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Diep C, Lee S, Xue Y, Xiao M, Pivetta B, Daza JF, Jung JJ, Wijeysundera DN, Ladha KS. Preoperative depression and outcomes after metabolic and bariatric surgery: A systematic narrative review. Obes Rev 2024; 25:e13743. [PMID: 38572605 DOI: 10.1111/obr.13743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/08/2024] [Accepted: 03/10/2024] [Indexed: 04/05/2024]
Abstract
Preoperative depression is prevalent among patients undergoing metabolic and bariatric surgery (MBS) and is a potentially modifiable risk factor. However, the impact of preoperative depression on MBS outcomes has not been systematically reviewed. A search of MEDLINE, Embase, Cochrane, and PsychINFO (inception to June 2023) was conducted for studies reporting associations between preoperative depression and any clinical or patient-reported outcomes after MBS. Eighteen studies (5 prospective and 13 retrospective) reporting on 5933 participants were included. Most participants underwent gastric bypass or sleeve gastrectomy. Meta-analyses were not conducted due to heterogeneity in reported outcomes; findings were instead synthesized using a narrative and tabular approach. Across 13 studies (n = 3390) the associations between preoperative depression and weight loss outcomes at 6-72 months were mixed overall. This may be related to differences in cohort characteristics, outcome definitions, and instruments used to measure depression. A small number of studies reported that preoperative depression was associated with lower quality of life, worse acute pain, and more perioperative complications after surgery. Most of the included studies were deemed to be at high risk of bias, resulting in low or very low certainty of evidence according to the Risk of Bias In Non-randomized Studies - of Exposure (ROBINS-E) tool. While the impact of preoperative depression on weight loss after MBS remains unclear, there is early evidence that depression has negative consequences on other patient-important outcomes. Adequately powered studies using more sophisticated statistical methods are needed to accurately estimate these associations.
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Affiliation(s)
- Calvin Diep
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sandra Lee
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Yuanxin Xue
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Maggie Xiao
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | - Bianca Pivetta
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
| | - Julian F Daza
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Canada
| | - James J Jung
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Surgery, Division of General Surgery, University of Toronto, Toronto, Canada
- Department of Surgery, St. Michael's Hospital, Toronto, Canada
| | - Duminda N Wijeysundera
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Anesthesia, St. Michael's Hospital, Toronto, Canada
| | - Karim S Ladha
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Anesthesia, St. Michael's Hospital, Toronto, Canada
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Gardizy A, Lindenfeldar G, Paul A, Chao AM. Binge-Spectrum Eating Disorders, Mood, and Food Insecurity in Young Adults With Obesity. J Am Psychiatr Nurses Assoc 2024; 30:603-612. [PMID: 36600469 DOI: 10.1177/10783903221147930] [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] [Indexed: 01/06/2023]
Abstract
BACKGROUND Disordered eating is common but underrecognized in people with obesity and the relationship of food insecurity, mood, and binge-spectrum eating disorders has not been well addressed in samples with higher weight. Young adults are particularly vulnerable to developing disordered eating. AIM The purpose of this study was to compare the prevalence of food insecurity, depressive symptoms, anxiety, and loneliness among young adults (aged 18-35 years) who screened positive for binge-spectrum eating disorders (i.e., binge eating disorder and bulimia nervosa), those with subthreshold forms of these disorders, and individuals who did not screen positive for these conditions. METHOD This was a cross-sectional study of young adults with a self-reported body mass index ≥30 kg/m2 from the United States who were recruited online. Participants (N = 1,331; M ± SD age = 28.0 ± 3.4 years; body mass index [BMI] = 36.5 ± 6.2 kg/m2; 73.9% male; 56.3% White) completed surveys that evaluated disordered eating behaviors, food insecurity, mood, and lifestyle factors. RESULTS In the sample, 8.0% of participants screened positive for binge-spectrum eating disorder and 16.0% had probable subthreshold symptoms. Higher depressive symptoms (odds ratio [OR] = 1.11, 95% confidence interval [CI] = [1.03, 1.20], p = .01), perceived stress (OR = 1.13, 95% CI = [1.07, 1.19], p < .001), and food insecurity scores (OR = 1.12, 95% CI = [1.03, 1.21], p = .01) were associated with an increased likelihood of threshold binge-spectrum eating disorders. CONCLUSION People with disordered eating should also be evaluated for mood disorders and food insecurity and vice versa. Further research is needed to evaluate interventions that address food insecurity and mood disorders, which may help to decrease disordered eating.
