1
|
Caredda C, St-Laurent A, Gagnon M, Harrison S, Bernier E, Gagnon G, Plante AS, Lemieux S, Bégin C, Marceau S, Biertho LD, Tchernof A, Provencher V, Drapeau V, Michaud A, Morisset AS. Attitudes and Behaviors towards Food and Weight in Late Pregnancy: A Comparative Approach between Individuals with and without Previous Bariatric Surgery. Healthcare (Basel) 2024; 12:342. [PMID: 38338227 PMCID: PMC10855954 DOI: 10.3390/healthcare12030342] [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: 12/12/2023] [Revised: 01/16/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
The aims of this study were to compare, between pregnant individuals with and without bariatric surgery: (1) eating behaviors, (2) intuitive eating components and, (3) attitudes towards weight gain. This retrospective study included data collected in healthy pregnant individuals with and without previous bariatric surgery who were recruited at the Centre Hospitalier Universitaire (CHU) de Québec-Université Laval. Pregnant individuals who underwent bariatric surgery (biliopancreatic bypass with duodenal switch [n = 14] or sleeve gastrectomy [n = 5]) were individually matched, for age (±0.4 years) and body mass index (BMI) (±0.3 kg/m2), with pregnant individuals who have not received bariatric surgery. In the second trimester, participants completed the Three Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale 2 (IES-2). In the third trimester, participants completed the French version of the Pregnancy Weight Gain Attitude Scale assessing attitudes towards weight gain. Pregnant individuals who have had bariatric surgery had a higher score for flexible restraint and a lower score for situational susceptibility to disinhibition compared to individuals who have not had undergone bariatric surgery (2.89 ± 1.15 vs. 1.95 ± 1.31; p = 0.04 and 1.11 ± 1.29 vs. 2.79 ± 1.44, respectively; p < 0.001). Regarding intuitive eating, pregnant individuals who experienced bariatric surgery had a higher score for reliance on internal hunger and satiety cues and a lower one for unconditional permission to eat compared with those who had not experienced bariatric surgery (3.99 ± 0.81 vs. 3.30 ± 1.03; p = 0.02 and 3.28 ± 0.54 vs. 3.61 ± 0.68, respectively; p = 0.03). No difference in attitudes towards weight gain was observed between groups. Overall, pregnant individuals who had undergone bariatric surgery had different eating behaviors and intuitive eating components compared to pregnant individuals without bariatric surgery. These results need to be confirmed in further studies with larger sample sizes.
Collapse
Affiliation(s)
- Chloé Caredda
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Audrey St-Laurent
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Marianne Gagnon
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
| | - Stéphanie Harrison
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
| | - Emilie Bernier
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Geneviève Gagnon
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Anne-Sophie Plante
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
| | - Simone Lemieux
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Catherine Bégin
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- École de Psychologie, Université Laval, Québec, QC G1V 0A6, Canada
| | - Simon Marceau
- Axe Obésité, Diabète de Type 2 et Métabolisme, Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC G1V 4G5, Canada; (S.M.); (L.D.B.)
| | - Laurent D. Biertho
- Axe Obésité, Diabète de Type 2 et Métabolisme, Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC G1V 4G5, Canada; (S.M.); (L.D.B.)
| | - André Tchernof
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
- Axe Obésité, Diabète de Type 2 et Métabolisme, Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC G1V 4G5, Canada; (S.M.); (L.D.B.)
| | - Véronique Provencher
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| | - Vicky Drapeau
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Département de Kinésiologie, Université Laval, Québec, QC G1V 0A6, Canada
| | - Andréanne Michaud
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
- Axe Obésité, Diabète de Type 2 et Métabolisme, Centre de Recherche de l’Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC G1V 4G5, Canada; (S.M.); (L.D.B.)
| | - Anne-Sophie Morisset
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada (A.S.-L.); (M.G.); (S.H.); (E.B.); (A.-S.P.); (S.L.); (C.B.); (V.P.); (V.D.); (A.M.)
- Axe Endocrinologie et Néphrologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, QC G1V 4G2, Canada
- École de Nutrition, Université Laval, Québec, QC G1V 0A6, Canada; (G.G.); (A.T.)
| |
Collapse
|
2
|
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.
