariatric surgery among adults is an area of growing concern. The study aimed to assess the prevalence of depression after bariatric surgery and estimate the consequences of depression after bariatric surgery. METHODS A cross-sectional study was conducted among adults in Saudi Arabia who had undergone bariatric surgery. The participants were recruited from different bariatric surgery centers across the country. The data was collected using a self-administered questionnaire that had three main sections, including demographic information, clinical characteristics, and the Patient Health Questionnaire-9 (PHQ-9) to assess depression. RESULTS The results of the study showed that among adults in Saudi Arabia who had undergone bariatric surgery, the prevalence of depression was high. Of the participants, 23.5% were found to have depression after bariatric surgery. This high prevalence suggests that depression is a significant consequence of bariatric surgery. CONCLUSION A high number of adults in Saudi Arabia experience depression after bariatric surgery. This shows a need for mental health checks and support before and after the surgery. With mental healthcare as a regular part of bariatric programs, patients would have a better chance of success and overall well-being. More research is needed to understand why depression happens after surgery and how to prevent it.
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Affiliation(s)
- Osman Suliman
- Clinical Sciences, College of Medicine, Al-Rayan Colleges, Al Madinah, SAU
| | | | | | - Aos S Shaker
- Medicine and Surgery, Al-Rayan Colleges, Al Madinah, SAU
| | | | | | - Rema F Alharbi
- Medicine and Surgery, Al-Rayan Colleges, Al Madinah, SAU
| | | | | | - Samah Osailan
- General Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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2
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Garin P, Favre L, Vionnet N, Frantz J, Eap CB, Vandenberghe F. The Influence of a Roux-en-Y Gastric Bypass on Plasma Concentrations of Antidepressants. Obes Surg 2023; 33:1422-1430. [PMID: 36949223 PMCID: PMC10156620 DOI: 10.1007/s11695-023-06526-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 02/17/2023] [Accepted: 02/23/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE Roux-en-Y gastric bypass (RYGB) involves alterations of the gastrointestinal tract resulting in altered absorption. Patients with obesity have a higher prevalence of depression, and antidepressants are often prescribed. Alterations caused by RYGB could modify drug bioavailability and cause potential subtherapeutic plasma concentrations, increasing the risk of depressive relapse. The aim of this study was to describe the evolution of trough drug dose-normalized antidepressant plasma concentrations before and after RYGB. MATERIALS AND METHODS This naturalistic prospective case series considers patients with trough plasma concentrations in a 1-year timeframe before and after RYGB. Only antidepressants prescribed to at least three patients were included in the present study. RESULTS Thirteen patients (n = 12 females, median age 44 years, median BMI before intervention = 41.3 kg/m2) were included. Two patients were treated concurrently with fluoxetine and trazodone; the remaining patients were all treated with antidepressant monotherapy. Therapeutic drug monitoring (TDM) values for duloxetine (n = 3), escitalopram (n = 4), fluoxetine (n = 4), and trazodone (n = 4) before (median 4.7 weeks) and after (median 21.3 weeks) RYGB intervention were analyzed. Compared to preintervention, median [interquartile range] decreases in dose-normalized trough plasma concentrations for duloxetine (33% [- 47; - 23]), escitalopram (43% [- 51; - 31]), fluoxetine (9% [- 20; 0.2]), and trazodone (16% [- 29; 0.3]) were observed. CONCLUSION This study shows a decrease in plasma antidepressant concentrations following RYGB. TDM before and after RYGB, in addition to close monitoring of psychiatric symptomatology, may help optimize antidepressant treatment after bariatric surgery. These results also highlight the need for prospective studies assessing the clinical evidence available through TDM in these patients.
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Affiliation(s)
- Paul Garin
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Route de Cery 11b, CH-1008, Prilly, Switzerland
| | - Lucie Favre
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Nathalie Vionnet
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Johanna Frantz
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Service of Liaison Psychiatry, Department of Psychiatry, Vaud University Hospital, Lausanne, Switzerland
| | - Chin B Eap
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Route de Cery 11b, CH-1008, Prilly, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
- Center for Research and Innovation in Clinical Pharmaceutical Sciences, University of Lausanne, Lausanne, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Frederik Vandenberghe
- Unit of Pharmacogenetics and Clinical Psychopharmacology, Centre for Psychiatric Neuroscience, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Route de Cery 11b, CH-1008, Prilly, Switzerland.