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Affiliation(s)
- Ariana Gardizy
- Ariana Gardizy, BSN, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - Alexandra Paul
- Alexandra Paul, BA, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Ariana M Chao
- Ariana M. Chao, PhD, CRNP, University of Pennsylvania School of Nursing and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Remmel S, Noom M, Sandstrom R, Mhaskar R, Diab ARF, Sujka JA, Docimo S, DuCoin CG. Preoperative comorbidities as a predictor of EBWL after bariatric surgery: a retrospective cohort study. Surg Endosc 2024:10.1007/s00464-024-10785-z. [PMID: 38580757 DOI: 10.1007/s00464-024-10785-z] [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: 11/15/2023] [Accepted: 03/07/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION The purpose of this study is to investigate the impact of preoperative comorbidities, including depression, anxiety, type 2 diabetes mellitus, obstructive sleep apnea, hypothyroidism, and the type of surgery on %EBWL (percent estimated body weight loss) in patients 1 year after bariatric surgery. Patients who choose to undergo bariatric surgery often have other comorbidities that can affect both the outcomes of their procedures and the postoperative period. We predict that patients who have depression, anxiety, diabetes mellitus, obstructive sleep apnea, or hypothyroidism will have a smaller change in %EBWL when compared to patients without any of these comorbidities. METHODS AND PROCEDURES Data points were retrospectively collected from the charts of 440 patients from March 2012-December 2019 who underwent a sleeve gastrectomy or gastric bypass surgery. Data collected included patient demographics, select comorbidities, including diabetes mellitus, obstructive sleep apnea, hypothyroidism, depression, and anxiety, and body weight at baseline and 1 year postoperatively. Ideal body weight was calculated using the formula 50 + (2.3 × height in inches over 5 feet) for males and 45.5 + (2.3 × height in inches over 5 feet) for females. Excess body weight was then calculated by subtracting ideal body weight from actual weight at the above forementioned time points. Finally, %EBWL was calculated using the formula (change in weight over 1 year/excess weight) × 100. RESULTS Patients who had a higher baseline BMI (p < 0.001), diabetes mellitus (p = 0.026), hypothyroidism (p = 0.046), and who had a laparoscopic sleeve gastrectomy rather than Roux-en-Y gastric bypass (p < 0.001) had a smaller %EBWL in the first year after bariatric surgery as compared to patients without these comorbidities at the time of surgery. Controversially, patients with anxiety or depression (p = 0.73) or obstructive sleep apnea (p = 0.075) did not have a statistically significant difference in %EBWL. CONCLUSION A higher baseline BMI, diabetes mellitus, hypothyroidism, and undergoing laparoscopic sleeve gastrectomy may lead to lower %EBWL in the postoperative period after bariatric surgery. At the same time, patients' mental health status and sleep apnea status were not related to %EBWL. This study provides new insight into which comorbidities may need tighter control in order to optimize weight loss outcomes after bariatric surgery.
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Affiliation(s)
- Shelby Remmel
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
| | - Madison Noom
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
| | - Reagan Sandstrom
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA
| | - Abdul-Rahman Fadi Diab
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
- Division of Gastrointestinal Surgery, Tampa General Hospital, Tampa, FL, USA
| | - Joseph Adam Sujka
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
- Division of Gastrointestinal Surgery, Tampa General Hospital, Tampa, FL, USA
| | - Salvatore Docimo
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA
- Division of Gastrointestinal Surgery, Tampa General Hospital, Tampa, FL, USA
| | - Christopher Garnet DuCoin
- University of South Florida Morsani College of Medicine, 560 Channelside Drive, Tampa, FL, 33602, USA.