Collapse
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
| |
Collapse
|
3
|
Montorio I, Izal M, Bellot A, Rodríguez J, de Iceta M. Personality Profiles Associated with Long-Term Success in Bariatric Surgery: 24-Month Follow-Up. Behav Sci (Basel) 2023; 13:797. [PMID: 37887447 PMCID: PMC10603863 DOI: 10.3390/bs13100797] [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: 07/28/2023] [Revised: 09/17/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
(1) Background: Bariatric surgery (BS) is highly effective for treating severe obesity in the long term. However, studies investigating predictors and personality profiles linked to BS success yield inconsistent results due to varying methodologies and limited research. This paper aims to identify personality profiles associated with BS success. (2) Method: The study involved 67 patients undergoing bariatric surgery, evaluated through clinical and personality measures. Weight loss was monitored at 6, 12, and 24 months post-surgery. Hierarchical case cluster analysis and iterative k-means cluster analysis identified distinct groups based on excess body mass index loss (%EBL) at these intervals. ANOVA was employed to compare personality profiles between groups. (3) Results: Average weight loss after 24 months was 67.2%. Two success profiles emerged: 46.5% showed very good success, achieving 90% EBL in 24 months, while 55% in the second cluster had less than 40% EBL throughout follow-up. The successful profile correlated with greater self-efficacy and improved emotional adjustment. (4) Conclusions: Successful BS outcomes were linked to personality traits promoting sustained weight loss post-surgery.
Collapse
Affiliation(s)
- Ignacio Montorio
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - María Izal
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Ana Bellot
- Psychology Faculty, Universidad Autónoma de Madrid, 28049 Madrid, Spain; (I.M.)
| | - Javier Rodríguez
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
| | - Mariano de Iceta
- Hospital Universitario Infanta Sofía, Universidad Europea de Madrid, 28702 Madrid, Spain
| |
Collapse
|
4
|
Salehian R, Ghanbari Jolfaei A, Mansoursamaei M, Mansoursamaei A, Vossoughi M, Elyasi Galeshi M. Prevalence and Correlates of Food Addiction in Bariatric Surgery Candidates and Its Effect on Bariatric Surgery Outcome: A Prospective Observational Study. Obes Surg 2023; 33:2090-2097. [PMID: 37131088 DOI: 10.1007/s11695-023-06621-3] [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: 02/17/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Studies have shown a high prevalence of food addiction (FA) in bariatric surgery candidates. This study examines prevalence of FA prior to and one year after bariatric surgery and the determinants of preoperative FA. Additionally, this study investigates how preoperative variables affect excess weight loss (EWL) one year after bariatric surgery. MATERIALS AND METHODS This prospective observational study included 102 patients at an obesity surgery clinic. Self-report measures, including demographic characteristics, the Yale Food Addiction Scale 2.0 (YFAS 2.0), the Depression Anxiety Stress Scale (DASS-21), and the Dutch Eating Behavior Questionnaire (DEBQ) were used two weeks before and one year after surgery. RESULTS The FA prevalence among bariatric surgery candidates decreased from 43.6% before surgery to 9.7% one year after surgery. Among independent variables, female gender and anxiety symptoms were associated with FA (OR = 4.20, 95% CI: 1.35-24.16, p = 0.028 and OR = 5.29, 95% CI: 1.49-18.81, p = 0.010, respectively). Only gender had a significant association with %EWL after surgery (p = 0.022); females had a higher mean %EWL than males. CONCLUSION FA is common among candidates for bariatric surgery, especially in women and participants with anxiety symptoms. The prevalence of FA, emotional eating, and external eating decreased after bariatric surgery.
Collapse
Affiliation(s)
- Razieh Salehian
- Mental Health Research Center, Psychosocial Health Research Institute, Rasoul-e-Akram Hospital, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, 14456-13131, Iran
| | - Atefeh Ghanbari Jolfaei
- Minimally Invasive Surgery Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, 14456-13131, Iran
| | - Maryam Mansoursamaei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, 19857-1744, Iran
| | - Ali Mansoursamaei
- School of Medicine, Shahroud University of Medical Science, Shahroud, 36147-73943, Iran
| | - Mehrdad Vossoughi
- Mental Health Research Center, Psychosocial Health Research Institute (PHRI), Iran University of Medical Sciences, Tehran, 14496-14535, Iran
| | - Mahdieh Elyasi Galeshi
- Mental Health Research Center, Psychosocial Health Research Institute, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran, 14456-13131, Iran.
