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Carmassi C, Musetti L, Cambiali E, Violi M, Simoncini M, Fantasia S, Massoni L, Massimetti G, Nannipieri M, Dell'Osso L. Exploring the relationship between problematic eating behaviors and bipolar disorder: A study on candidates for bariatric surgery. J Affect Disord 2024; 368:564-572. [PMID: 39293606 DOI: 10.1016/j.jad.2024.09.094] [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: 03/06/2024] [Revised: 09/09/2024] [Accepted: 09/14/2024] [Indexed: 09/20/2024]
Abstract
BACKGROUND Obesity is a major concern in patients with bipolar disorder (BD) and problematic eating behaviors have been suggested to mediate their relationship. The association between problematic eating behaviors and obesity has been studied but limited data have explored the role of BD. We investigated problematic eating behaviors among patients with BD compared with candidates for bariatric surgery (BS), with or without BD, and explored the possible correlations between mood spectrum, impulsivity, body mass index (BMI). METHODS 50 euthymic patients with BD and 200 subjects eligible for BS, 48 with BD (BS + BD) and 152 without BD (BS-BD), were recruited at the Psychiatric Clinic of University of Pisa. Assessments included: Structured Clinical Interview (SCID-5), Emotional Eating Scale (EES), Yale Food Addiction Scale (YFAS), Eating Disorder Inventory (EDI-2), Eating Disorder Questionnaire (EDE-Q), Night Eating Scale (NES), Grazing Questionnaire (GQ), Mood Spectrum Self-Report (MOOD-SR), Barratt Impulsivity Scale (BIS). RESULTS BS + BD reported significantly higher EDI-2 and EDE-Q scores than the other groups. BD and BS + BD showed significantly higher BIS-11 scores than BS-BD. Among BS, EES and YFAS were associated with mood spectrum symptoms. LIMITATIONS Small BD sample size, BS may have underreported psychiatric symptoms to get approved for surgery, the interview didn't inquire about BS receiving GLP-1 agonists therapy. CONCLUSIONS Results showed a high prevalence of problematic eating behaviors among patients with BD and severely obese. Problematic eating behaviors may aggravate BD symptoms. Mood spectrum symptoms in obese subjects need to be carefully researched in as relate to severity and post-surgical course of BS.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Musetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Erika Cambiali
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | - Miriam Violi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marly Simoncini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Sara Fantasia
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Leonardo Massoni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Monica Nannipieri
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Miller-Matero LR, Ross K, Arellano C, Zelenak L, DePascale E, Gavrilova L, Braciszewski JM, Hecht LM, Haley EN, Brescacin C, Carlin AM. Cannabis use following bariatric surgery is associated with anxiety and maladaptive eating. Surg Obes Relat Dis 2024; 20:91-97. [PMID: 37863791 DOI: 10.1016/j.soard.2023.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND There are limited data regarding the association of cannabis use with outcomes after bariatric surgery. As such, it is challenging to know how to counsel patients using cannabis. OBJECTIVES The purpose of this study was to examine whether postsurgical cannabis use was associated with psychiatric symptoms and maladaptive eating among individuals up to 4 years after bariatric surgery. SETTING Single health system. METHODS All patients who underwent bariatric surgery over a 4-year period were invited to participate. Participants (N = 765) completed questionnaires online regarding postsurgical cannabis use, psychiatric symptoms, and maladaptive eating. RESULTS Any cannabis use after bariatric surgery was associated with increased likelihood of having elevated symptoms of anxiety (odds ratio [OR] = 1.88, P = .003; 37.8% versus 24.4%), increased likelihood of grazing behaviors (OR = 1.77, P = .01; 71.2% versus 58.2%), and higher scores for eating in response to depression (P = .01; 12.13 versus 10.75). Weekly cannabis use was associated with loss of control eating (OR = 1.81, P = .04; 37.2% versus 24.7%), binge eating (OR = 2.16, P = .03; 20.0% versus 10.4%), and night eating behaviors (OR = 2.11, P = .01; 40.0% versus 24.0%). Cannabis use was not associated with depression (P > .05). CONCLUSIONS Cannabis use after bariatric surgery was associated with anxiety symptoms and engaging in maladaptive eating behaviors. Frequent cannabis use (i.e., ≥1 per week) was associated with additional types of maladaptive eating. Clinicians involved in presurgical and postsurgical care may want to counsel patients currently using cannabis, especially those who are engaging in frequent use.
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Affiliation(s)
- Lisa R Miller-Matero
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan.
| | - Kaitlin Ross
- Wayne State University School of Medicine, Detroit, Michigan
| | - Camila Arellano
- Wayne State University School of Medicine, Detroit, Michigan
| | - Logan Zelenak
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Eve DePascale
- Henry Ford Health, Behavioral Health, Detroit, Michigan
| | - Lyubov Gavrilova
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Jordan M Braciszewski
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Leah M Hecht
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Erin N Haley
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, Michigan
| | - Carly Brescacin
- Henry Ford Health, Behavioral Health, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| | - Arthur M Carlin
- Wayne State University School of Medicine, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
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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] [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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Sun S, Chen S, Wang Z, Xiong Y, Xie S. Social Networking Site Use and Emotional Eating Behaviors among Chinese Adolescents: The Effects of Negative Social Comparisons and Perspective-Taking. Behav Sci (Basel) 2023; 13:768. [PMID: 37754046 PMCID: PMC10525161 DOI: 10.3390/bs13090768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Emotional eating has emerged as a significant disordered eating and public health concern among adolescents. Despite the widespread prevalence of social networking site (SNS) use among this population, research investigating the influence of SNS use on adolescent eating behaviors remains limited. This study is to examine the impact of SNS use on emotional eating among Chinese adolescents, with a specific focus on exploring the mediating role of negative social comparisons and the moderating effect of perspective-taking. Data were obtained through an online survey involving 778 middle school students in China. The findings indicate that SNS use exerts a positive influence on adolescents' engagement in emotional eating, with this association being mediated by the presence of negative social comparisons. Perspective-taking demonstrated a protective role in the context of adolescents' utilization of social media platforms. For individuals characterized by high levels of perspective-taking, the effects of SNS use on negative social comparisons are mitigated, subsequently reducing its impact on emotional eating.
