1
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Tempany J, Collier A, Ali A. The impact of a preoperative evaluation process on weight reduction and glycemic control in patients undergoing bariatric and metabolic surgery. Obes Sci Pract 2024; 10:e735. [PMID: 38465290 PMCID: PMC10924108 DOI: 10.1002/osp4.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Metabolic surgery is a sustainable intervention for obesity and type 2 diabetes. Preoperative education optimizes weight loss and glycemic control outcomes. Objective This study aimed to determine the effect of a generalized preoperative evaluation process (PEP) in patients who underwent bariatric surgery on weight loss and glycemic control pre- and post-surgery. Methods Data were retrospectively collected and analyzed for patients with type 2 diabetes who underwent bariatric surgery between 2010 and 2016. Patients were categorized into two groups determined by participation in the PEP. The groups were named the PEP group and non-PEP group. The correlation among engagement in the PEP was determined using the chi-square test and t-test. Statistical analysis with p < 0.05 was deemed significant. Results 129 patients were included in the study; 86 females (67%) and 43 males (33%). Fifty-nine patients (46%) engaged in the PEP and 70 (54%) patients did not engage in the PEP. A greater reduction in weight loss was observed in the PEP group versus the non-PEP group from initial enrollment to pre-surgery (14.3 ± 9.2 kg vs. 11.6 ± 9.2 kg; p = 0.11), and from pre-surgery to 2-years post-surgery (20.6 ± 14.8 kg vs. 16.9 ± 15.6 kg; p = 0.17). A greater reduction in HbA1c from initial enrollment to pre-surgery was seen in the PEP group versus the non-PEP group (0.90 ± 1.28% vs. 0.63 ± 1.07%); however, this was not maintained from pre-surgery to 2-year post-surgery (0.51 ± 1.18% vs. 0.70 ± 1.73%). In both cases, the statistical difference was insignificant. Conclusion The PEP was not associated with improvements in short-term weight loss or glycemic control pre-surgery and a 2-years post-surgery. Patients may benefit from individually tailored preoperative weight management strategies.
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Affiliation(s)
| | - Andrew Collier
- School of Health & Life SciencesGlasgow Caledonian UniversityGlasgowUK
| | - Abdulmajid Ali
- Bariatric Surgery UnitUniversity Hospital AyrAyrUK
- University of the West of ScotlandGlasgowUK
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2
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Mendes C, Carvalho M, Oliveira L, Rodrigues LM, Gregório J. Nurse-led intervention for the management of bariatric surgery patients: A systematic review. Obes Rev 2023; 24:e13614. [PMID: 37607837 DOI: 10.1111/obr.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 06/16/2023] [Accepted: 06/24/2023] [Indexed: 08/24/2023]
Abstract
The prevalence of obesity has become a global health concern, and severe obesity is associated with various chronic diseases and decreased quality of life. Bariatric surgery has shown success in treating obesity. Nevertheless, some patients experience weight regain and unsatisfactory outcomes. Multidisciplinary interventions have been shown to improve postoperative outcomes. Case managers, often specialized nurses, play a crucial role in patient support and coordination of care. However, the diverse design of case-managing interventions hinders the assessment of their success. Thus, the aim of this review is to identify the most successful structural characteristics of case-managing interventions, with or without the support of e-Health, in the process of perioperative management of bariatric surgery patients. A systematic literature review was conducted following the PRISMA guidelines. PubMed, MEDLINE, EBSCOhost, and CINAHL databases were searched for relevant studies published in the last 10 years. Eligible studies included randomized controlled trials, controlled clinical studies, case studies, or observational studies that evaluated perioperative care in bariatric surgery. The PICO framework was used to frame the search strategy. The initial search yielded 225 articles, of which 10 studies met the inclusion criteria. Nurse-led case-managing interventions with a multidisciplinary approach showed positive results in weight loss, physical activity, and quality of life. Patient-centered care models were found to promote adherence to treatment and patient satisfaction. E-Health technologies improved quality of life but not weight loss. The duration of behavioral interventions and the long-term outcomes after surgery remained unclear. Nurse-led case-management interventions, with a focus on behavioral change and multidisciplinary approaches, show promise in improving outcomes in bariatric surgery patients. Patient-centered care models and longer term interventions may contribute to sustained weight loss and better postoperative outcomes. Further research is needed to determine the optimal duration of interventions and the long-term effects on weight maintenance.