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3
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Feig EH, Harnedy LE, Thorndike AN, Psaros C, Healy BC, Huffman JC. A Positive Emotion-Focused Intervention to Increase Physical Activity After Bariatric Surgery: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e39856. [PMID: 36201380 PMCID: PMC9585441 DOI: 10.2196/39856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background Physical activity levels after bariatric surgery are usually low, despite the significant protective health benefits of physical activity in this population. Positive psychological well-being is associated with improved adherence to health behaviors, but bariatric surgery patients often have negative associations with physical activity that prevent sustained engagement. Objective The Gaining Optimism After weight Loss Surgery (GOALS) pilot randomized controlled trial is aimed at testing a novel intervention to increase physical activity after bariatric surgery, which incorporates positive psychological skill-building with motivational interviewing and goal-setting. Methods The GOALS trial is a 2-arm, 24-week pilot randomized controlled trial that aims to enroll 58 adults who report less than 200 minutes per week of moderate to vigorous physical activity and a desire to become more active 6-12 months after bariatric surgery. GOALS is testing the feasibility, acceptability, and preliminary efficacy of a positive psychology–motivational interviewing telephone intervention targeting to increase physical activity and associated positive affect. Intervention components include positive psychology, goal-setting, self-monitoring via provided Fitbits, and motivational interviewing to overcome barriers and increase motivation. The intervention is compared to a physical activity education control that includes mailings with psychoeducation around physical activity and provision of a Fitbit. The primary outcomes of the pilot trial are feasibility and acceptability, measured as session completion rates and participant ratings of ease and helpfulness of each session. The main secondary outcome is change in accelerometer-measured moderate to vigorous physical activity post intervention and at 24-week follow-up. Additional outcomes include changes in attitudes related to physical activity, psychological well-being, and physical health measures. Results This multiphase project was funded in 2020 and institutional review board approval was obtained for the proposed trial in 2021. Recruitment for the randomized controlled trial began in July 2022. Upon completion of the pilot trial, we will examine the feasibility, acceptability, and preliminary efficacy of the intervention. Conclusions Although bariatric surgery is the most effective treatment available for severe obesity, weight regain occurs, often in the context of low psychological well-being. Many individuals would benefit from learning strategies to increase positive psychological well-being after bariatric surgery, which could help them maintain lifestyle changes. Positive psychology is a novel approach to improve adherence by increasing positive associations with health behaviors including physical activity. The GOALS pilot trial will determine whether this type of intervention is feasible and acceptable to this population and will provide a foundation for a future full-scale randomized controlled efficacy trial. Trial Registration ClinicalTrials.gov NCT04868032; https://clinicaltrials.gov/ct2/show/NCT04868032 International Registered Report Identifier (IRRID) PRR1-10.2196/39856
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Affiliation(s)
- Emily H Feig
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Lauren E Harnedy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Anne N Thorndike
- Harvard Medical School, Boston, MA, United States.,Department of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Christina Psaros
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
| | - Brian C Healy
- Harvard Medical School, Boston, MA, United States.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.,Harvard Medical School, Boston, MA, United States
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American Society of Metabolic and Bariatric Surgery Consensus Statement on Laparoscopic Adjustable Gastric Band Management. Surg Obes Relat Dis 2022; 18:1120-1133. [DOI: 10.1016/j.soard.2022.06.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 11/21/2022]
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5
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Alyahya RA, Alnujaidi MA. Prevalence and Outcomes of Depression After Bariatric Surgery: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e25651. [PMID: 35784972 PMCID: PMC9249077 DOI: 10.7759/cureus.25651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2022] [Indexed: 11/05/2022] Open
Abstract
Surgeons often focus on weight loss and improvement of obesity-related conditions as a primary outcome after bariatric surgery. However, the success of bariatric surgery also relies on the improvement of mental health status. Therefore, the current meta-analysis was carried out to reveal the prevalence of depressive symptoms and their subsequent impact on bariatric surgery outcomes. This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the recommendation of Cochrane Collaboration. All clinical studies reporting the prevalence and/or the outcomes of depression after bariatric surgery were included in the current meta-analysis. This meta-analysis encompassed 33 articles, including a total of 101,223 patients. The prevalence of post-bariatric surgery depression was 15.3% (95% confidence intervals {CI}: 15.0-15.5%, p<0.001) among which severe, moderate, and minimal depression accounted for 1.9% (95% CI: 1.5-2.4%, p<0.001), 5.1% (95% CI: 4.4-5.8%, p<0.001), and 64.9% (95% CI: 63.3-66.5%, p<0.001), respectively. Depression is negatively correlated with weight loss (correlation -0.135; 95% CI: -0.176 to 0.093; p<0.001) and positively correlated with eating disorder (correlation 0.164; 95% CI: 0.079-0.248; p<0.001). The prevalence of post-bariatric surgery depression is relatively high reaching up to 64.9%, with almost one in five patients affected by it. Depression is associated with weight regain, eating disorders, and quality of life.