| |
Collapse
|
5
|
Liu X, Turel O, Xiao Z, Lv C, He Q. Neural differences of food-specific inhibitory control in people with healthy vs higher BMI. Appetite 2023; 188:106759. [PMID: 37390598 DOI: 10.1016/j.appet.2023.106759] [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: 11/20/2022] [Revised: 05/18/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023]
Abstract
Consistent with the idea that deficits in inhibition limit resistance to tempting, tasty, high-calorie foods, and might result in a higher BMI, we test whether people with higher BMIs (BMI >25 kg/m2) present inefficient inhibitory control over food-related responses. To unpack this association, we also examine individual differences in the neural mechanisms of food inhibitory control in healthy vs higher BMI individuals. We test these aspects with a sample of 109 participants (49 with higher BMI and 60 with healthy BMI) and the food stop-signal task, which was used to examine individuals' inhibitory control. Results demonstrated that people with higher BMI had significantly poorer food inhibitory control than healthy BMI individuals. fMRI results showed that, in both Go (Go_food vs Go_nature) and Stop conditions (Stop_food vs Stop_nature), compared to healthy BMI individuals, individuals with higher BMI had lower activation in the superior frontal gyrus, precuneus, precentral gyrus, and supramarginal gyrus in the food stimulus condition. Moreover, ROI analysis results showed that under the Stop_food condition, the activation in the inferior frontal gyrus in the higher BMI group was significantly negatively correlated with inhibitory control abilities. These results suggest that people with a higher BMI have limited ability to inhibit food impulsions, and that the prefrontal regions and parietal cortex may contribute to the progression of inhibitory control limitations in relation to food.
Collapse
Affiliation(s)
- Xing Liu
- Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Ofir Turel
- Computing Information Systems, The University of Melbourne, Parkville, VIC, Australia
| | - Zhibing Xiao
- Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Chenyu Lv
- Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China
| | - Qinghua He
- Faculty of Psychology, MOE Key Laboratory of Cognition and Personality, Southwest University, Chongqing, China; Southwest University Branch, Collaborative Innovation Center of Assessment toward Basic Education Quality at Beijing Normal University, Chongqing, China.
| |
Collapse
|
6
|
Brunault P, Bourbao-Tournois C, Ballon N, de Luca A. Psychiatric, psychological and addiction management in obesity surgery: Early identification for better support. J Visc Surg 2023; 160:S22-S29. [PMID: 36725454 DOI: 10.1016/j.jviscsurg.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Although bariatric surgery results in a significant weight reduction and an improvement in the quality of life in most people who undergo surgery, there are inter-individual differences in terms of postoperative results. Psychological, psychiatric and addictive disorders contribute substantially to these difficulties. Between 20% and 50% of bariatric surgery candidates have a current psychiatric/addictive disorder and approximately 30-75% have a history of a psychiatric/addictive disorder within their lifetime. Surgery is accompanied in the short-term by an improvement in depressive symptoms and binge eating, but these symptoms tend to increase again beyond the 3rd postoperative year. Over the long-term, only the improvement in depression remains durable, whilepostoperative anxiety and disordered eating symptoms do not differ significantly from the preoperative levels. There is a two to four fold increased risk of post-surgical suicide and suicide attempts (from the 1st postoperative year onward), as well as an increased risk of alcohol-abuse (beyond two years after surgery). Psychological support must therefore continue long-term. Several psychotherapeutic and pharmacological treatments have demonstrated their effectiveness in improving the postoperative prognosis of patients with psychological/psychiatric disorders. The early integration of psychological/psychiatric/addiction evaluation and support into multidisciplinary management makes it easier to identify these difficulties and to optimize the postoperative prognosis, both in terms of weight and quality of life. Prior to surgery, patients should be systematically evaluated by a psychologist or psychiatrist in order to identify and to manage disorders that could negatively impact the postoperative prognosis. After surgery, this assessment and support can be carried out in a programmed and systematic way for those patients who were identified preoperatively as the most vulnerable, but support can also be offered during follow-up in the event of specific symptoms (i.e., loss of control over food intake, failure in terms of weight or quality of life, suicidal ideation, loss of control over alcohol use, significant depression or anxiety symptoms).