- Division of Gastrointestinal Surgery, Tampa General Hospital, Tampa, FL, USA.
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Benítez T, Caixàs A, Rebasa P, Luna A, Crivillés S, Gutiérrez T, Deus J. Psychopathological profile before and after bariatric surgery. Sci Rep 2023; 13:16172. [PMID: 37758783 PMCID: PMC10533840 DOI: 10.1038/s41598-023-43170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
Presurgical psychopathological assessment usually focuses on detecting severe mental disorders. However, mild intensity psychopathology and eating behaviour pattern may also influence postsurgical outcomes. The aim was to identify psychopathology and eating behaviour pattern in candidates prepared for bariatric surgery compared to a normative population before and after surgery. A cohort of 32 patients seeking bariatric surgery in a university hospital between March 2016 and March 2017 were evaluated with Personality Assessment Inventory (PAI), 36-item EDE-Q and BES before and after surgery. Thirty-two patients before and 26 one year after surgery were included. The PAI presurgical psychometric profile suggested a mild mixed adjustment disorder focused on somatic complaints. After surgery, patients improved in somatic complaints (p < 0.001), and depression (p = 0.04). Related eating disorders were more common than those of the normative group and improved significantly after surgery in scores for compulsive intake (BES p < 0.001) and overall key behaviours of eating disorders and related cognitive symptoms (EDE-Q/G p < 0.001). In our cohort ready for bariatric surgery a mild psychopathological profile is still present and becomes closer to that of the normative group after surgery. Further studies are needed to evaluate the effects of mild psychopathology on outcomes after bariatric surgery.
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Affiliation(s)
- Tura Benítez
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
| | - Assumpta Caixàs
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain.
- Endocrinology and Nutrition Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain.
| | - Pere Rebasa
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Alexis Luna
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, 08208, Sabadell, Spain
- Department of Surgery, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Sara Crivillés
- Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Parc del Taulí, 1, 08208, Sabadell, Barcelona, Spain
- Mental Health Department, Hospital Universitari Parc Taulí, 08208, Sabadell, Spain
| | - Teresa Gutiérrez
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
| | - Joan Deus
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, 08193, Bellaterra, Spain
- MRI Research Unit, Department of Radiology, Hospital del Mar, 08003, Barcelona, Spain
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Pruccoli J, Mack I, Klos B, Schild S, Stengel A, Zipfel S, Giel KE, Schag K. Mental Health Variables Impact Weight Loss, Especially in Patients with Obesity and Binge Eating: A Mediation Model on the Role of Eating Disorder Pathology. Nutrients 2023; 15:3915. [PMID: 37764699 PMCID: PMC10537364 DOI: 10.3390/nu15183915] [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: 07/27/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Various mental health and eating behavior variables have been independently associated with predicting weight loss in individuals with obesity. This study aims to investigate a mediation model that assesses the distinct contributions of these variables in predicting weight changes in patients with obesity following an outpatient behavioral weight loss intervention (BWLI). METHODS General mental health (depression, anxiety, stress, impulsivity), eating behavior (cognitive restraint, disinhibition, hunger), eating disorder pathology, and body mass index (BMI) were assessed in a group of 297 patients with obesity at the admission of a BWLI program. BMI was re-evaluated during the final treatment session. A mediation model was employed to examine whether mental health and eating behavior variables predicted BMI changes, with eating disorder pathology serving as a mediator. The model was tested both overall and within two patient subgroups: those with regular binge eating (≥four episodes/month) and those without. RESULTS In the overall sample (n = 238), the relationships between depression, impulsivity, and cognitive restraint with BMI change were mediated by eating disorder pathology. In the subgroup with regular binge eating (n = 99, 41.6%), the associations between stress and disinhibition with BMI change were additionally mediated by eating disorder pathology. In the subgroup without regular binge eating, eating disorder pathology showed no mediating effect. DISCUSSION Multiple mental health and eating behavior variables assessed at admission predicted BMI changes, particularly when mediated by eating disorder pathology in patients with regular binge eating. A comprehensive psychopathological assessment prior to starting BWLI may help identify multiple factors affecting prognosis and treatment outcomes. Long-term follow-up studies in this field are required.