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Affiliation(s)
- Cláudia Mendes
- Hospital Espírito Santo de Évora, EPE, Évora, Portugal
- CRI.COM-Centro Responsabilidade Integrada de Cirurgia da Obesidade e Metabólica, Évora, Portugal
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
- Escuela de Doctorado, Programa de Ciencias de la Salud, Universidade de Alcalá, Madrid, Spain
| | - Manuel Carvalho
- Hospital Espírito Santo de Évora, EPE, Évora, Portugal
- CRI.COM-Centro Responsabilidade Integrada de Cirurgia da Obesidade e Metabólica, Évora, Portugal
| | - Leandro Oliveira
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - Luís Monteiro Rodrigues
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
| | - João Gregório
- CBIOS-Universidade Lusófona's Research Center for Biosciences and Health Technologies, Lisbon, Portugal
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3
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Lodewijks Y, van der Ven R, Nienhuijs S. A broad focus on additional programmes prior to bariatric surgery: A systematic review. Clin Obes 2022; 12:e12518. [PMID: 35289099 DOI: 10.1111/cob.12518] [Citation(s) in RCA: 1] [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] [Received: 10/27/2021] [Revised: 02/14/2022] [Accepted: 02/26/2022] [Indexed: 12/15/2022]
Abstract
Additional preoperative programmes may be beneficial for candidates who seek bariatric surgery, but there is no consensus on the optimal preparation. This systematic review aimed to summarize the effects of a preoperative programme on weight loss. A literature search was performed for Embase, Cinahl, PubMed and Cochrane Library. Studies on preoperative exercise, behaviour and/or diet programmes administered in adult patients in a bariatric trajectory measuring weight loss were included. Initial results yielded 2148 titles, 70 of which were thoroughly analysed and 37 articles were included, comprising 10 333 patients. Eleven out of 37 studies included postoperative weight loss as an outcome in interventions focused on diet (n = 5), behaviour (n = 2), exercise (n = 2) and a combination of interventions (n = 2). Only one study (9%) which administered exercise as a preoperative programme showed a significant effect on postoperative weight loss. In total, 33 studies included preoperative weight loss as an outcome, which was significant in 64% of the cases. It is difficult to draw conclusions from the investigated data as it was extremely heterogeneous concerning the intensity, duration and administration of a programme. Nevertheless, it seems that a preoperative weight loss programme seems beneficial in terms of preoperative weight loss, postoperative physical activity and improved mental health postinterventional. The use of a core outcome set is recommended for future studies.
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Affiliation(s)
- Yentl Lodewijks
- Department of Obesity Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Roos van der Ven
- Department of Obesity Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - Simon Nienhuijs
- Department of Obesity Surgery, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
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4
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Wright C, Barnett A, Campbell KL, Kelly JT, Hamilton K. Behaviour change theories and techniques used to inform nutrition interventions for adults undergoing bariatric surgery: A systematic review. Nutr Diet 2022; 79:110-128. [PMID: 35137502 PMCID: PMC9304301 DOI: 10.1111/1747-0080.12728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/07/2021] [Accepted: 01/06/2022] [Indexed: 01/25/2023]
Abstract
Aim This systematic review aimed to describe behaviour change theories and techniques used to inform nutrition interventions for adults undergoing bariatric surgery. Methods A systematic search was conducted across PubMed, PsycInfo, CENTRAL, EMBASE and CINAHL from inception until 09 March 2021. Eligible studies were randomised controlled trials involving nutrition interventions performed by a healthcare provider, to adults that were waitlisted or had undergone bariatric surgery and received a nutrition intervention explicitly informed by one or more behaviour change theories or behaviour change techniques. Screening was conducted independently by two authors. Behaviour change techniques were examined using the behaviour change technique taxonomy version one which includes 93 hierarchical techniques clustered into 16 groups. Quality of included studies was assessed using Cochrane risk of bias 2.0. Results Twenty‐one publications were included, involving 15 studies and 14 interventions, with 1495 participants. Bias was low or had some concerns. Two interventions reported using behaviour change theories (transtheoretical model and self‐determination theory). Thirteen behaviour change technique taxonomy groupings and 29 techniques were reported across 14 interventions. Common techniques included ‘1.2 Problem solving’ (n = 9 studies), ‘3.1 Social support (unspecified)’ (n = 9 studies), ‘1.1 Goal setting (behaviour)’ (n = 6 studies) and ‘2.3 Self‐monitoring of behaviour’ (n =‐ 6 studies). Conclusion While behaviour change techniques have been included, behaviour change theory is not consistently reported and/or adopted to inform nutrition interventions for adults undergoing bariatric surgery. Integrating behaviour change theory and techniques in nutrition interventions is important for researchers and bariatric surgery teams, including dietitians, to effectively target behaviours for this population.