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Affiliation(s)
- Shan Sun
- Department of Psychology, Hubei University, Wuhan 430062, China
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Miller-Matero LR, Ross K, DePascale E, Arellano C, Zelenak L, Braciszewski JM, Hecht LM, Haley EN, Loree AM, Carlin AM. Post-surgical cannabis use is associated with weight loss among individuals up to 4 years after bariatric surgery. Surg Endosc 2023:10.1007/s00464-023-10126-6. [PMID: 37202524 DOI: 10.1007/s00464-023-10126-6] [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: 03/07/2023] [Accepted: 05/08/2023] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Although cannabis is known to stimulate appetite, it is not clear whether cannabis use may impact weight loss outcomes following bariatric surgery. Although some work has suggested that pre-surgical cannabis use is not associated with post-surgical weight loss, the role of post-surgical cannabis use has not yet been examined. The purpose of this study was to measure pre- and post-surgical cannabis use and determine whether cannabis use was associated with weight loss outcomes following bariatric surgery. METHODS Patients who underwent bariatric surgery over a 4-year period at a single health care system were invited to complete a survey regarding pre- and post-surgical cannabis use and report their current weight. Pre-surgical weight and BMI were extracted from medical records to calculate change in BMI (ΔBMI), percent total weight loss (%TWL), percent excess weight loss (%EWL), whether participants experienced a successful weight loss outcome, and whether participants had weight recurrence. RESULTS Among all participants (N = 759), 10.7% and 14.5% engaged in pre- and post-surgical cannabis use, respectively. Pre-surgical cannabis use was not associated with any weight loss outcomes (p > 0.05). Any post-surgical cannabis use was associated with lower %EWL (p = 0.04) and greater likelihood of weight recurrence (p = 0.04). Weekly cannabis use was associated with lower %EWL (p = 0.003), lower %TWL (p = 0.04), and a lower likelihood of having a successful weight loss outcome (p = 0.02). CONCLUSIONS Although pre-surgical cannabis use may not predict weight loss outcomes, post-surgical cannabis was associated with poorer weight loss outcomes. Frequent use (i.e., weekly) may be especially problematic. Providers should consider screening patients for cannabis use and educate them about the potential impact of postoperative cannabis use on weight loss following bariatric surgery.
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Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA.
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA.
| | - Kaitlin Ross
- Wayne State University School of Medicine, Detroit, MI, USA
| | - Eve DePascale
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
| | | | - Logan Zelenak
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Leah M Hecht
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Erin N Haley
- Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Amy M Loree
- Center for Health Policy & Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA
| | - Arthur M Carlin
- Wayne State University School of Medicine, Detroit, MI, USA
- Department of Surgery, Henry Ford Health, Detroit, MI, USA
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Judgment towards emotions as a mediator of the relationship between emotional eating and depression symptoms in bariatric surgery candidates. Eat Weight Disord 2022; 27:3675-3683. [PMID: 36449208 DOI: 10.1007/s40519-022-01508-1] [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: 06/28/2022] [Accepted: 11/01/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE Emotional eating is common in bariatric surgery candidates, and often is associated with depression and poorer weight loss outcomes following surgery. However, less is known about other modifiable risk factors that may link depression and emotional eating. The aim of the current study was to examine facets of mindfulness as potential mediators of the relationship between emotional eating and depression severity in bariatric surgery candidates. METHODS Bariatric surgery candidates (n = 743) were referred by their surgeons for a comprehensive psychiatric pre-surgical evaluation that included self-report questionnaires assessing depression severity, emotional overeating, and facets of mindfulness. Mediation effects were examined for each mindfulness facet based on prior research. RESULTS Only the nonjudging mindfulness facet significantly mediated the relationship between emotional eating and depression, suggesting that greater emotional eating may be associated with greater depression severity through higher levels of judgement towards thoughts and emotions. A reverse mediation analysis showed that depression severity was not a significant mediator of the relationship between nonjudging and emotional eating. CONCLUSION Fostering a nonjudgmental stance towards thoughts and feelings may be helpful in improving eating habits that would support greater post-surgical success. Other clinical and research implications are discussed. LEVEL OF EVIDENCE Level V, descriptive study.
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Carr MM, Lawson JL, Wiedemann AA, Barnes RD. Examining impairment and distress from food addiction across demographic and weight groups. Eat Behav 2021; 43:101574. [PMID: 34678631 PMCID: PMC8629934 DOI: 10.1016/j.eatbeh.2021.101574] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 09/29/2021] [Accepted: 09/29/2021] [Indexed: 12/27/2022]
Abstract
Rates of food addiction (FA) vary across weight and demographic groups. Factors influencing discrepant prevalence rates are largely unknown. Rates of clinically significant distress or impairment also vary across demographic groups, yet prior studies have overlooked the diagnostic significance of distress/impairment in heterogenous groups. We tested if weight and demographic groups differed in their likelihood of endorsing distress/impairment from FA. Participants (N = 1832) recruited from Amazon Mechanical Turk completed the modified Yale Food Addiction Scale 2.0 (mYFAS). The mYFAS includes 11 dichotomous symptom indicators and one dichotomous distress/impairment indicator. Differences in distress/impairment were tested across weight, sex, racial/ethnic, and educational groups using logistic regression. FA severity was controlled for using FA symptom count. There were no differences among racial/ethnic and educational groups (p > 0.05). Compared to men, women were more likely to report distress/impairment (aOR = 1.96, 95% CI = 1.28-3.03). People with obesity were more likely to report distress/impairment compared to people with overweight (aOR = 2.20, 95% CI = 1.39-3.49) or normal weight (aOR = 1.99, 95% CI = 1.26-3.13). Individual characteristics (i.e., sex, weight) may influence reporting of distress/impairment from FA. Further inquiry may be appropriate for men and people with normal weight or overweight presenting with FA symptoms who otherwise deny distress/impairment.
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Affiliation(s)
- Meagan M Carr
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America.
| | - Jessica L Lawson
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America; U.S. Department of Veterans Affairs, Psychology Service, VA Connecticut Healthcare System, 950 Campbell Ave., West Haven, CT 06516, United States of America
| | - Ashley A Wiedemann
- Department of Psychiatry, Yale School of Medicine, 300 George St., New Haven, CT 06511, United States of America
| | - Rachel D Barnes
- Division - General Internal Medicine, University of Minnesota Medical School, 420 Delaware St. SE, Minneapolis, MN 55455, United States of America
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Sönmez Güngör E, Çelebi C, Akvardar Y. The Relationship of Food Addiction With Other Eating Pathologies and Impulsivity: A Case-Control Study. Front Psychiatry 2021; 12:747474. [PMID: 34899418 PMCID: PMC8661135 DOI: 10.3389/fpsyt.2021.747474] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
The concept of food addiction (FA) has become central in recent years in understanding the psychological etiology of obesity. In this matched case-control study from Turkey, it was aimed to examine the prevalence of FA and related risk factors in four consecutive body mass index (BMI) categories. The case group consisted of pre-operative bariatric surgery patients with BMI over 35.0 kg/m2 (n = 40) and the control group was composed of age- and gender- matching individuals from the other categories, namely obese (n = 35), overweight (n = 40), and normal weight (n = 40). The Yale Food Addiction Scale (YFAS) and a standardized clinical interview using the DSM-5 substance use disorders criteria adopted for FA, the Eating Disorder Examination Questionnaire (EDEQ) and the Barratt Impulsivity Scale (BIS-11) were used as assessment instruments. It was found that FA was significantly associated with more serious eating pathologies, more frequent weight-cycling and earlier onset of dieting, higher impulsivity, and higher BMI. Motor and total impulsivity scores showed a positive albeit week correlation with the severity of FA but no significant correlation with BMI, indicating a relationship between impulsivity and weight gain in some but not all individuals. The severity of FA predicted the increase in BMI. Our findings suggest that FA is associated with weight gain in a group of individuals, plausibly through impulsive overeating. Emphasis on FA and its clinical implications such as addiction-based treatments may improve outcomes in obesity and facilitate health promotion.