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Affiliation(s)
- Jacopo Pruccoli
- Pediatric Neurology and Psychiatry Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Regional Center for Feeding and Eating Disorders in the Developmental Age, 40138 Bologna, Italy;
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Isabelle Mack
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
| | - Bea Klos
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
| | - Sandra Schild
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
- DZPG (German Center for Mental Health), 72076 Tübingen, Germany
- Department for Psychosomatic Medicine, Charité Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität at Berlin, and Berlin Institute of Health, 12203 Berlin, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
- DZPG (German Center for Mental Health), 72076 Tübingen, Germany
| | - Katrin Elisabeth Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
- DZPG (German Center for Mental Health), 72076 Tübingen, Germany
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, 72076 Tübingen, Germany; (B.K.); (S.S.); (A.S.); (S.Z.); (K.E.G.); (K.S.)
- Centre of Excellence for Eating Disorders Tübingen (KOMET), 72076 Tübingen, Germany
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Coughlin JW, Nauman E, Wellman R, Coley RY, McTigue KM, Coleman KJ, Jones DB, Lewis KH, Tobin JN, Wee CC, Fitzpatrick SL, Desai JR, Murali S, Morrow EH, Rogers AM, Wood GC, Schlundt DG, Apovian CM, Duke MC, McClay JC, Soans R, Nemr R, Williams N, Courcoulas A, Holmes JH, Anau J, Toh S, Sturtevant JL, Horgan CE, Cook AJ, Arterburn DE. Preoperative Depression Status and 5 Year Metabolic and Bariatric Surgery Outcomes in the PCORnet Bariatric Study Cohort. Ann Surg 2023; 277:637-646. [PMID: 35058404 PMCID: PMC9994793 DOI: 10.1097/sla.0000000000005364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine whether depression status before metabolic and bariatric surgery (MBS) influenced 5-year weight loss, diabetes, and safety/utilization outcomes in the PCORnet Bariatric Study. SUMMARY OF BACKGROUND DATA Research on the impact of depression on MBS outcomes is inconsistent with few large, long-term studies. METHODS Data were extracted from 23 health systems on 36,871 patients who underwent sleeve gastrectomy (SG; n=16,158) or gastric bypass (RYGB; n=20,713) from 2005-2015. Patients with and without a depression diagnosis in the year before MBS were evaluated for % total weight loss (%TWL), diabetes outcomes, and postsurgical safety/utilization (reoperations, revisions, endoscopy, hospitalizations, mortality) at 1, 3, and 5 years after MBS. RESULTS 27.1% of SG and 33.0% of RYGB patients had preoperative depression, and they had more medical and psychiatric comorbidities than those without depression. At 5 years of follow-up, those with depression, versus those without depression, had slightly less %TWL after RYGB, but not after SG (between group difference = 0.42%TWL, P = 0.04). However, patients with depression had slightly larger HbA1c improvements after RYGB but not after SG (between group difference = - 0.19, P = 0.04). Baseline depression did not moderate diabetes remission or relapse, reoperations, revision, or mortality across operations; however, baseline depression did moderate the risk of endoscopy and repeat hospitalization across RYGB versus SG. CONCLUSIONS Patients with depression undergoing RYGB and SG had similar weight loss, diabetes, and safety/utilization outcomes to those without depression. The effects of depression were clinically small compared to the choice of operation.