Collapse
Affiliation(s)
- P Brunault
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Université de Tours, QualiPsy, EE 1901, Tours, France; Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France.
| | - C Bourbao-Tournois
- Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France; CHRU de Tours, Service de Chirurgie Digestive et Endocrinienne, Tours, France
| | - N Ballon
- CHRU de Tours, Service d'Addictologie Universitaire, Équipe de Liaison et de Soins en Addictologie, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France; Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France
| | - A de Luca
- Centre Spécialisé pour la prise en charge de l'Obésité sévère, CHRU de Tours, Tours, France; Inserm U1069, Université de Tours, Tours, France; CHRU de Tours, Unité Mobile de Nutrition, Tours, France
| |
Collapse
|
7
|
Mas M, Chambaron S, Chabanet C, Brindisi MC. Inhibition and shifting across the weight status spectrum. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-8. [PMID: 35188844 DOI: 10.1080/23279095.2022.2039656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Executive functioning (EF) is of major interest in the study of cognitive factors involved in obesity. Among EF, shifting is related to behavioral flexibility, and inhibition to the ability to refrain from impulsive behavior. A deficit in those two EF could predict individual difficulties to maintain a healthy lifestyle. Weak evidence of deficits in shifting and inhibition in individuals of higher Body Mass Index (BMI) have been observed. The objective was to clarify the relationship between inhibition and shifting regarding weight status group differences in healthy adults. Two neuropsychological tests from the Test of Attentional Performance (TAP) battery were used to measure EF performance of three groups of men and women: normal-weight (NW, n = 38), overweight (OW, n = 40) and obesity (OB, n = 37). The results show that individuals with higher BMI have lower inhibition capacities and that classically used weight status categories might not capture cognitive variability. No differences in shifting were observed concerning weight status nor BMI. This paper provides new insights on cognitive factors in obesity by presenting data from healthy individuals with overweight and obesity. The results support that assessing inhibition capacities might be of interest in a clinical setting for patients with difficulties to lose weight.
Collapse
Affiliation(s)
- Marine Mas
- Centre des Sciences du Gout et de l'Alimentation, INRAE, Dijon, France
| | | | - Claire Chabanet
- Centre des Sciences du Gout et de l'Alimentation, INRAE, Dijon, France
| | - Marie-Claude Brindisi
- Centre des Sciences du Gout et de l'Alimentation, INRAE, Dijon, France
- CHU Dijon, Dijon, France
| |
Collapse
|
8
|
Zhao K, Xu X, Zhu H, Ren Z, Zhang T, Yang N, Zhu S, Xu Q. Trajectory Analysis and Predictors of the Percentage of Body Fat Among Chinese Sleeve Gastrectomy Patients. Diabetes Metab Syndr Obes 2021; 14:4959-4970. [PMID: 35002268 PMCID: PMC8721014 DOI: 10.2147/dmso.s347032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The weight loss in Chinese patients after sleeve gastrectomy is different, and the differences can be evaluated through the trajectories of the percentage of body fat (BF%). Patients' baseline psychosocial factors may be associated with these trajectories. MATERIALS AND METHODS We selected 267 patients who received sleeve gastrectomy for the first time. The BF% at baseline and 1, 3, 6, 12 months after surgery and baseline psychosocial variables were retrospectively collected. The trajectory model was established according to BF% based on the growth mixture model. The baseline psychosocial variables were compared among different trajectory classes. RESULTS Four types of trajectory classes were obtained. The differences in preoperative dietary self-efficacy, exercise self-efficacy, depression, social support, working status, alcohol consumption, and gender among the classes were statistically significant. The pairwise comparison of the above variables revealed that the differences of gender, dietary self-efficacy and exercise self-efficacy among classes were highly effective. CONCLUSION Female gender, low dietary self-efficacy and low exercise self-efficacy were predictors for poor BF% trajectory in sleeve gastrectomy patients. Health professionals can early identify patients who are most likely to lose weight in a not-ideal manner based on the above predictors.
Collapse
Affiliation(s)
- Kang Zhao
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Xinyi Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
- Faculty of Health, The Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Ziqi Ren
- School of Nursing, Fudan University, Shanghai, People’s Republic of China
| | - Tianzi Zhang
- Department of Nursing, Jiangsu College of Nursing, Huai’an, Jiangsu, People’s Republic of China
| | - Ningli Yang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, People’s Republic of China
| |
Collapse
|
9
|
Akkuş ÖÖ, Atalay BG, Parlak E. COVID 19 Pandemic: Changes in the emotions, body weights and nutrition habits of individuals during social intervention measures. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-210006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: During the Covid 19 pandemic, the increase in the anxiety levels of individuals is associated with the increase in body weight. OBJECTIVE: To evaluate the effects of changes in individuals’ experiences and mood on eating habits and body weights in during social restrictions due to COVID-19. METHODS: The study included 623 adults in Turkey. Demographic characteristics, anthropometric measurements, information about nutritional habits during the pandemic period were questioned via an online survey. The Beck Depression Inventory (BDI) was used to evaluate individuals’ negative perspectives. RESULTS: The rate of patients who experienced body weight changes during the pandemic period was 61.4% (40.2% experienced increase), the mean BDI value was found to be higher in individuals whose body weight increased/decreased compared to those who experienced no change in body weight (p = 0.008, p = 0.02, respectively). Variables that positively affected the BDI scores, which was performed in individuals with increased body weight, main meal numbers (p < 0.03), and change in dried fruit consumption (p = 0.05). The variables that negatively affected the BDI scores were body weight increase (p = 0.05) and changes in cheese consumption. CONCLUSIONS: We found that the changes in the emotional state during COVID-19 had an effect on dietary habits and body weight. There is a need for more comprehensive randomized studies on the interaction between lifestyle changes during the social intervention period due to the Covid 19 epidemic, quality of life, emotional state and eating habits.