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Affiliation(s)
- Ekin Sönmez Güngör
- Department of Psychiatry, Erenköy Mental Health and Neurological Diseases Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cengiz Çelebi
- Department of Psychiatry, Büyükçekmece Mimar Sinan State Hospital, Istanbul, Turkey
| | - Yildiz Akvardar
- Department of Psychiatry, School of Medicine, Marmara University, Istanbul, Turkey
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9
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The Assessment of Food Addiction and the Yale Food Addiction Scale in Bariatric Surgery Populations. BEHAVIOUR CHANGE 2021. [DOI: 10.1017/bec.2021.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Food addiction (FA) appears among bariatric weight loss surgery candidates who struggle to control the intake of hyperpalatable/refined foods have high rates of psychopathology and related health problems. Despite this, prevalence rates of FA in the bariatric sector are reported as low or variable. We investigated the prevalence of FA and the applicability of conventionally used metrics for 166 pre-surgery candidates from a weight management centre (USA) and a major metropolitan hospital (Australia). Self-report measures assessed FA (Yale Food Addiction Scale (YFAS)), body mass index (BMI), disordered eating, addictive personality, psychopathology, and diet. Consistent with prior research, standard YFAS scoring, requiring the endorsement of a distress/impairment (D/I) criterion (FA + D/I), yielded a FA prevalence rate of 12.7%, compared to 37.3% when D/I was omitted (FA − D/I). We compared profiles for those with FA using each scoring method against those ‘without’, who did not meet a minimum of three YFAS symptoms (non-FA ≤ 2). Both methods differentiated those with and without FA on addictive traits, disordered eating and hyperpalatable food consumption. Only FA + D/I differentiated markers of psychological distress or impairment, including depression, anxiety and quality of life. Results indicate a need for further FA research in bariatric settings.
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Personality Dimensions Associated with Food Addiction in a Sample of Pre-operative Bariatric Surgery Patients from Turkey. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00663-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity. Eat Weight Disord 2020; 25:1621-1629. [PMID: 31728923 DOI: 10.1007/s40519-019-00800-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/17/2019] [Indexed: 12/15/2022] Open
Abstract
PURPOSE After bariatric surgery (BS) a significant minority of patients do not reach successful weight loss or tend to regain weight. In recent years, interest for the psychological factors that predict post-surgical weight loss has increased with the objective of developing interventions aimed to ameliorate post-surgical outcomes. In the present study, predictive models of successful or poor weight loss 12 months after BS were investigated considering pre-surgery level of psychopathological symptoms, dysfunctional eating behaviors and trait impulsivity at baseline (pre-surgery). METHODS Sixty-nine patients with morbid obesity canditates for laparoscopic sleeve gastrectomy were assessed regarding metabolic and psychological dimensions. Successful post-surgery weight loss was defined as losing at least 50% of excess body weight (%EWL). RESULTS Logistic models adjusted for patient sex, age and presence of metabolic diseases showed that the baseline presence of intense psychopathological symptoms and low attentional impulsivity predict poor %EWL (< 50%), as assessed 12-month post-surgery. CONCLUSIONS The present findings suggest that intensity of general psychopathology and impulsivity, among other psychological factors, might affect post-surgery %EWL. Conducting adequate psychological assessment at baseline of patients candidates for BS seems to be crucial to orient specific therapeutic interventions. LEVEL OF EVIDENCE Level III, case-control analytic study.
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12
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Miller-Matero LR, Hamann A, LaLonde L, Martens KM, Son J, Clark-Sienkiewicz S, Sata M, Coleman JP, Hecht LM, Braciszewski JM, Carlin AM. Predictors of Alcohol Use after Bariatric Surgery. J Clin Psychol Med Settings 2020; 28:596-602. [PMID: 33205321 DOI: 10.1007/s10880-020-09751-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2020] [Indexed: 12/25/2022]
Abstract
Patients undergoing bariatric surgery are at risk for devloping an alcohol use disorder (AUD). The purpose of this study was to investigate pre-surgical psychosocial risk factors for post-surgical alcohol consumption and hazardous drinking. Participants (N = 567) who underwent bariatric surgery between 2014 and 2017 reported their post-surgical alcohol use. Information was collected from the pre-surgical evaluation including history of alcohol use, psychiatric symptoms, and maladaptive eating behaviors (i.e., binge eating, purging, and emotional eating). Younger age and pre-surgical alcohol use predicted post-surgical alcohol use and hazardous drinking. In addition, higher levels of depressive symptoms and maladaptive eating patterns predicted post-surgical binge drinking. Clinicians conducting pre-surgical psychosocial evaluations should be aware of the multiple risk factors related to post-surgical problematic alcohol use. Future research should evaluate whether preventive interventions for high-risk patients decrease risk for post-surgical alcohol misuse.
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Affiliation(s)
- Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA. .,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA.