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Affiliation(s)
- Janelle W Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD
| | | | - Robert Wellman
- Kaiser Permanente Washington Health Research institute, Seattle, WA
| | - R Yates Coley
- Kaiser Permanente Washington Health Research institute, Seattle, WA
| | - Kathleen M McTigue
- Departments of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Karen J Coleman
- Kaiser Permanente Southern California, Department of Research and Evaluation, Pasadena, CA
| | - Daniel B Jones
- Department of Surgery, Beth israel Deaconess Medical Center and Harvard Medical School Boston, MA
| | - Kristina H Lewis
- Departments of Epidemiology & Prevention, and implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Jonathan N Tobin
- Clinical Directors Network (CDN) and The Rockefeller University Center for Clinical and Translational Science, New York, NY
| | - Christina C Wee
- Department of Surgery, Beth israel Deaconess Medical Center and Harvard Medical School Boston, MA
| | | | | | - Sameer Murali
- Kaiser Permanente Southern California Medical Group, Oakland, CA
| | - Ellen H Morrow
- Department of Surgery, University of Utah, Salt Lake City, UT
| | - Ann M Rogers
- Penn State University College of Medicine, Penn State Health, Department of Surgery, Hershey, PA
| | - G Craig Wood
- Obesity Institute, Geisinger Medical Center, Danville, PA
| | | | | | | | | | - Rohit Soans
- Temple University Hospital, Philadelphia, PA
| | - Rabih Nemr
- Weill Cornell Medical College, New York, NY
| | | | | | - John H Holmes
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Jane Anau
- Louisiana Public Health Institute, New Orleans, LA
| | - Sengwee Toh
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Jessica L Sturtevant
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Casie E Horgan
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
| | - Andrea J Cook
- Kaiser Permanente Washington Health Research institute, Seattle, WA
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Aguiar PV, Dionisio WÁDS, Souza EADC, Vantini D, Campanholi R, Pinto TCC, Ximenes RCC. Binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. Eat Weight Disord 2023; 28:12. [PMID: 36800040 PMCID: PMC9938051 DOI: 10.1007/s40519-023-01533-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 12/17/2022] [Indexed: 02/18/2023] Open
Abstract
PURPOSE The aim of the present study was to determine possible associations between binge eating, depressive symptoms and suicidal ideation in obese candidates for bariatric surgery. METHODS A cross-sectional study was conducted with 254 obese patients recruited from the general surgery service for bariatric procedures at the hospital affiliated with the Federal University of Pernambuco, Brazil. Evaluations were performed using the Binge Eating Scale (BES), Beck Depression Inventory, Beck Scale for Suicidal Ideation (BSSI) and a questionnaire addressing sociodemographic characteristics. RESULTS Most patients were women (82%), 48% had a moderate binge eating disorder, 42% a severe binge eating disorder, 32% had symptoms suggestive of mild, moderate or severe depression and 6% had suicidal ideation. Severe binge eating was positively associated with depressive symptoms (p < 0.001) and suicidal ideation (p < 0.05). Cases of severe binge eating were more frequent in young adults, but not necessarily associated with symptoms of depression or suicidal ideation in this portion of the sample. CONCLUSIONS The present findings underscore the need for psychological and psychiatric follow-up of obese candidates for bariatric surgery using appropriate assessment scales to guide therapeutic approaches. LEVEL III Evidence obtained from cross-sectional study.
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Affiliation(s)
- Priscilla Vasconcelos Aguiar
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Weslley Álex da Silva Dionisio
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil.
| | | | - Davi Vantini
- Clinical Analysis Laboratory, Faculdade de Medicina Do ABC, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Raphael Campanholi
- Clinical Analysis Laboratory, Faculdade de Medicina Do ABC, Centro Universitário FMABC, Santo André, SP, Brazil
| | - Tiago Coimbra Costa Pinto
- Postgraduate Program in Neuropsychiatry and Behavioral Sciences, Universidade Federal de Pernambuco, Recife, PE, Brazil
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Aylward L, Konsor M, Cox S. Binge Eating Before and After Bariatric Surgery. Curr Obes Rep 2022; 11:386-394. [PMID: 36287376 DOI: 10.1007/s13679-022-00486-w] [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] [Accepted: 09/22/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW The purpose is to review the state of the literature of binge eating in the context of bariatric surgery including prevalence, conceptualization, assessment, course, and related sequela throughout the perioperative continuum, particularly highlighting new advancements and future directions. RECENT FINDINGS Accurate assessment of binge eating in bariatric samples is essential for optimization of patient outcomes. Binge eating is less prevalent after bariatric surgery; however, prevalence rates increase over time. Most studies do not find a relationship between pre-operative binge eating and suboptimal weight outcomes after surgery. Refinement in understanding and conceptualization of post-operative binge eating is needed; new conceptualizations have proposed such a definition. Emerging constructs relevant to binge eating for bariatric patients include food addiction and food insecurity. Despite the introduction of formal diagnostic criteria for binge eating disorder, many uncertainties regarding the prevalence, course, and effects of binge eating currently exist; varied assessment methods continue to be a barrier to research on binge eating in bariatric surgery samples. Consensus on operational definitions for post-operative binge eating and best practices for assessment are areas for future consideration.