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Abdul Wahab R, Al-Ruwaily H, Coleman T, Heneghan H, Neff K, le Roux CW, Fallon F. The Relationship Between Percentage Weight Loss and World Health Organization-Five Wellbeing Index (WHO-5) in Patients Having Bariatric Surgery. Obes Surg 2022; 32:1667-1672. [PMID: 35305228 PMCID: PMC8986673 DOI: 10.1007/s11695-022-06010-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
Purpose The association between bariatric surgery outcome and depression remains controversial. Many patients with depression are not offered bariatric surgery due to concerns that they may have suboptimal outcomes. The aim of this study was to investigate the relationship between baseline World Health Organization-Five Wellbeing Index (WHO-5) and percentage total weight loss (%TWL) in patients after bariatric surgery. Materials and Methods All patients were routinely reviewed by the psychologist and screened with WHO-5. The consultation occurred 3.5 ± 1.6 months before bariatric surgery. Body weight was recorded before and 1 year after surgery. A total of 45 out of 71 (63.3%) patients with complete WHO-5 data were included in the study. Data analysis was carried out with IBM SPSS Statistics (version 27) to determine the correlation between baseline WHO-5 and %TWL in patients having bariatric surgery. Results Overall, 11 males and 34 females were involved with mean age of 47.5 ± 11.5 and BMI of 46.2 ± 5.5 kg/m2. The %TWL between pre- and 1-year post-surgery was 30.0 ± 8.3% and the WHO-5 Wellbeing Index mean score was 56.5 ± 16.8. We found no correlation between %TWL and the WHO-5 Wellbeing Index (r = 0.032, p = 0.83). Conclusion There was no correlation between the baseline WHO-5 Wellbeing Index and %TWL 1-year post-bariatric surgery. Patients with low mood or depression need to be assessed and offered appropriate treatment but should not be excluded from bariatric surgery only based on their mood. Graphical Abstract ![]()
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Affiliation(s)
- Roshaida Abdul Wahab
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Heshma Al-Ruwaily
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Therese Coleman
- Obesity Complications Clinic, St Vincent's Private Hospital, Merrion Road, Dublin, D04 NE02, Ireland
| | - Helen Heneghan
- Obesity Complications Clinic, St Vincent's Private Hospital, Merrion Road, Dublin, D04 NE02, Ireland
| | - Karl Neff
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland.,Obesity Complications Clinic, St Vincent's Private Hospital, Merrion Road, Dublin, D04 NE02, Ireland
| | - Carel W le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland. .,Obesity Complications Clinic, St Vincent's Private Hospital, Merrion Road, Dublin, D04 NE02, Ireland.