| | - Aaron Hamann
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA.,Department of Surgery, Henry Ford Health System, Detroit, MI, USA
| | - Leah LaLonde
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA
| | - Kellie M Martens
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA.,Department of Surgery, Henry Ford Health System, Detroit, MI, USA
| | - John Son
- Wayne State University School of Medicine, Henry Ford Health System, Detroit, MI, USA
| | | | - Monika Sata
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA
| | - Joseph P Coleman
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Leah M Hecht
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health System, 1 Ford Place, 3A, Detroit, MI, 48202, USA.,Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA
| | - Arthur M Carlin
- Department of Surgery, Henry Ford Health System, Detroit, MI, USA.,Wayne State University School of Medicine, Henry Ford Health System, Detroit, MI, USA
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Clark-Sienkiewicz SM, Hecht LM, Pester B, Martens K, Hamann A, Carlin AM, Miller-Matero LR. Racial Differences in Psychological Symptoms and Eating Behaviors Among Bariatric Surgery Candidates. J Racial Ethn Health Disparities 2020; 8:94-98. [DOI: 10.1007/s40615-020-00761-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/29/2020] [Accepted: 04/13/2020] [Indexed: 12/26/2022]
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14
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Koball AM, Ames G, Goetze RE, Grothe K. Bariatric Surgery as a Treatment for Food Addiction? A Review of the Literature. CURRENT ADDICTION REPORTS 2020. [DOI: 10.1007/s40429-020-00297-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
PURPOSE OF REVIEW The purpose of this review was to examine different forms of disordered eating among individuals with excess weight, including their rates, correlates, and psychosocial treatments. RECENT FINDINGS Binge eating/binge eating disorder, loss of control eating, emotional eating, and food addiction are all fairly prevalent among individuals with excess weight. They appear to share many of the same correlates, including broader eating disorder psychopathology, body/shape/weight concerns, depression, anxiety, and low self-esteem. Behavioral, cognitive-behavioral, and third-wave (e.g., acceptance, mindfulness) therapies appear effective in improving binge eating, loss of control eating, emotional eating, associated features (e.g., weight and shape concerns), and psychological distress (e.g., depression). Certain forms of disordered eating are elevated among individuals with excess weight, and psychosocial interventions have been found effective in improving symptomatology. Empirical research examining the efficacy of treatments for food addiction is lacking, and greatly needed given both its rate and controversy.
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Affiliation(s)
- Bethany A Nightingale
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
| | - Stephanie E Cassin
- Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
- Centre for Mental Health, University Health Network, Toronto, ON, Canada.
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16
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Validation of the Yale Food Addiction Scale 2.0 Among a Bariatric Surgery Population. Obes Surg 2019; 29:2923-2928. [DOI: 10.1007/s11695-019-03927-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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17
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Miller-Matero LR, Brescacin C, Clark SM, Troncone CL, Tobin ET. Why WAIT? Preliminary evaluation of the weight assistance and intervention techniques (WAIT) group. PSYCHOL HEALTH MED 2019; 24:1029-1037. [PMID: 30843419 DOI: 10.1080/13548506.2019.1587478] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Individuals who attempt to lose weight may struggle because they lack skills to address problematic eating behaviors. There are multiple programs that have taught patients some of these behavioral strategies; however, it is not clear which strategies patients find to be the most useful. The purpose of this study was to examine preliminary outcomes after completion of a six-week integrative group for weight management. Retrospective chart reviews were conducted of 51 patients who completed an integrative, psychological weight management group. Patients were mailed surveys 1-2 years after completion of the group assessing for current problematic eating behaviors (i.e. emotional eating and food addiction), satisfaction with treatment, and skills they continue to use. The majority of patients lost weight, were satisfied with the group, found the group to be helpful, and felt confident they could maintain behavior changes. The strategies patients most commonly continued to use post-group included mindful eating, keeping a food diary, carrying out an exercise plan, regular weigh-ins, and planning for social eating. The number of food addiction symptoms decreased from pre- to post-group. An integrative psychological weight management group may provide patients with skills and confidence to assist with managing problematic eating behaviors and weight loss.
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Affiliation(s)
- Lisa R Miller-Matero
- a Department of Behavioral Health , Henry Ford Health System , Detroit, MI, USA.,b Department of Internal Medicine , Henry Ford Health System , Detroit, MI, USA.,c Center for Health Policy and Health Services Research , Henry Ford Health System , Detroit, MI, USA
| | - Carly Brescacin
- a Department of Behavioral Health , Henry Ford Health System , Detroit, MI, USA
| | - Shannon M Clark
- a Department of Behavioral Health , Henry Ford Health System , Detroit, MI, USA.,c Center for Health Policy and Health Services Research , Henry Ford Health System , Detroit, MI, USA
| | | | - Erin T Tobin
- a Department of Behavioral Health , Henry Ford Health System , Detroit, MI, USA.,b Department of Internal Medicine , Henry Ford Health System , Detroit, MI, USA
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18
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Penzenstadler L, Soares C, Karila L, Khazaal Y. Systematic Review of Food Addiction as Measured with the Yale Food Addiction Scale: Implications for the Food Addiction Construct. Curr Neuropharmacol 2019; 17:526-538. [PMID: 30406740 PMCID: PMC6712300 DOI: 10.2174/1570159x16666181108093520] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 05/03/2018] [Accepted: 10/30/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The concept of food addiction attracts much interest in the scientific community. Research is mainly based on the Yale Food Addiction Scale (YFAS), a tool developed to assess food addiction. Substance use disorder criteria have been used to develop this scale. OBJECTIVE The aim of this paper was to review the clinical significance of food addiction diagnoses made with the YFAS and to discuss the results in light of the current debate on behavioral addictions. METHODS We performed a systematic review of the studies that assessed food addiction with the YFAS published between January 2014 and July 2017 by searching the electronic databases PsycINFO, MEDLINE, and PsycARTICLES. RESULTS Sixty publications were included in the analysis. Thirty-three studies examined nonclinical samples and 27 examined clinical samples. All studies used YFAS scoring results to define food addiction. The prevalence of food addiction according to the YFAS varied largely by the studied samples. In general, a higher body mass index and the presence of eating disorders (EDs), especially binge eating disorder (BED), were associated with higher YFAS scores. CONCLUSION The concept of food addiction has not been established to this day although it can be grouped with other EDs such as BED. More research is needed to understand this behavior and the differences between food addiction and other EDs. The criteria for food addiction should be revisited in light of the concepts currently used to examine behavioral addictions.