Collapse
Affiliation(s)
| | | | - Eda Parlak
- Toros University, Nutrition and Dietetic Department, Mersin, Turkey
| |
Collapse
|
10
|
Marchitelli S, Mazza C, Lenzi A, Ricci E, Gnessi L, Roma P. Weight Gain in a Sample of Patients Affected by Overweight/Obesity with and without a Psychiatric Diagnosis during the Covid-19 Lockdown. Nutrients 2020; 12:E3525. [PMID: 33207742 PMCID: PMC7697678 DOI: 10.3390/nu12113525] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 01/01/2023] Open
Abstract
The present study aimed at identifying psychological and psychosocial variables that might predict weight gain during the COVID-19 lockdown in patients affected by overweight/obesity with and without a psychiatric diagnosis. An online survey was administered between 25 April and 10 May 2020, to investigate participants' changes in dietary habits during the lockdown period. 110 participants were recruited and allocated to two groups, 63 patients had no psychiatric diagnosis; there were 47 patients with psychiatric diagnosis. ANOVA analyses compared the groups with respect to psychological distress levels, risk perception, social support, emotion regulation, and eating behaviors. For each group, a binary logistic regression analysis was conducted, including the factors that were found to significantly differ between groups. Weight gain during lockdown was reported by 31 of the participants affected by overweight/obesity without a psychiatric diagnosis and by 31 patients with a psychiatric diagnosis. Weight gain predictors were stress and low depression for patients without a psychiatric diagnosis and binge eating behaviors for patients with a psychiatric diagnosis. Of patients without a psychiatric diagnosis, 60% reported much more frequent night eating episodes. The risk of night eating syndrome in persons affected by overweight/obesity with no psychiatric diagnosis should be further investigated to inform the development of tailored medical, psychological, and psychosocial interventions.
Collapse
Affiliation(s)
- Serena Marchitelli
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.L.); (L.G.)
| | - Cristina Mazza
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Andrea Lenzi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.L.); (L.G.)
| | - Eleonora Ricci
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy;
| | - Lucio Gnessi
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (S.M.); (A.L.); (L.G.)
| | - Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy;
| |
Collapse
|
11
|
Ahmed HO, Ezzat RF. Quality of life of obese patients after treatment with the insertion of intra-gastric balloon versus Atkins diet in Sulaimani Governorate, Kurdistan Region, Iraq. Ann Med Surg (Lond) 2019; 37:42-46. [PMID: 30622706 PMCID: PMC6304342 DOI: 10.1016/j.amsu.2018.11.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/18/2018] [Accepted: 11/19/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Health-related quality of life of obese patients, before and after weight loss by insertion of BioEnterics Intra-gastric Balloon is studied widely. But the quality of life not related to comorbidity of the obese patients like mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life is not studied on a wide scale. AIM To evaluates the effect of the obesity on different aspects of life, and to evaluate the influence of weight loss after BIB insertion or Atkins diet on the quality of life regarding mood, satisfaction with relationships, achieved goals, self-concepts, and self-perceived ability to cope with one's daily life. PATIENTS MATERIALS AND METHODS A prospective randomized study, from a total of 180 patients, 80 patients were selected to enroll in the work, over a period of 4 years from 2008 to 2012 in Hatwan private hospital and the private clinic, the closing date was 1st January 2013.Approval for the current work was obtained from the Ethics Committee of University, College of Medicine. The work has been reported in line with the STROCSS criteria. The study was designed as a descriptive longitudinal study conducted on 40 patients who underwent intra-gastric balloon insertion compared to a matched group (for age, BMI) of 40 patients on Atkin's diet. RESULTS Two comparable groups of obese patients were studied, each group consists of 40 female patients, mean age in group A was 27 years (20-39 years) with mean body weight 90 kg (80-100) and mean body mass index 36 (31-39.9) who were treated with insertion of BIB. While mean age in group B was 29 years (20-39 years) with mean body weight 91 kg (80-102) and mean body mass index 36.5 (31-39.9). Statistically important changes occurred in the quality of life of the patients after either method of treatments to different degrees (p-value 0.005917). CONCLUSION The patients lost more weight after insertion of intra-gastric balloon up to 35 kg of body weight, while the patients on Atkins diet lost up to 20 kg body weight. This results in statistically significant improvement of most aspects of QOL. Especially in Feeling happier, more satisfaction with the new body image, Improvement of self-esteem, encouraged for more regular exercises, less nervous, embarrassed less by unimportant matters, have less negative thoughts, and the craving of foods decreased remarkably.