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Affiliation(s)
- Charlene Wright
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia
| | - Amandine Barnett
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Katrina L Campbell
- School of Medicine and Dentistry, Centre of Applied Health Economics and Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.,Healthcare Excellence and Innovation, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Jaimon T Kelly
- Centre for Online Health, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.,Centre for Health Services Research, The University of Queensland, Saint Lucia, Queensland, Australia
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, Mount Gravatt, Queensland, Australia.,Health Sciences Research Institute, University of California, Merced, California, USA
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5
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García-Delgado Y, López-Madrazo-Hernández MJ, Alvarado-Martel D, Miranda-Calderín G, Ugarte-Lopetegui A, González-Medina RA, Hernández-Lázaro A, Zamora G, Pérez-Martín N, Sánchez-Hernández RM, Ibarra-González A, Bengoa-Dolón M, Mendoza-Vega CT, Appelvik-González SM, Caballero-Díaz Y, Hernández-Hernández JR, Wägner AM. Prehabilitation for Bariatric Surgery: A Randomized, Controlled Trial Protocol and Pilot Study. Nutrients 2021; 13:2903. [PMID: 34578781 PMCID: PMC8465022 DOI: 10.3390/nu13092903] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/13/2021] [Accepted: 08/20/2021] [Indexed: 12/15/2022] Open
Abstract
Bariatric surgery is the most efficacious treatment for obesity, though it is not free from complications. Preoperative conditioning has proved beneficial in various clinical contexts, but the evidence is scarce on the role of prehabilitation in bariatric surgery. We describe the protocol and pilot study of a randomized (ratio 1:1), parallel, controlled trial assessing the effect of a physical conditioning and respiratory muscle training programme, added to a standard 8-week group intervention based on therapeutical education and cognitive-behavioural therapy, in patients awaiting bariatric surgery. The primary outcome is preoperative weight-loss. Secondary outcomes include associated comorbidity, eating behaviour, physical activity, quality of life, and short-term postoperative complications. A pilot sample of 15 participants has been randomized to the intervention or control groups and their baseline features and results are described. Only 5 patients completed the group programme and returned for assessment. Measures to improve adherence will be implemented and once the COVID-19 pandemic allows, the clinical trial will start. This is the first randomized, clinical trial assessing the effect of physical and respiratory prehabilitation, added to standard group education and cognitive-behavioural intervention in obese patients on the waiting list for bariatric surgery. Clinical Trial Registration: NCT0404636.
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Affiliation(s)
- Yaiza García-Delgado
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - María José López-Madrazo-Hernández
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Dácil Alvarado-Martel
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Guillermo Miranda-Calderín
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Arantza Ugarte-Lopetegui
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Raúl Alberto González-Medina
- Internal Medicine Nursing 8th North Wing, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain;
| | - Alba Hernández-Lázaro
- Department of Endocrinology and Nutrition, Hospital Universitario Dr. Negrín, 35010 Gran Canaria, Spain;
| | - Garlene Zamora
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Nuria Pérez-Martín
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
| | - Rosa María Sánchez-Hernández
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Adriana Ibarra-González
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
| | - Mónica Bengoa-Dolón
- Department of Pneumology, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain;
| | - Carmen Teresa Mendoza-Vega
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Svein Mikael Appelvik-González
- Department of Rehabilitation and Physical Medicine, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (G.M.-C.); (A.U.-L.); (C.T.M.-V.); (S.M.A.-G.)
| | - Yurena Caballero-Díaz
- Department of General and Digestive Surgery, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (Y.C.-D.); (J.R.H.-H.)
| | - Juan Ramón Hernández-Hernández
- Department of General and Digestive Surgery, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (Y.C.-D.); (J.R.H.-H.)
| | - Ana María Wägner
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular-Materno Infantil, 35016 Gran Canaria, Spain; (M.J.L.-M.-H.); (N.P.-M.); (R.M.S.-H.); (A.I.-G.)
- Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, 35001 Las Palmas, Spain; (D.A.-M.); (G.Z.)
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6
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Julien CA, Lavoie KL, Ribeiro PAB, Dragomir AI, Mercier LA, Garneau PY, Pescarus R, Bacon SL. Behavioral weight management interventions in metabolic and bariatric surgery: A systematic review and meta-analysis investigating optimal delivery timing. Obes Rev 2021; 22:e13168. [PMID: 33403754 DOI: 10.1111/obr.13168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/13/2022]
Abstract
Metabolic and bariatric surgery (MBS) yields unprecedented clinical outcomes, though variability is high in weight change and health benefits. Behavioral weight management (BWM) interventions may optimize MBS outcomes. However, there is a lack of an evidence base to inform their use in practice, particularly regarding optimal delivery timing. This paper evaluated the efficacy of BWM conducted pre- versus post- versus pre- and post-MBS. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and included pre- and/or post-operative BWM interventions in adults reporting anthropometric and/or body composition data. Thirty-six studies (2,919 participants) were included. Post-operative BWM yielded greater decreases in weight (standardized mean difference [SMD] = -0.41; 95% confidence interval [CI]: -0.766 to -0.049, p < 0.05; I2 = 93.5%) and body mass index (SMD = -0.60; 95% CI: -0.913 to -0.289, p < 0.001; I2 = 87.8%) relative to comparators. There was no effect of BWM delivered pre- or joint pre- and post-operatively. The risk of selection and performance bias was generally high. Delivering BWM after MBS appears to confer the most benefits on weight, though there was high variability in study characteristics and risk of bias across trials. This provides insight into the type of support that should be considered post-operatively.
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Affiliation(s)
- Cassandre A Julien
- Department of Psychology, University of Quebec at Montreal, Montréal, Canada.,Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montreal, Montréal, Canada.,Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Paula A B Ribeiro
- Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Anda I Dragomir
- Department of Psychology, University of Quebec at Montreal, Montréal, Canada.,Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Li Anne Mercier
- Department of Psychology, University of Quebec at Montreal, Montréal, Canada.,Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Pierre Y Garneau
- Department of Surgery, University of Montreal, Montréal, Canada.,General and Bariatric Surgery Division, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Radu Pescarus
- Department of Surgery, University of Montreal, Montréal, Canada.,General and Bariatric Surgery Division, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Montreal North Island Integrated Health and Social Services University Centre (CIUSSS-NIM), Montréal, Canada.,Department of Health, Kinesiology & Applied Physiology, Concordia University, Montréal, Canada
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7
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Jones RA, Lawlor ER, Birch JM, Patel MI, Werneck A, Hoare E, Griffin SJ, van Sluijs EM, Sharp SJ, Ahern AL. The impact of adult behavioural weight management interventions on mental health: A systematic review and meta-analysis. Obes Rev 2021; 22:e13150. [PMID: 33103340 PMCID: PMC7116866 DOI: 10.1111/obr.13150] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/04/2020] [Accepted: 09/14/2020] [Indexed: 12/27/2022]
Abstract
There is good evidence that behavioural weight management interventions improve physical health; however, the impact on mental health remains unclear. We evaluated the impact of behavioural weight management interventions on mental health-related outcomes in adults with overweight or obesity at intervention-end and 12 months from baseline. Eligible studies were randomized controlled trials (RCTs) or cluster RCTs of adult behavioural weight loss interventions reporting affect, anxiety, binge eating, body image, depression, emotional eating, quality of life, self-esteem and stress. We searched seven databases from inception to 7 May 2019 and included 43 articles reporting 42 RCTs. Eighteen studies were deemed to be at high risk of bias. We conducted random-effects meta-analyses, stratified analyses and meta-regression using Stata. Interventions generated greater improvements than comparators for depression, mental health-related quality of life and self-efficacy at intervention-end and 12 months from baseline. There was no difference between groups for anxiety, overall quality of life, self-esteem or stress at intervention-end. There was insufficient evidence to assess the impact on anxiety, binge eating, body image, emotional eating, affect, life satisfaction, self-esteem or stress at intervention-end and/or 12 months from baseline. Although evidence suggests that interventions benefit some aspects of mental health, high-quality, transparently reported RCTs measuring a range of mental health outcomes over longer durations are required to strengthen the evidence base.