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Affiliation(s)
- Louise Penzenstadler
- Address correspondence to this author at the Geneva University Hospitals, Rue de Grand-Pré, 70 C, 1202 Geneva, Switzerland; Tel: +41 22 372 57 50; Fax: +41 22 372 55 70; E-mail:
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19
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Guerrero Pérez F, Sánchez-González J, Sánchez I, Jiménez-Murcia S, Granero R, Simó-Servat A, Ruiz A, Virgili N, López-Urdiales R, Montserrat-Gil de Bernabe M, Garrido P, Monseny R, García-Ruiz-de-Gordejuela A, Pujol-Gebelli J, Monasterio C, Salord N, Gearhardt AN, Carlson L, Menchón JM, Vilarrasa N, Fernández-Aranda F. Food addiction and preoperative weight loss achievement in patients seeking bariatric surgery. EUROPEAN EATING DISORDERS REVIEW 2018; 26:645-656. [DOI: 10.1002/erv.2649] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 09/17/2018] [Accepted: 09/24/2018] [Indexed: 12/19/2022]
Affiliation(s)
| | | | - Isabel Sánchez
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
| | - Roser Granero
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Department of Psychobiology and Methodology; Autonomous University of Barcelona; Barcelona Spain
| | - Andreu Simó-Servat
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
| | - Ana Ruiz
- Department of Endocrinology; Joan XXIII University Hospital; Tarragona Spain
| | - Nuria Virgili
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
| | | | | | - Pilar Garrido
- Dietetics and Nutrition Unit; University Hospital of Bellvitge; Barcelona Spain
| | - Rosa Monseny
- Dietetics and Nutrition Unit; University Hospital of Bellvitge; Barcelona Spain
| | - Amador García-Ruiz-de-Gordejuela
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Jordi Pujol-Gebelli
- Bariatric and Metabolic Surgery Unit, Service of General and Gastrointestinal Surgery; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Carmen Monasterio
- Pneumology Department; University Hospital of Bellvitge; Barcelona Spain
- CIBER Enfermedades Respiratorias (CibeRes); Instituto de Salud Carlos III; Madrid Spain
| | - Neus Salord
- Pneumology Department; University Hospital of Bellvitge; Barcelona Spain
- CIBER Enfermedades Respiratorias (CibeRes); Instituto de Salud Carlos III; Madrid Spain
| | | | - Lily Carlson
- Department of Psychology; University of Michigan; Ann Arbor Michigan
| | - José M. Menchón
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
- CIBER de Salud Mental (CIBERSAM); Instituto de Salud Carlos III; Madrid Spain
| | - Nuria Vilarrasa
- Department of Endocrinology; University Hospital of Bellvitge; Barcelona Spain
- CIBERDEM-CIBER de Diabetes y Enfermedades Metabólicas Asociadas; Instituto de Salud Carlos III; Madrid Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn); Instituto de Salud Carlos III; Madrid Spain
- Clinical Sciences Department, School of Medicine and Health Sciences; University of Barcelona; Barcelona Spain
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20
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Romer AL, Su Kang M, Nikolova YS, Gearhardt AN, Hariri AR. Dopamine genetic risk is related to food addiction and body mass through reduced reward-related ventral striatum activity. Appetite 2018; 133:24-31. [PMID: 30296504 DOI: 10.1016/j.appet.2018.09.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 12/29/2022]
Abstract
The prevalence rate of obesity continues to rise in the U.S., but effective treatment options remain elusive resulting in increased emphasis on prevention. One such area of prevention research capitalizes on the relatively novel behavioral construct of food addiction, which has been implicated in obesity. Food addiction reflects an individual's propensity for compulsive eating despite negative consequences, and shares not only symptoms with both eating and substance use disorders but also genetic and neural correlates within neural reward-circuitry modulated by dopamine. Here, we examined associations between food addiction scores, body mass index (BMI), reward-related ventral striatum activity, and a polygenic score approximating dopamine signaling in 115 non-Hispanic Caucasian young adult university students. As predicted, polygenic dopamine scores were related to ventral striatum activity, which in turn was associated with higher food addiction scores. In addition, food addiction was related to BMI. An exploratory post-hoc path analysis further indicated that polygenic scores were indirectly related to both food addiction and BMI, in part, through ventral striatum activity. Collectively, our results provide evidence supporting the utility of food addiction in weight gain prevention research by establishing links with known risk-related neural and genetic biomarkers.
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Affiliation(s)
| | - Min Su Kang
- University of Pennsylvania, Philadelphia, PA, USA
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21
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Examination of the Effectiveness of a Brief, Adapted Dialectical Behavior Therapy-Skills Training Group for Bariatric Surgical Candidates. Obes Surg 2018; 29:252-261. [DOI: 10.1007/s11695-018-3515-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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22
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Brewer JA, Ruf A, Beccia AL, Essien GI, Finn LM, van Lutterveld R, Mason AE. Can Mindfulness Address Maladaptive Eating Behaviors? Why Traditional Diet Plans Fail and How New Mechanistic Insights May Lead to Novel Interventions. Front Psychol 2018; 9:1418. [PMID: 30250438 PMCID: PMC6139346 DOI: 10.3389/fpsyg.2018.01418] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/20/2018] [Indexed: 01/20/2023] Open
Abstract
Emotional and other maladaptive eating behaviors develop in response to a diversity of triggers, from psychological stress to the endless external cues in our modern food environment. While the standard approach to food- and weight-related concerns has been weight-loss through dietary restriction, these interventions have produced little long-term benefit, and may be counterproductive. A growing understanding of the behavioral and neurobiological mechanisms that underpin habit formation may explain why this approach has largely failed, and pave the way for a new generation of non-pharmacologic interventions. Here, we first review how modern food environments interact with human biology to promote reward-related eating through associative learning, i.e., operant conditioning. We also review how operant conditioning (positive and negative reinforcement) cultivates habit-based reward-related eating, and how current diet paradigms may not directly target such eating. Further, we describe how mindfulness training that targets reward-based learning may constitute an appropriate intervention to rewire the learning process around eating. We conclude with examples that illustrate how teaching patients to tap into and act on intrinsic (e.g., enjoying healthy eating, not overeating, and self-compassion) rather than extrinsic reward mechanisms (e.g., weighing oneself), is a promising new direction in improving individuals' relationship with food.
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Affiliation(s)
- Judson A. Brewer
- Center for Mindfulness in Medicine, Healthcare, and Society, Division of Mindfulness, University of Massachusetts Medical School, Worcester, MA, United States
| | - Andrea Ruf
- Center for Mindfulness in Medicine, Healthcare, and Society, Division of Mindfulness, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ariel L. Beccia
- Center for Mindfulness in Medicine, Healthcare, and Society, Division of Mindfulness, University of Massachusetts Medical School, Worcester, MA, United States
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Gloria I. Essien
- Contemplative Studies, Brown University, Providence, RI, United States
| | - Leonard M. Finn
- Needham Wellesley Family Medicine PC, Wellesley, MA, United States
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA, United States
| | - Remko van Lutterveld
- Center for Mindfulness in Medicine, Healthcare, and Society, Division of Mindfulness, University of Massachusetts Medical School, Worcester, MA, United States
| | - Ashley E. Mason
- Department of Medicine, Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States
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23
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Müller A, Leukefeld C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M. Food addiction and other addictive behaviours in bariatric surgery candidates. EUROPEAN EATING DISORDERS REVIEW 2018; 26:585-596. [DOI: 10.1002/erv.2629] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Crispin Leukefeld
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | - Carolin Hase
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
| | | | - Julian W. Mall
- Department of General, Vascular and Bariatric Surgery; KRH Klinikum Nordstadt; Hannover Germany
| | - Hinrich Köhler
- Department of Surgery; Herzogin Elisabeth Hospital; Braunschweig Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy; Hannover Medical School; Hannover Germany
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24
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Establishing a food addiction diagnosis using the Yale Food Addiction Scale: A closer look at the clinically significant distress/functional impairment criterion. Appetite 2018; 129:55-61. [PMID: 29966727 DOI: 10.1016/j.appet.2018.06.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 12/11/2022]
Abstract
The concept of food addiction (FA) represents a set of problematic eating behaviors related to overeating. According to the Yale Food Addiction Scale (YFAS), which was based on the DSM-IV-TR substance dependence diagnostic criteria, a FA diagnosis is assigned when at least three criteria and the criterion evaluating clinically significant distress and/or functional impairment are endorsed. Considering the decisive role of this last criterion, the present study aimed to investigate its endorsement among individuals suffering from severe obesity and awaiting bariatric surgery. A total of 146 individuals were recruited at the Quebec Heart and Lung Institute and were invited to complete various questionnaires. Differences between individuals who endorsed at least three FA criteria and reported distress/impairment (FA+D/I; N = 24) and individuals who endorsed at least three FA criteria but did not report distress/impairment (FA-D/I; N = 27) were examined. Results revealed that 16% of the total sample fulfilled a FA diagnosis when considering the clinically significant distress/functional impairment criterion; however, this prevalence rate climbed to 35% when removing the inclusion of distress/impairment. Furthermore, individuals from the FA+D/I group showed more FA symptomatology and hedonic hunger, but did not statistically differ from the FA-D/I group on expected markers of psychological distress (depressive symptoms and quality of life). Lastly, the experience of withdrawal symptoms and hedonic hunger were found to be the best predictors of the endorsement of the distress/impairment criterion. This study underlines the impact of this criterion in establishing a FA diagnosis and highlights the importance of considering alternative ways to interpret findings from the YFAS when dealing with clinical samples.