Collapse
Affiliation(s)
- Hiwa Omer Ahmed
- Professor in Metabolic and Bariatric Surgery, Senior Lecturer in College of Medicine, University of Sulaimani, Manager of Hospital for Endoscopic and Bariatric Surgery, Sulaimani City, Kurdistan, Iraq
| | - Rajan Fuad Ezzat
- General Surgeon, Suliamani Teaching Hospital, Sulaimani City, Kurdistan, Iraq
| |
Collapse
|
12
|
Lin HC, Tsao LI. Living with my small stomach: The experiences of post-bariatric surgery patients within 1 year after discharge. J Clin Nurs 2018; 27:4279-4289. [DOI: 10.1111/jocn.14616] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Hsiu-Chin Lin
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
- Center of Bariatric With Metabolic surgery; Mackay Memorial Hospital; Taipei Taiwan
| | - Lee-Ing Tsao
- College of Nursing; National Taipei University of Nursing and Health Sciences; Taipei Taiwan
| |
Collapse
|
13
|
Lloyd FMM, Hewison A, Efstathiou N. "It just made me feel so desolate": Patients' narratives of weight gain following laparoscopic insertion of a gastric band. J Clin Nurs 2017; 27:732-742. [PMID: 28906072 DOI: 10.1111/jocn.14072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2017] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To describe the experiences of patients who have failed to maintain weight loss following the insertion of a laparoscopic adjustable gastric band (LAGB) for the treatment of morbid obesity. BACKGROUND Obesity is a global health problem resulting in physical, psychological and economic problems and presenting challenges for health services. Surgical intervention is an increasingly common approach to treatment; however, some patients do not sustain their weight loss following bariatric surgery and little is known about people's longer-term experiences following LAGB insertion. DESIGN A narrative-based qualitative interview study. METHODS A purposive sample of ten participants who had undergone LAGB insertion for morbid obesity was recruited. Semistructured interviews were conducted in 2014. Thematic analysis identified codes and emerging themes common to the participants' experiences. FINDINGS Three major themes emerged: living with the side effects, regret and lack of support. These reflect the difficulties participants experienced and provide new insights on why weight loss is not sustained after 2 years following surgery. CONCLUSION Participants reported that the surgery had a detrimental effect on their lives and some regretted having the band inserted. These findings identify areas of care that need to be addressed if patients undergoing LAGB are to experience its potential benefits and indicate that further research is needed into the long-term effects of gastric band insertion. Patients need to be better informed about the consequences of bariatric surgery if it is to have a lasting impact on their weight reduction. RELEVANCE TO CLINICAL PRACTICE Patients require comprehensive information and support before and after LAGB insertion to develop strategies which will help them lose weight and sustain it over the longer term. Clinicians need to be sensitive to patients' needs when weight loss plateaus or weight is regained and intensify support during these periods.