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Affiliation(s)
- Laura Aylward
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, USA
| | - Madeline Konsor
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Stephanie Cox
- West Virginia University School of Medicine, Department of Behavioral Medicine and Psychiatry, Morgantown, USA.
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Fu M, Chen S, Xu R, Chen J, Chen X, Gan W, Huang H, Duan G. Effects of Intravenous Analgesia Using Tramadol on Postoperative Depression State and Sleep Quality in Women Undergoing Abdominal Endoscopic Surgery: A Randomized Controlled Trial. Drug Des Devel Ther 2022; 16:1289-1300. [PMID: 35531319 PMCID: PMC9075899 DOI: 10.2147/dddt.s357773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose This study aimed to explore the effects of intravenous analgesia using tramadol on postoperative depression, anxiety, and sleep in women undergoing abdominal endoscopic surgery. Patients and Methods Two hundred female patients (100 in each group) who underwent abdominal endoscopic surgery were recruited to randomly receive intravenous analgesia with sufentanil combined with tramadol (tramadol group) or sufentanil (control group). The primary outcome was the incidence of postoperative depression, which was assessed at 1, 2, and 3 days after surgery using the 13-item Beck Depression Inventory. The secondary outcomes were the incidence of anxiety and sleep quality, which were assessed using the 20-item Self-Rating Anxiety Scale and Richards–Campbell Sleep Questionnaire. Results The incidence of depression (Beck depression scale≥4) during the 3-day follow-up in the control group was 51%, which was significantly higher than that in the tramadol group of 28% (relative risk [RR]=0.55; 95% confidence interval [CI], 0.38–0.79; P=0.001). No difference was found in the incidence of anxiety state (Self-Rating Anxiety Scale≥40) between the tramadol and control groups (7%vs 5%; RR=1.40; 95% CI, 0.46–4.25; P=0.552). All of the Richards–Campbell sleep scales of patients in the tramadol group at 1 (77.4±15.2 vs 64.2±20.1, P<0.001), 2 (84.1±14.9 vs 71.8±18.8, P<0.001), and 3 days (87.0±12.2 vs 70.3±21.0, P<0.001) after surgery were higher than those in the control group. Conclusion Intravenous analgesia using tramadol can effectively improve the postoperative depression and sleep status of women undergoing abdominal endoscopic surgery. Tramadol is recommended for use in postoperative analgesia when improving postoperative mood, and sleep is needed in clinical practice.
