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Pietrabissa G, Bertuzzi V, Simpson S, Guerrini Usubini A, Cattivelli R, Bertoli S, Mozzi E, Roviaro G, Castelnuovo G, Molinari E. Psychological Aspects of Treatment with Intragastric Balloon for Management of Obesity: A Systematic Review of the Literature. Obes Facts 2022; 15:1-18. [PMID: 34818229 PMCID: PMC8820150 DOI: 10.1159/000518200] [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: 04/27/2021] [Accepted: 06/24/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Optimizing maintenance of weight loss for people with obesity following intragastric balloon (IGB) therapy hinges on the degree to which health care providers can recognize both the impact of emotional problems and mood difficulties on their capacity to self-manage, and requirements for additional support. However, there is limited research on the psychological correlates of IGB therapy. This systematic review, for the first time, attempts to identify and synthesize the empirical evidence for the reciprocal influence between psychological variables and IGB outcomes. METHODS A literature search was performed in the PubMed, SCOPUS, MEDLINE, and Google Scholar databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least 2 reviewers. The selected articles were assessed for quality using the Strengthening the Reporting of Observational Studies Epidemiology (STROBE) checklist. Data were extracted to address the review aims and presented as a narrative synthesis. The review protocol was preregistered (Prospero CRD42019121291). RESULTS A total of 16,179 titles, 14,369 abstracts, and 51 full-text articles were screened, of which 16 studies were included. Findings suggest that female gender, older age, basic educational level, and single/divorced civil status, together with lower levels of depression, binge eating, higher perceived quality of life, and motivation to change were predictors of enhanced IGB treatment outcomes. Dissatisfaction with treatment was higher in those with impaired obesity-related social-life difficulties. The IGB treatment was effective in reducing weight and improving depression, anxiety, eating disorder symptoms, and the overall life quality of patients with obesity - mainly within 6 months from the device positioning and in conjunction with conventional therapies. DISCUSSION/CONCLUSION In line with the available literature on obesity and bariatric surgery interventions, poor mental health appears to be an important barrier for successful weight loss among patients with obesity undergoing IGB treatment. In order to improve the efficacy and effectiveness of the IGB therapy, more comprehensive and standardized studies are needed to provide insight into the psychological mechanisms maintaining weight management issues.
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Affiliation(s)
- Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy,
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy,
| | - Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Susan Simpson
- Department of Justice and Society, University of South Australia, Adelaide, South Australia, Australia
- Regional Eating Disorders Unit, NHS Lothian, Edinburgh, United Kingdom
| | - Anna Guerrini Usubini
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Simona Bertoli
- Department of Endocrine and Metabolic Diseases, Obesity Unit and Laboratory of Nutrition and Obesity Research, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Food, Environmental and Nutritional Sciences, International Center for the Assessment of Nutritional Status, University of Milan, Milan, Italy
| | - Enrico Mozzi
- Division of General Surgery, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Giancarlo Roviaro
- Division of General Surgery, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
| | - Enrico Molinari
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy
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Bomberg EM, Ryder JR, Brundage RC, Straka RJ, Fox CK, Gross AC, Oberle MM, Bramante CT, Sibley SD, Kelly AS. Precision medicine in adult and pediatric obesity: a clinical perspective. Ther Adv Endocrinol Metab 2019; 10:2042018819863022. [PMID: 31384417 PMCID: PMC6661805 DOI: 10.1177/2042018819863022] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 06/19/2019] [Indexed: 12/13/2022] Open
Abstract
It remains largely unknown as to why some individuals experience substantial weight loss with obesity interventions, while others receiving these same interventions do not. Person-specific characteristics likely play a significant role in this heterogeneity in treatment response. The practice of precision medicine accounts for an individual's genes, environment, and lifestyle when deciding upon treatment type and intensity in order to optimize benefit and minimize risk. In this review, we first discuss biopsychosocial determinants of obesity, as understanding the complexity of this disease is necessary for appreciating how difficult it is to develop individualized treatment plans. Next, we present literature on person-specific characteristics associated with, and predictive of, weight loss response to various obesity treatments including lifestyle modification, pharmacotherapy, metabolic and bariatric surgery, and medical devices. Finally, we discuss important gaps in our understanding of the causes of obesity in relation to the suboptimal treatment outcomes in certain patients, and offer solutions that may lead to the development of more effective and targeted obesity therapies.
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Affiliation(s)
- Eric M. Bomberg
- Department of Pediatrics and Center for
Pediatric Obesity Medicine, University of Minnesota, Minneapolis, 717
Delaware Street SE, Room 371, Minneapolis, MN 55414, USA
| | - Justin R. Ryder
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
| | - Richard C. Brundage
- Department of Experimental and Clinical
Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Robert J. Straka
- Department of Experimental and Clinical
Pharmacology, University of Minnesota, Minneapolis, MN, USA
| | - Claudia K. Fox
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
| | - Amy C. Gross
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
| | - Megan M. Oberle
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
| | - Carolyn T. Bramante
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
- Department of Medicine, University of
Minnesota, Minneapolis, MN, USA
| | | | - Aaron S. Kelly
- Department of Pediatrics, University of
Minnesota, Minneapolis, MN, USA
- Center for Pediatric Obesity Medicine,
University of Minnesota, Minneapolis, MN, USA
- Department of Medicine, University of
Minnesota, Minneapolis, MN, USA
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