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Affiliation(s)
| | - Emma R. Lawlor
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | - Jack M. Birch
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Manal I. Patel
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Andre Werneck
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, Brazil
| | - Erin Hoare
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Food and Mood Centre, Centre for Innovation in Mental and Physical Health and Clinical Treatment, School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3004, Australia
| | - Simon J. Griffin
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Cambridge, UK
| | | | - Amy L. Ahern
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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8
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Conz CA, Jesus MCPD, Kortchmar E, Braga VAS, Machado RET, Merighi MAB. Path taken by morbidly obese people in search of bariatric surgery in the public health system. Rev Lat Am Enfermagem 2020; 28:e3294. [PMID: 32696927 PMCID: PMC7365606 DOI: 10.1590/1518-8345.3579.3294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 03/12/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: to understand the path taken in the public health system by people with
morbid obesity in the search for bariatric surgery. Method: qualitative research based on the social phenomenology of Alfred Schütz, with
17 hospitalized morbidly obese people, with a scheduled date for bariatric
surgery. The phenomenological interview with open questions was used and the
statements were analyzed in the light of the theoretical-methodological
framework and literature related to the theme. Results: the participants were able to schedule bariatric surgery by referring
friends, family and public people. The waiting list for the procedure
generated anguish and anxiety due to fear of surgery, weight gain, risk of
worsening health and physical limitations, but it helped prepare for its
performance. The experience lived in the search for bariatric surgery led
these people to want continuity of care in the Basic Health Unit, after the
surgery, by professionals trained to meet their needs. Conclusion: the aspects inscribed in the path of people in search of bariatric surgery
signal the need to strengthen the assistance-related flows of the public
health system and to invest in professional training to reduce the social
inequalities in access to bariatric surgery and increased quality of
services.
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Affiliation(s)
| | | | - Estela Kortchmar
- Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil
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9
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Intervenção educativa e indicadores de obesidade de candidatos à gastroplastia: estudo quase-experimental. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao0305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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EVANGELISTA MM, CRISP AH, ROSSATO SL, VIEIRA CM, BOSSA R, OLIVEIRA MRMD. Randomized controlled trial protocol: A quanti-quali approach for analyzing the results of an intervention on the waiting list for bariatric surgery. REV NUTR 2019. [DOI: 10.1590/1678-9865201932e180234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objective This article aims to describe the protocol of a randomized clinical trial and the baseline results of the study of a one-year interdisciplinary intervention in users of the public health system in the bariatric surgery waiting list. Methods A randomized, single-blind clinical trial will be conducted including 88 participants recruited on an outpatient clinic of the public health system. Participants were randomized into the control group (n=44), receiving the usual treatment; and into the intervention group (n=44), participating in the educational intervention. Participants had their food intake, negative affectivity and physical inactivity/sedentary behavior assessed, as well as anthropometric and body composition measurements; their blood samples were collected; and also had different physical capacity tests. Results Of the 157 participants invited, 27 had severe functional limitations, one was under-age, and four declined the study due to associated diseases. Eighty-eight participants were randomized: 44 for the Control Group and 44 for the Intervention Group. When comparing the demographic and biochemical characteristics, there were no differences between groups except for serum glucose (GC=110.4±46.8mg/dL and GI93.1±16.9mg/dL, p=0.039). Conclusion This study protocol describes the methodology used in the study of educational intervention for the promotion of health care of patients on the waiting list for bariatric surgery. It shows that there is similarity between the baseline comparison groups. Registro Brasileiro de Ensaios Clínicos (Brazilian Clinical Trials Registry), RBR-775y3d.