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Affiliation(s)
- Mengyue Fu
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Shi Chen
- Department of Anesthesiology, Chongqing Beibu Maternity Hospital, Chongqing, People’s Republic of China
| | - Rui Xu
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Jie Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xuehan Chen
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Wanxia Gan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - He Huang
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Guangyou Duan
- Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
- Correspondence: Guangyou Duan; He Huang, Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China, Email ;
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Aylward L, Lilly C, Tabone L, Szoka N, Abunnaja S, Cox S. Anxiety Predicts Reduced Weight Loss 30 Months after Bariatric Surgery. Surg Obes Relat Dis 2022; 18:919-927. [DOI: 10.1016/j.soard.2022.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/28/2022] [Accepted: 04/01/2022] [Indexed: 10/18/2022]
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Sommer LM, Halbeisen G, Erim Y, Paslakis G. Two of a Kind? Mapping the Psychopathological Space between Obesity with and without Binge Eating Disorder. Nutrients 2021; 13:3813. [PMID: 34836069 PMCID: PMC8625654 DOI: 10.3390/nu13113813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/24/2021] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Obesity (OB) is a frequent co-morbidity in Binge Eating Disorder (BED), suggesting that both conditions share phenotypical features along a spectrum of eating-related behaviors. However, the evidence is inconsistent. This study aimed to comprehensively compare OB-BED patients against OB individuals without BED and healthy, normal-weight controls in general psychopathological features, eating-related phenotypes, and early life experiences. (2) Methods: OB-BED patients (n = 37), OB individuals (n = 50), and controls (n = 44) completed a battery of standardized questionnaires. Responses were analyzed using univariate comparisons and dimensionality reduction techniques (linear discriminant analysis, LDA). (3) Results: OB-BED patients showed the highest scores across assessments (e.g., depression, emotional and stress eating, food cravings, food addiction). OB-BED patients did not differ from OB individuals in terms of childhood traumatization or attachment styles. The LDA revealed a two-dimensional solution that distinguished controls from OB and OB-BED in terms of increasing problematic eating behaviors and attitudes, depression, and childhood adversities, as well as OB-BED from OB groups in terms of emotional eating tendencies and self-regulation impairments. (4) Conclusions: Findings support the idea of a shared spectrum of eating-related disorders but also highlight important distinctions relevant to identifying and treating BED in obese patients.
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Affiliation(s)
- Laura Marie Sommer
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georg Halbeisen
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (L.M.S.); (Y.E.)
| | - Georgios Paslakis
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westfalia, Ruhr-University Bochum, Virchowstr. 65, 32312 Luebbecke, Germany;
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Bianciardi E, Raimondi G, Samela T, Innamorati M, Contini LM, Procenesi L, Fabbricatore M, Imperatori C, Gentileschi P. Neurocognitive and Psychopathological Predictors of Weight Loss After Bariatric Surgery: A 4-Year Follow-Up Study. Front Endocrinol (Lausanne) 2021; 12:662252. [PMID: 34025579 PMCID: PMC8131828 DOI: 10.3389/fendo.2021.662252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 03/30/2021] [Indexed: 11/13/2022] Open
Abstract
Twenty to thirty percent of patients experience weight regain at mid and long-term follow-up. Impaired cognitive functions are prevalent in people suffering from obesity and in those with binge eating disorder, thereby, affecting the weight-loss outcomes. The aim of our study was to investigate neurocognitive and psychopathological predictors of surgical efficacy in terms of percentage of excess weight loss (%EWL) at follow-up intervals of one year and 4-year. Psychosocial evaluation was completed in a sample of 78 bariatric surgery candidates and included psychometric instruments and a cognitive battery of neuropsychological tests. A schedule of 1-year and 4-year follow-ups was implemented. Wisconsin Sorting Card Test total correct responses, scores on the Raven's Progressive Matrices Test, and age predicted %EWL at, both, early and long-term periods after surgery while the severity of pre-operative binge eating (BED) symptoms were associated with lower %EWL only four years after the operation. Due to the role of pre-operative BED in weight loss maintenance, the affected patients are at risk of suboptimal response requiring ongoing clinical monitoring, and psychological and pharmacological interventions when needed. As a result of our findings and in keeping with the latest guidelines we encourage neuropsychological assessment of bariatric surgery candidates. This data substantiated the rationale of providing rehabilitative interventions tailored to cognitive domains and time specific to the goal of supporting patients in their post-surgical course.
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Affiliation(s)
- Emanuela Bianciardi
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
- *Correspondence: Emanuela Bianciardi,
| | - Giulia Raimondi
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Tonia Samela
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Marco Innamorati
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Lorenzo Maria Contini
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Leonardo Procenesi
- Psychiatric Chair, Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Mariantonietta Fabbricatore
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Claudio Imperatori
- Cognitive and Clinical Psychology Laboratory, Department of Human Science, European University of Rome, Rome, Italy
| | - Paolo Gentileschi
- Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy
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Comment on: Depression subtypes, binge eating, and weight loss in bariatric surgery candidates. Surg Obes Relat Dis 2020; 16:697-698. [PMID: 32127254 DOI: 10.1016/j.soard.2020.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/30/2020] [Indexed: 11/21/2022]
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