Collapse
Affiliation(s)
| | - Alistair Hewison
- College of Medical and Dental Sciences, Institute of Clinical Sciences, School of Nursing, University of Birmingham, Birmingham, UK
| | - Nikolaos Efstathiou
- College of Medical and Dental Sciences, Institute of Clinical Sciences, School of Nursing, University of Birmingham, Birmingham, UK
| |
Collapse
|
14
|
Rodríguez-Hurtado J, Ferrer-Márquez M, Fontalba-Navas A, García-Torrecillas JM, Olvera-Porcel MC. Influence of psychological variables in morbidly obese patients undergoing bariatric surgery after 24 months of evolution. Cir Esp 2017; 95:378-384. [PMID: 28750780 DOI: 10.1016/j.ciresp.2017.06.002] [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: 03/14/2017] [Revised: 06/13/2017] [Accepted: 06/17/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Bariatric surgery is considered a more effective means of achieving weight loss than non-surgical options in morbid obesity. Rates of failure or relapse range from 20 to 30%. The study aims to analyse the influence of psychological variables (self-esteem, social support, coping strategies and personality) in the maintenance of weight loss after bariatric surgery. METHODS A cohort study was conducted involving 64 patients undergoing bariatric surgery for 24 months. At the end of the follow-up period, patients were divided into 2sub-cohorts classified as successes or failures. Success or favorable development was considered when the value of percent excess weight loss was 50 or higher. RESULTS No statistically significant differences were observed between the 2groups in any variable studied. All patients had high self-esteem (87,3 those who failed and 88,1 those who are successful) and social support (90,2 and 90,9). Patients who succeed presented higher scores for cognitive restructuring (57,1) and were more introverted (47,1), while those who failed scored more highly in desiderative thinking (65,7) and were more prone to aggression (50,7) and neuroticism (51,7). CONCLUSIONS High self-esteem and social support does not guarantee successful treatment. The groups differed in how they coped with obesity but the data obtained do not justify the weight evolution. In the absence of psychopathology, personality trait variability between patients is insufficient to predict the results.
Collapse
Affiliation(s)
| | | | - Andrés Fontalba-Navas
- Subdirección Médica, Área de Gestión Sanitaria Norte de Málaga, Antequera, Málaga, España
| | | | | |
Collapse
|
15
|
Mirica RM, Ionescu M, Mirica A, Ginghina O, Iosifescu R, Rosca A, Munteanu R, Iordache N, Zagrean L. Quality of Life Assessment After Bariatric Surgery—a Single-Center Experience. Indian J Surg 2017. [DOI: 10.1007/s12262-017-1624-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
|
16
|
Gilmartin J, Bath-Hextall F, Maclean J, Stanton W, Soldin M. Quality of life among adults following bariatric and body contouring surgery. ACTA ACUST UNITED AC 2016; 14:240-270. [DOI: 10.11124/jbisrir-2016-003182] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
17
|
Backes CF, Lopes E, Tetelbom A, Heineck I. Medication and nutritional supplement use before and after bariatric surgery. SAO PAULO MED J 2016; 134:0. [PMID: 27812597 DOI: 10.1590/1516-3180.2015.0241030516] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 05/03/2016] [Indexed: 01/01/2023] Open
Abstract
CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction.
Collapse
Affiliation(s)
- Charline Fernanda Backes
- Master's Student in the Postgraduate Pharmaceutical Sciences Program, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Edyane Lopes
- PhD. Pharmacist, School of Public Health, Health Department of the State of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Airton Tetelbom
- MD. Coordinator of the Health Technology Assessment Center, Grupo Hospitalar Conceição; Head Professor of Public Health, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA); Associate Professor of Public Health, Universidade Luterana do Brasil (ULBRA); and Contributing Professor in the Postgraduate Epidemiology Program, Department of Social Medicine, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Isabela Heineck
- PhD. Associate Professor, Postgraduate Pharmaceutical Sciences Program and Postgraduate Pharmaceutical Services, School of Pharmacy, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
18
|
van Wezenbeek MR, van Hout GC, Nienhuijs SW. Medical and Psychological Predictors for Long-Term Bariatric Success Using Primary Vertical-Banded Gastroplasty as a Model. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
|
19
|
Brunault P, Ducluzeau PH, Bourbao-Tournois C, Delbachian I, Couet C, Réveillère C, Ballon N. Food Addiction in Bariatric Surgery Candidates: Prevalence and Risk Factors. Obes Surg 2016; 26:1650-3. [PMID: 27107892 DOI: 10.1007/s11695-016-2189-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
20
|
Abstract
BACKGROUND The vertical banded gastroplasty (VBG) used to be a common restrictive bariatric procedure but has been abandoned by many due to a high failure rate, a high incidence of long-term complications, and the newer adjustable gastric band (AGB) and sleeve. However, potential favorable long-term results and the upcoming banded gastric bypass, with a similar mechanical outlet restriction and control of the pouch size, renewed our interest in the VBG. Therefore, we investigated the long-term outcome of primary VBG at the Catharina Hospital in the Netherlands. METHODS Patients that underwent a primary VBG between 1998 and 2008 were included. Patients' characteristics, operative details, evolution on weight and comorbidities, complications, and outcome of revisions were reviewed. RESULTS A total of 392 patients (80 % female) were reviewed with a mean age of 40 ± 9 years and body mass index of 44 ± 5 kg/m(2). Mean follow-up after VBG was 66 ± 50 months and showed a mean excess weight loss (EWL) of 53 ± 27 % and comorbidity reduction of 54 %. One hundred fifty-two patients (39 %) out of 227 patients (58 %) with long-term complaints underwent revisional surgery. Main reasons for revision were weight regain and vomiting/food intolerance. Analysis before revision showed an outlet dilatation (17 %), pouch dilatation (16 %), and outlet stenosis (10 %). After revision, an additional EWL of 23 % and 33 % further reduction in comorbidities was seen. CONCLUSIONS Primary VBG has an acceptable EWL of 53 % and 55 % of comorbidities were improved. However, the high complication rate, often necessitating revision, underlines the limits of this procedure.