| | - Finian Fallon
- Obesity Complications Clinic, St Vincent's Private Hospital, Merrion Road, Dublin, D04 NE02, Ireland
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Bawahab MA, Abd El Maksoud WM, Abbas KS, Alahmary AM, Alturaifi T, Alkhashrami S, Solaiman O. Effects of Laparoscopic Sleeve Gastrectomy on Negative Emotional States: A Prospective Multicenter Study. Bariatr Surg Pract Patient Care 2021. [DOI: 10.1089/bari.2021.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mohammed A. Bawahab
- Surgery Department, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Khaled S. Abbas
- Surgery Department, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Turki Alturaifi
- Surgery Department, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Shahad Alkhashrami
- Anesthesia Department, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Osama Solaiman
- Psychiatry Division, Internal Medicine Department, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
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9
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Oliver A, Hooper S, Lau R, Hutchinson A. Effect of a multidisciplinary rehabilitation program for patients receiving weight management interventions on eating behaviours and health-related quality of life. Obes Res Clin Pract 2021; 15:268-274. [PMID: 33736958 DOI: 10.1016/j.orcp.2021.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
The rapid rise in obesity prevalence is life-style related and tackling this problem requires a pro-active multi-faceted approach to management. A private health care provider in Melbourne, Australia, developed a multidisciplinary rehabilitation program for patients who had undergone bariatric surgery or receiving pharmacological weight loss treatments. The study aim was to assess the programs' effect on patients' quality of life, mental well-being, and eating behaviours. METHODS A prospective, observational, before and after study design was used. A total of 54 patients, 27 who had bariatric surgery and 27 receiving pharmacotherapy participated. Outcome measures were: change in weight and BMI, intuitive eating scale, impact of weight on quality of life scale and the depression, anxiety and stress scale. RESULTS Both medical and surgical patients reported improvements in their health-related quality of life and eating behaviours. Despite this, at program completion 71.4% of patients who had bariatric surgery reported severe anxiety and 52.4% severe stress levels. CONCLUSION Participation in a rehabilitation program that provided patients with peer support and access to expert advice supported patients to make healthy eating choices and improved their quality of life. The high prevalence of stress and anxiety related symptoms highlights the need to provide individuals who have undergone bariatric surgery with ongoing mental health support.
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Affiliation(s)
- Abigail Oliver
- Prevention and Chronic Illness Care, Merri Health, Melbourne, Australia; Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia.
| | - Suzie Hooper
- Epworth Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia.
| | - Rosalind Lau
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Australia.
| | - Ana Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research Epworth/Deakin Partnership, Faculty of Health, Deakin University, Geelong, Australia.
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10
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Earnings and employment for women after bariatric surgery: a matched cohort study. Int J Obes (Lond) 2021; 45:766-775. [PMID: 33495524 DOI: 10.1038/s41366-021-00737-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 10/27/2020] [Accepted: 01/04/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND/OBJECTIVES Bariatric surgery induces durable weight loss and improves health and quality of life. Less is known about how bariatric surgery affects labour market outcomes. This study examined the development of earnings and employment status among women with obesity who underwent bariatric surgery versus matched comparators. SUBJECTS/METHODS This study included two cohorts of women in Sweden who gave birth between 1992 and 2014: a cohort with bariatric patients and their full sisters (sister cohort) and a cohort with bariatric patients and comparators matched on BMI, education, birth year, and previous cardiovascular, psychiatric, and musculoskeletal inpatient care diagnoses (BMI-matched cohort). Taxable annual earnings were retrieved from the Swedish Income Tax Register from 2 years before to 5 years after surgery. Employment status was measured dichotomously (employed/not employed) based on earnings data. Adjusted mean and prevalence differences were estimated for earnings and employment by ordinary least squares regression. RESULTS The sister cohort included 1400 patient-sister pairs. At baseline, patients and their sisters were of similar age (38.3 vs. 38.6 years) but had different BMI (37.3 vs. 26.7 kg/m2). The BMI-matched cohort included 2967 patient-comparator pairs with similar age (36.1 vs. 36.2 years) and BMI (37.1 vs. 37.0 kg/m2) before surgery. During follow-up, similar developments of earnings and employment status were observed between bariatric patients and the comparators in both cohorts. When comparing absolute levels of earnings in the sister cohort, the difference in earnings at 2 years before surgery [mean difference -$4137 (95% CI -5245 to -3028)] was similar to the difference in earnings at 5 years after surgery [-$5620 (-7024 to -4215)]. Similar results were found in the BMI-matched cohort, but of smaller magnitude. CONCLUSIONS Bariatric surgery had little influence on the development of annual earnings and employment for women with obesity in Sweden over 5 years after surgery.