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25
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Janse Van Vuuren MA, Strodl E, White KM, Lockie PD. Emotional food cravings predicts poor short‐term weight loss following laparoscopic sleeve gastrectomy. Br J Health Psychol 2018; 23:532-543. [DOI: 10.1111/bjhp.12302] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 10/23/2017] [Indexed: 12/12/2022]
Affiliation(s)
| | - Esben Strodl
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
| | - Katherine M. White
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
| | - Philip D. Lockie
- School of Psychology and Counselling Queensland University of Technology Brisbane Queensland Australia
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26
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27
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Burrows T, Kay-Lambkin F, Pursey K, Skinner J, Dayas C. Food addiction and associations with mental health symptoms: a systematic review with meta-analysis. J Hum Nutr Diet 2018; 31:544-572. [DOI: 10.1111/jhn.12532] [Citation(s) in RCA: 112] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- T. Burrows
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - F. Kay-Lambkin
- Faculty Health and Medicine; NHMRC Centre for Research Excellence in Mental Health and Substance Use; National Drug and Alcohol Research Centre; University of Newcastle; Newcastle NSW Australia
| | - K. Pursey
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - J. Skinner
- School of Health Sciences; Faculty of Health and Medicine; Priority Research Centre of Physical Activity and Nutrition; University of Newcastle; Newcastle NSW Australia
| | - C. Dayas
- School of Biomedicine and Pharmacy; Faculty of Health and Medicine; University of Newcastle; Newcastle NSW Australia
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28
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Ouellette AS, Rodrigue C, Lemieux S, Tchernof A, Biertho L, Bégin C. An examination of the mechanisms and personality traits underlying food addiction among individuals with severe obesity awaiting bariatric surgery. Eat Weight Disord 2017; 22:633-640. [PMID: 29022218 DOI: 10.1007/s40519-017-0440-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 09/07/2017] [Indexed: 12/11/2022] Open
Abstract
PURPOSE The aetiology underlying addiction has often been investigated to shed more light on the factors contributing to the development and maintenance of various disorders. In the field of addictive eating behaviours, data on the aetiological factors related to food addiction (FA) in the bariatric context remain scarce. The present study aimed to explore mechanisms and variables underlying FA among individuals suffering from severe obesity and awaiting bariatric surgery. METHODS Participants (N = 146) were recruited at the Quebec Heart and Lung Institute during their pre-operative visit and were invited to complete questionnaires. Participants with and without FA were compared on reward sensitivity, impulsivity, emotion dysregulation, and personality traits. RESULTS Findings showed that bariatric candidates with FA (16%) presented more emotion dysregulation, more harm avoidance, and less self-directedness. Further exploration showed that the association between harm avoidance and the number of FA criteria endorsed was mediated by emotion dysregulation, while the association between self-directedness and the number of FA criteria endorsed was mediated by reward sensitivity. CONCLUSIONS These results indicate that an inability to regulate affect by strategies other than eating highly palatable food, in a context where negative affect and long-term goals can hardly be sustained, underlies a diagnostic of FA among bariatric candidates. From a clinical standpoint, the presence of a double vulnerability leading to FA symptomatology could help design better-targeted interventions to maximise weight loss maintenance in the bariatric context. LEVEL OF EVIDENCE Level V, descriptive study.
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Affiliation(s)
- Anne-Sophie Ouellette
- School of Psychology, Laval University, 2325 allée des Bibliothèques, Quebec City, QC, G1V 0A6, Canada
| | - Christopher Rodrigue
- School of Psychology, Laval University, 2325 allée des Bibliothèques, Quebec City, QC, G1V 0A6, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC, G1V 0A6, Canada.,Institute of Nutrition and Functional Foods, Laval University, 2440 boulevard Hochelaga, Quebec City, QC, G1V 0A6, Canada
| | - André Tchernof
- School of Nutrition, Laval University, 2425 rue de l'Agriculture, Quebec City, QC, G1V 0A6, Canada.,Quebec Heart and Lung Institute, 2725 chemin Ste-Foy, Quebec City, QC, G1V 4G5, Canada
| | - Laurent Biertho
- Quebec Heart and Lung Institute, 2725 chemin Ste-Foy, Quebec City, QC, G1V 4G5, Canada.,Department of Surgery, Laval University, 1050 avenue de la Médecine, Quebec City, QC, G1V 0A6, Canada
| | - Catherine Bégin
- School of Psychology, Laval University, 2325 allée des Bibliothèques, Quebec City, QC, G1V 0A6, Canada. .,Institute of Nutrition and Functional Foods, Laval University, 2440 boulevard Hochelaga, Quebec City, QC, G1V 0A6, Canada.