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Affiliation(s)
| | - Alex Harley CRISP
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil; Universidade Metodista de Piracicaba, Brasil
| | - Sinara Laurini ROSSATO
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil; Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil
| | - Carla Maria VIEIRA
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil; Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil
| | - Rayli BOSSA
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Brasil; Centro Universitário de Rio Preto, Brasil
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Madeira T, do Carmo I, Bicha Castelo H, Santos O. Self-Regulation of Weight After Sleeve Gastrectomy. Behav Modif 2017; 42:231-248. [PMID: 28845694 DOI: 10.1177/0145445517724540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Bariatric surgery is recognized as the most effective method for achieving relevant weight loss in subjects with severe obesity. However, there is insufficient knowledge about weight self-regulation and quality of motivation in these patients. The main goal of this study was to characterize the association between the percentage of excess weight loss (%EWL) and the motivation to manage weight, at least 1 year after sleeve gastrectomy (SG). This is an observational longitudinal retrospective study. All patients corresponding to predefined inclusion criteria who underwent SG from January 2008 to July 2010 at a main general hospital were invited. A version of the Treatment Self-Regulation Questionnaire (TSRQ) was used to assess patients' quality of motivation: TSRQ concerning continuing the weight self-management program. Clinical data were collected from patients' records. Overall, 81 patients participated (16 men and 65 women, 25-64 years old). The average body mass index was significantly reduced from 45.3 ± 7.0 kg/m2 preoperatively to 32.7 ± 6.9 kg/m2 postoperatively. Autonomous self-regulation was higher than externally controlled self-regulation, regarding motives to keep managing weight after SG. Postoperatively, %EWL correlated negatively with external self-regulation. SG was found to be associated with the quality of motivation for losing weight. External motivations were associated with worse results. These findings support the importance of multiprofessional teams in the assessment and treatment of patients, aiming for the promotion of weight self-regulation after bariatric surgery.
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Affiliation(s)
- Teresa Madeira
- 1 Instituto de Saúde Ambiental, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa.,2 Faculdade de Medicina, Universidade de Lisboa
| | | | | | - Osvaldo Santos
- 1 Instituto de Saúde Ambiental, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa.,2 Faculdade de Medicina, Universidade de Lisboa
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Lerdal A, Gay CL, Bonsaksen T, Fagermoen MS. Predictors of physical and mental health in persons with morbid obesity attending a patient education course - a two-year follow-up study. Health Qual Life Outcomes 2017; 15:103. [PMID: 28506306 PMCID: PMC5433048 DOI: 10.1186/s12955-017-0675-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 05/04/2017] [Indexed: 11/23/2022] Open
Abstract
Background People with morbid obesity (body mass index ≥40) may experience changes in their health after participating in a tailored patient education course. The aims of this study were to assess the changes in physical and mental health in persons with morbid obesity during the 2 years following an educational course and to explore possible socio-demographic, treatment, and personal predictors of physical and mental health outcomes. Methods In this prospective longitudinal cohort study, self-report questionnaire data were collected from people with morbid obesity at the beginning of mandatory educational courses while on a waiting list for gastric surgery and at two-year follow-up. Of the 185 who attended the courses, 142 (77%) volunteered to participate in the study, and the 59 with complete data at the two-year follow-up were included in the analysis. Physical and mental health were measured with the physical and mental component summary scores from the Short Form 12v2. Self-esteem was measured by the Rosenberg Self-Esteem Scale, and self-efficacy by the General Self-Efficacy Scale. Results The participants reported better physical health at two-year follow-up than at baseline. Mental health did not change significantly over time. Receiving surgical treatment during the study period predicted better physical health at two-year follow-up, even after controlling for physical health at baseline. Mental health at baseline was the only significant baseline predictor of mental health at follow-up. However, increasing self-esteem and self-efficacy over the two-year study period independently predicted better mental health at follow up after controlling for mental health at baseline. Conclusion Our study showed that people with morbid obesity on a waiting list for bariatric surgery improved their physical health during the 2 years after attending a tailored patient educational course. Improving self-esteem and self-efficacy may be important personal factors for maintaining mental health during this period. Trial Registration NCT01336725. Registered 14 April 2011.
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Affiliation(s)
- Anners Lerdal
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway. .,Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway.
| | - Caryl L Gay
- Department for Patient Safety and Research, Lovisenberg Diakonale Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway.,Department of Family Health Care Nursing, University of California at San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, P.O. Box 4, St. Olavs Plass, N-0130, Oslo, Norway.,VID Specialized University, Faculty of Health Studies, Vågsgaten 40, 4306, Sandnes, Norway
| | - May Solveig Fagermoen
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway
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