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Walsh TP, Gill TK, Evans AM, Yaxley A, Chisholm JA, Kow L, Arnold JB, Shanahan EM. Changes in foot pain, structure and function following bariatric surgery. J Foot Ankle Res 2018; 11:35. [PMID: 29988337 PMCID: PMC6022514 DOI: 10.1186/s13047-018-0277-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 06/14/2018] [Indexed: 12/25/2022] Open
Abstract
Background Bariatric surgery candidates have a high prevalence of foot pain, depression and elevated plantar pressures. There is, however, limited research into how these factors interact pre- and post-surgery. The aims of this study were therefore to investigate the mechanical and non-mechanical factors associated with foot pain severity before, and the change after, surgery. Methods Bariatric surgery candidates underwent baseline and six-month follow-up measures. Foot pain was measured with the Manchester-Oxford Foot Questionnaire. Mechanical measures included body mass index (BMI), dynamic plantar pressures, radiographic foot posture, and hindfoot range of motion. Depressive symptoms, the non-mechanical measure, were assessed by questionnaire. Multivariable linear regression was used to determine which variables were associated with foot pain at baseline and at follow-up. Multilevel repeated models assessed the associations between foot pain and plantar pressure, adjusting for the interaction between group and follow-up time. Results Forty-five participants (84% female), with mean (SD) age of 45.7 (9.4) years were recruited. Twenty-nine participants had bariatric surgery and 16 participants remained on the waiting list (controls). Following bariatric surgery, foot pain reduced significantly by - 35.7 points (95% CI -42.2 to - 28.8), while depressive symptoms and whole foot peak pressures had a significant mean change of - 5.9 points (95% CI -10.3 to - 1.5) and - 36 kPa (95% CI -50 to - 22), respectively. In multivariable analysis, depressive symptoms were associated with foot pain at baseline β = 0.7 (95% CI 0.2 to 1.2) after controlling for age, gender, BMI, foot posture and plantar pressure. Depressive symptoms were also associated with foot pain at follow-up in those undergoing bariatric surgery, β = 1.2 (95% CI 0.8 to 1.7). Foot posture and hindfoot range of motion did not change following surgery and a change in plantar pressures was not associated with a change in foot pain. Conclusions Foot pain severity in bariatric surgery candidates was associated with depressive symptoms at baseline. Reduced foot pain following bariatric surgery was associated with an improvement in depressive symptoms, without a significant change in foot posture or foot function. Foot pain severity in bariatric candidates may be mediated by non-mechanical or non-local factors before and following surgery.
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Affiliation(s)
- Tom P Walsh
- 1College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042 Australia.,2Department of Orthopaedics and Trauma, The Queen Elizabeth Hospital, Woodville South, South Australia 5011 Australia
| | - Tiffany K Gill
- 3Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia 5005 Australia
| | - Angela M Evans
- 4Discipline of Podiatry, College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086 Australia
| | - Alison Yaxley
- 5Nutrition & Dietetics, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia 5042 Australia
| | - Jacob A Chisholm
- 6Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia 5042 Australia
| | - Lilian Kow
- 6Department of Gastrointestinal Surgery, Flinders Medical Centre, Bedford Park, South Australia 5042 Australia
| | - John B Arnold
- 7Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, South Australia 5000 Australia
| | - E Michael Shanahan
- 1College of Medicine and Public Health, Flinders University, Bedford Park, South Australia 5042 Australia.,Department of Rheumatology, Southern Adelaide Local Health Network, Bedford Park, South Australia 5042 Australia
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Abstract
OBJECTIVE The aim of this study is to identify psychosocial variables associated with the relationship between weight loss and change in depressive symptoms following gastric banding surgery. METHODS Ninety-nine adults completed self-report questionnaires assessing depressive symptoms and other psychosocial variables (self-esteem, body image dissatisfaction, perceived physical health, and perceived weight-based stigmatisation) prior to gastric-band surgery and monthly for 6-month post-surgery. RESULTS Weight, depressive symptoms, and other psychosocial variables improved significantly 1-month post-surgery and remained lower to 6 months. Weight loss from baseline to 1- and 6-months post-surgery significantly correlated with change in depressive symptoms. Body image dissatisfaction and self-esteem accounted for some of the variance in change in depressive symptoms from baseline to 1-month and baseline to 6-months post-surgery. CONCLUSIONS Depressive symptoms improved significantly and rapidly after bariatric surgery, and body image dissatisfaction and self-esteem predicted change in depressive symptoms. Interventions targeting body image and self-esteem may improve depressive symptoms for those undergoing weight loss interventions.