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29
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Ivezaj V, Wiedemann AA, Grilo CM. Food addiction and bariatric surgery: a systematic review of the literature. Obes Rev 2017; 18:1386-1397. [PMID: 28948684 PMCID: PMC5691599 DOI: 10.1111/obr.12600] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 07/22/2017] [Accepted: 07/25/2017] [Indexed: 02/03/2023]
Abstract
Emerging research suggests that rates of food addiction are high among individuals seeking bariatric surgery, but little is known about associated features and the prognostic significance of pre-operative food addiction. Thus, this article provides a systematic review and synthesis of the literature on food addiction and bariatric surgery. Articles were identified through PubMed and SCOPUS databases, resulting in a total of 19 studies which assessed food addiction among pre-bariatric and/or post-bariatric surgery patients using the Yale Food Addiction Scale. Most studies were cross-sectional, and only two studies prospectively measured food addiction both pre-operatively and post-operatively. The presence of pre-surgical food addiction was not associated with pre-surgical weight or post-surgical weight outcomes, yet pre-surgical food addiction was related to broad levels of psychopathology. The relationship between food addiction and substance misuse among individuals undergoing bariatric surgery is mixed. In addition, very few studies have attempted to validate the construct of food addiction among bariatric surgery patients. Results should be interpreted with caution due to the methodological limitations and small sample sizes reported in most studies. Future rigorous research with larger and more diverse samples should prospectively examine the clinical utility and validity of the food addiction construct following bariatric surgery.
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Affiliation(s)
- V Ivezaj
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - A A Wiedemann
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - C M Grilo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.,Department of Psychology, Yale University, New Haven, CT, USA
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30
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Emotion regulation and mental well-being before and six months after bariatric surgery. Eat Weight Disord 2017; 22:353-360. [PMID: 28390005 PMCID: PMC5440497 DOI: 10.1007/s40519-017-0379-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/01/2017] [Indexed: 02/08/2023] Open
Abstract
PURPOSE According to the current state of research, mental health improves due to bariatric surgery. However, improvements in weight and psychosocial aspects often show a gradual decline with time. As emotion regulation (ER) appears to be a key variable in the successful outcome of weight loss treatments, the present study aimed at investigating ER-strategies applied by bariatric surgery candidates pre- and post-surgery and examining interactions between ER, depressive symptoms, health-related quality of life (HrQoL), and post-surgical weight loss. METHODS Prior to and 6 months after bariatric surgery, 45 patients (76% women) completed self-report questionnaires assessing depressive symptoms (Beck Depression Inventory-II), HrQoL (Short Form-36 Health Survey), and ER-strategies (Emotion Regulation Inventory for Negative Emotions). RESULTS Six months post-surgery, the patients reported significant improvements in depressive symptomatology, HrQoL, and satisfaction with ER compared to pre-surgery. Groups differing in their course of ER-satisfaction also differed in psychosocial dimensions pre- to post-surgery, increased satisfaction being related to less impairment and enhanced communication of negative emotions as a form of an adaptive regulation. Patients with higher weight loss applied the strategy of controlled expression more frequently post-surgery than pre-surgery and compared to patients with lower weight loss. CONCLUSIONS Postoperative weight loss leads to improvements in ER-satisfaction and mental well-being. As satisfaction with ER seems to be associated with less impaired mental well-being among bariatric surgery candidates, presumably even more positive psychosocial outcomes could be obtained post-surgery by implementing trainings explicitly encouraging the use of adaptive ER-strategies.
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31
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The relationship between emotional regulation and eating behaviour: a multidimensional analysis of obesity psychopathology. Eat Weight Disord 2017; 22:105-115. [PMID: 27068173 PMCID: PMC5334401 DOI: 10.1007/s40519-016-0275-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/16/2016] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The aim of this study is to show that the differences among eating behaviours are related to the emotional dysregulation connected to the mental dimensions being part of the obese psychopathology. Eating behaviours can be considered a diagnostic feature at the initial screening for determining the obesity treatment: nutritional or bariatric surgery. METHODS 1828 Obese subjects underwent psychiatric assessment before entering obesity nutritional treatment or bariatric surgery following the multidisciplinary programme. 1121 subjects were selected and enrolled in this study: 850 were inpatients visited or hospitalised at the Obesity Centre or at the Bariatric Surgery Units, 271 were outpatients visited at the Eating Disorder and Obesity Unit. Psychiatric examination was used to exclude psychiatric disorders and investigate eating behaviours distinguished on the basis of food intake rhythm in: gorging, snacking, grazing and binge. They are related to the mental dimensions: impulsiveness, body image, mood and anxiety, taking part in the emotional regulation system. Specific psychometric tools were used to investigate the different mental dimensions of the single eating behaviours and their differences. Statistical analysis of the psychopathological features was performed using ANOVA, ANCOVA, Levene test, Bonferroni's and Tamhane post hoc test. Significance was set at p < 0.05. RESULTS Data analysis shows significant differences of psychopathology among all the eating behaviours and an increase in the emotional dysregulation determining maladaptive behaviours. DISCUSSION Eating behaviours are connected to the balance of the different features of mental dimensions implicated in the emotional regulation system. They could provide significant clinical information and therefore be part of the obesity diagnostic criteria and therapeutic programme.
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Novelle JM, Alvarenga MS. Cirurgia bariátrica e transtornos alimentares: uma revisão integrativa. JORNAL BRASILEIRO DE PSIQUIATRIA 2016. [DOI: 10.1590/0047-2085000000133] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO Objetivo Realizar revisão sobre transtornos alimentares e comportamentos alimentares transtornados relacionados à cirurgia bariátrica. Métodos Revisão integrativa da literatura nas bases de dados PubMed, Lilacs, Bireme, portal SciELO com descritores indexados com critérios de inclusão: oferecer dado sobre a presença ou frequência de transtorno alimentar e/ou comportamentos alimentares disfuncionais previamente e/ou após a cirurgia. Resultados Foram selecionados 150 estudos (14 nacionais e 136 internacionais): 80,6% eram com avaliação de pacientes pré-/pós-cirúrgicos; 12% eram estudos de caso e 7,3% eram estudos de revisão. Diferentes instrumentos foram usados para avaliação, principalmente o Questionnaire on Eating and Weight Patterns, a Binge Eating Scale e Eating Disorders Examination Questionnaire. A compulsão alimentar foi o comportamento mais avaliado, com frequências/prevalências variando de 2% a 94%; no caso do transtorno da compulsão alimentar as frequências/prevalências variaram de 3% a 61%. Houve também a descrição de anorexia e bulimia nervosa, síndrome da alimentação noturna e comportamento beliscador. Alguns estudos apontam melhora dos sintomas no pós-cirúrgico e/ou seguimento enquanto outros apontam surgimento ou piora dos problemas. Conclusão Apesar da variabilidade entre métodos e achados, comportamentos alimentares disfuncionais são muito frequentes em candidatos à cirurgia bariátrica e podem ainda surgir ou piorar após a intervenção cirúrgica. Profissionais de saúde devem considerar de maneira mais cuidadosa tais problemas neste público, dadas às consequências para o resultado cirúrgico e qualidade de vida.