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Pinto TF, de Bruin PFC, de Bruin VMS, Lopes PM, Lemos FN. Obesity, Hypersomnolence, and Quality of Sleep: the Impact of Bariatric Surgery. Obes Surg 2018; 27:1775-1779. [PMID: 28054298 DOI: 10.1007/s11695-016-2536-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
PURPOSE Obesity is commonly associated with poor sleep, excessive daytime sleepiness (EDS) and depressive mood but the impact of bariatric surgery on these conditions is incompletely understood. This study aimed to investigate the course of EDS and sleep quality in bariatric surgery patients in relation with changes in body weight and depressive symptoms. METHODS In patients consecutively submitted to bariatric surgery, baseline and postoperative sleep quality were evaluated by the Pittsburgh Sleep Quality Index (PSQI), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS), risk for OSA by the Berlin Questionnaire (BQ), and depressive symptoms by the Beck Depression Inventory-Short Form (BDI). Comorbidities were assessed by interview and chart review. RESULTS Sixty patients (M/F = 9/51) with a mean (±SD) age of 34.7 ± 9.2 years and body mass index (BMI) of 46.04 ± 7.52 kg/m2 were studied. Bariatric surgery improved PSQI score (6.4 ± 3.8 versus 4.1 ± 2.8; p < 0.001), ESS score (8.1 ± 4.7 versus 6.0 ± 3.3; p < 0.001), BDI score (9.8 ± 7.0 versus 4.7 ± 4.6; p = 0.001), and risk for OSA (68.3 versus 5%). Twelve of the 18 subjects with baseline EDS (ESS ≥ 10) developed normal ESS score after surgery. In these subjects, significant postoperative improvement in depressive symptoms score was observed (12.0 ± 9.0 versus 5.5 ± 5.0; p = 0.041), in contrast to the remaining six cases with persistent EDS, who showed no significant change in these symptoms (5.5 ± 5.0 versus 3.2 ± 3.1; p = 0.416). CONCLUSION Bariatric surgery has a beneficial effect on sleep quality and EDS. Postoperative improvement in EDS can be related to a reduction in depressive symptoms.
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Affiliation(s)
- Thisciane Ferreira Pinto
- Laboratory of Sleep and Biological Rhythms, Department of Medicine, Universidade Federal do Ceará, Rua Professor Costa Mendes, 1.608/4th floor, Fortaleza, CE, 60430-140, Brazil
| | - Pedro Felipe Carvalhedo de Bruin
- Laboratory of Sleep and Biological Rhythms, Department of Medicine, Universidade Federal do Ceará, Rua Professor Costa Mendes, 1.608/4th floor, Fortaleza, CE, 60430-140, Brazil.
| | - Veralice Meireles Sales de Bruin
- Laboratory of Sleep and Biological Rhythms, Department of Medicine, Universidade Federal do Ceará, Rua Professor Costa Mendes, 1.608/4th floor, Fortaleza, CE, 60430-140, Brazil
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Ferreira Pinto T, Carvalhedo de Bruin PF, Sales de Bruin VM, Ney Lemos F, Azevedo Lopes FH, Marcos Lopes P. Effects of bariatric surgery on night eating and depressive symptoms: a prospective study. Surg Obes Relat Dis 2017; 13:1057-1062. [DOI: 10.1016/j.soard.2016.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 10/20/2022]
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Abstract
PURPOSE OF REVIEW Little is known about the psychological effects on life after bariatric surgery despite the high prevalence of psychological disorders in candidates seeking this procedure. Our review discusses the literature around the psychological impact of bariatric surgery, exploring whether the procedure addresses underlying psychological conditions that can lead to morbid obesity and the effect on eating behaviour postoperatively. RECENT FINDINGS Findings show that despite undisputed significant weight loss and improvements in comorbidities, current literature suggests some persisting disorder in psychological outcomes like depression and body image for patients at longer term follow-up, compared to control groups. Lack of postoperative psychological monitoring and theoretical mapping limits our understanding of reasons behind these findings. Reframing bariatric approaches to morbid obesity to incorporate psychological experience postoperatively would facilitate understanding of psychological aspects of bariatric surgery and how this surgical treatment maps onto the disease trajectory of obesity.
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Affiliation(s)
- Sandra Jumbe
- Centre for Primary Care and Public Health, Blizard Institute, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB UK
| | - Claire Hamlet
- Centre for Appearance Research, Department of Health and Social Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY UK
| | - Jane Meyrick
- Department of Health and Social Sciences, University of the West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY UK
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