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Machado TD, Dalle Molle R, Reis RS, Rodrigues DM, Mucellini AB, Minuzzi L, Franco AR, Buchweitz A, Toazza R, Ergang BC, Cunha ACDA, Salum GA, Manfro GG, Silveira PP. Interaction between perceived maternal care, anxiety symptoms, and the neurobehavioral response to palatable foods in adolescents. Stress 2016; 19:287-94. [PMID: 27295200 DOI: 10.1080/10253890.2016.1191464] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Studies in rodents have shown that early life trauma leads to anxiety, increased stress responses to threatening situations, and modifies food intake in a new environment. However, these associations are still to be tested in humans. This study aimed to verify complex interactions among anxiety diagnosis, maternal care, and baseline cortisol on food intake in a new environment in humans. A community sample of 32 adolescents and young adults was evaluated for: psychiatric diagnosis using standardized interviews, maternal care using the Parental Bonding Inventory (PBI), caloric consumption in a new environment (meal choice at a snack bar), and salivary cortisol. They also performed a brain fMRI task including the visualization of palatable foods vs. neutral items. The study found a three-way interaction between anxiety diagnosis, maternal care, and baseline cortisol levels on the total calories consumed (snacks) in a new environment. This interaction means that for those with high maternal care, there were no significant associations between cortisol levels and food intake in a new environment. However, for those with low maternal care and who have an anxiety disorder (affected), cortisol was associated with higher food intake; whereas for those with low maternal care and who did not have an anxiety disorder (resilient), cortisol was negatively associated with lower food intake. In addition, higher anxiety symptoms were associated with decreased activation in the superior and middle frontal gyrus when visualizing palatable vs. neutral items in those reporting high maternal care. These results in humans mimic experimental research findings and demonstrate that a combination of anxiety diagnosis and maternal care moderate the relationship between the HPA axis functioning, anxiety, and feeding behavior in adolescents and young adults.
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Affiliation(s)
- Tania Diniz Machado
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Roberta Dalle Molle
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Roberta Sena Reis
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Danitsa Marcos Rodrigues
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Amanda Brondani Mucellini
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Luciano Minuzzi
- d Department of Psychiatry and Behavioural Neurosciences , McMaster University , Hamilton , ON , Canada
| | - Alexandre Rosa Franco
- e PUCRS, Instituto do Cérebro (InsCer), Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- f PUCRS, Faculdade de Medicina , Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- g PUCRS, Faculdade de Engenharia , Programa de Pós-Graduação em Engenharia Elétrica , Porto Alegre , Brazil
| | - Augusto Buchweitz
- e PUCRS, Instituto do Cérebro (InsCer), Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- f PUCRS, Faculdade de Medicina , Programa de Pós-Graduação em Medicina e Ciências da Saúde , Porto Alegre , Brazil
- h PUCRS, Faculdade de Letras , Programa de Pós-Graduação em Letras , Linguística , Porto Alegre , Brazil
| | - Rudineia Toazza
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Bárbara Cristina Ergang
- i Graduação em Nutrição: Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Ana Carla de Araújo Cunha
- i Graduação em Nutrição: Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Giovanni Abrahão Salum
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Gisele Gus Manfro
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- c Programa de Pós-Graduação em Ciências Médicas: Psiquiatria. Faculdade de Medicina , Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
| | - Patrícia Pelufo Silveira
- a Programa de Pós-Graduação em Saúde da Criança e do Adolescente, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
- b Programa de Pós-Graduação em Neurociências , Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil
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Conceição EM, Utzinger LM, Pisetsky EM. Eating Disorders and Problematic Eating Behaviours Before and After Bariatric Surgery: Characterization, Assessment and Association with Treatment Outcomes. EUROPEAN EATING DISORDERS REVIEW 2015; 23:417-25. [PMID: 26315343 PMCID: PMC4861632 DOI: 10.1002/erv.2397] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 07/30/2015] [Indexed: 01/22/2023]
Abstract
Accumulating evidence suggests that bariatric surgery candidates are likely to present with eating disorders (EDs) and/or problematic eating behaviours (EBs), and research suggests that these problems may persist or develop after bariatric surgery. While there is growing evidence indicating that EDs and EBs may impact bariatric surgery outcomes, the definitions and assessment methods used lack consensus, and findings have been mixed. The aims of this paper were (1) to summarize the existing literature on pre‐operative and post‐operative EDs and problematic EBs; (2) to discuss the terms, definitions and assessment measures used across studies; and (3) to consider the extent to which the presence of these problems impact surgery outcomes. We highlight the importance of investigators utilizing consistent definitions and assessment methodologies across studies. © 2015 The Authors. European Eating Disorders Review published by Eating Disorders Association and John Wiley & Sons Ltd.
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Affiliation(s)
| | - Linsey M Utzinger
- Department of Clinical Research, Neuropsychiatric Research Institute, Fargo, ND, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Emily M Pisetsky
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
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Opolski M, Chur-Hansen A, Wittert G. The eating-related behaviours, disorders and expectations of candidates for bariatric surgery. Clin Obes 2015; 5:165-97. [PMID: 26173752 DOI: 10.1111/cob.12104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 05/13/2015] [Accepted: 05/21/2015] [Indexed: 12/17/2022]
Abstract
It is important that clinicians and researchers understand the possible eating-related difficulties experienced by pre-bariatric surgery candidates, as well as their expectations of how their eating and hunger will change after surgery. This review examines English-language publications related to the eating-related behaviours, disorders and expectations of bariatric candidates. Seventy-five articles related to binge eating disorder, grazing, night eating syndrome, emotional eating, food cravings and addiction, and pre-surgical expectations of post-surgical eating in this population were critically reviewed. A variety of often problematic eating behaviours appear more common in bariatric candidates than in non-obese populations. The literature suggests that 4-45% of candidates may have binge eating disorder, 20-60% may graze, 2-42% may have night eating syndrome, 38-59% may engage in emotional eating and 17-54% may fit criteria for food addiction. Binge eating may also be more prevalent in bariatric candidates than in similarly obese non-surgical individuals. Expectations of surgery are high, with pre-surgical candidates believing their bariatric procedure will virtually guarantee significantly improved eating behaviours. Study replications are needed, and further investigation into prevalence, impacts and candidate characteristics related to disordered eating behaviours, as well as candidates' expectations of eating after surgery, will be important. Further comparisons of bariatric candidates to similarly obese non-bariatric populations will be important to understand eating-related characteristics of candidates beyond those related to their weight. Future research may be improved by the use of validated measures, replicable methodologies, minimization of data collected in circumstances where respondents may been motivated to 'fake good', use of prospective data and consistent definitions of key terminology.
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Affiliation(s)
- M Opolski
- School of Psychology, University of Adelaide, Adelaide, Australia
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
| | - A Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - G Wittert
- Discipline of Medicine, School of Medicine, University of Adelaide, Adelaide, Australia
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