Collapse
|
21
|
Beaulac J, Sandre D. Impact of a CBT psychotherapy group on post-operative bariatric patients. SPRINGERPLUS 2015; 4:764. [PMID: 26682117 PMCID: PMC4674458 DOI: 10.1186/s40064-015-1558-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/24/2015] [Indexed: 01/18/2023]
Abstract
Psychological difficulties for patients seeking bariatric surgery are greater and in the post-operative phase, a significant minority go on to experience significant psychosocial difficulties, increasing their risk of poorer post-operative adjustment and associated weight regain. 17 post-operative patients participated in an eight-week cognitive behavioral therapy (CBT) based psychotherapy group at the Ottawa Hospital. A pre-post design with a 3-month follow-up investigated the impact of the group on emotional eating, general as well as obesity-specific adjustment, psychological distress, and attachment. There were significant and meaningful improvements in patients’ level of psychological distress, perceived difficulties in their lives, and weight-related adjustment that were maintained at a 3-month follow-up period. Although statistical change was not significant, there were also meaningful improvements in emotional overeating and relationship anxiety and avoidance. The intervention also appeared to be acceptable to patients in that attendance and satisfaction were good. Findings suggest that a short-term CBT psychotherapy group led to significant and meaningful benefits in psychological wellbeing for post-surgical bariatric patients.
Collapse
Affiliation(s)
- Julie Beaulac
- Department of Psychology, The Ottawa Hospital, Ottawa, ON Canada ; Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Daniella Sandre
- Department of Psychology, The Ottawa Hospital, Ottawa, ON Canada
| |
Collapse
|
22
|
Brandão I, Ramalho S, Pinto-Bastos A, Arrojado F, Faria G, Calhau C, Coelho R, Conceição E. Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes. Eat Weight Disord 2015; 20:513-8. [PMID: 26122195 DOI: 10.1007/s40519-015-0199-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 06/11/2015] [Indexed: 01/27/2023] Open
Abstract
PURPOSE This study aims to examine associations between metabolic profile and psychological variables in post-bariatric patients and to investigate if metabolic and psychological variables, namely high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glycated hemoglobin (HbA 1c), impulsivity, psychological distress, depressive and eating disorder symptoms are independently associated with percentage of excess weight loss (%EWL) after bariatric surgery. METHODS One hundred and fifty bariatric patients (BMI = 33.04 ± 5.8 kg/m(2)) who underwent to bariatric surgery for more than 28.63 ± 4.9 months were assessed through a clinical interview, a set of self-report measures and venous blood samples. Pearson's correlations were used to assess correlations between %EWL, metabolic and psychological variables. Multiple linear regression was conducted to investigate which metabolic and psychological variables were independently associated with %EWL, while controlling for type of surgery. RESULTS Higher TG blood levels were associated with higher disordered eating, psychological distress and depression scores. HDL-C was associated with higher depression scores. Both metabolic and psychological variables were associated with %EWL. Regression analyses showed that, controlling for type of surgery, higher % EWL is significantly and independently associated with less disordered eating symptoms and lower TG and HbA_1c blood concentrations (R (2) aj = 0.383, F (4, 82) = 14.34, p < 0.000). CONCLUSION An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.
Collapse
Affiliation(s)
- Isabel Brandão
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Sofia Ramalho
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Pinto-Bastos
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Filipa Arrojado
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Gil Faria
- CINTESIS-Center for Research in Health Technologies and Information Systems, 4200-450, Porto, Portugal.,Department of General Surgery, Oporto Hospital Center, Porto, Portugal
| | - Conceição Calhau
- Department of General Surgery, Oporto Hospital Center, Porto, Portugal.,Department of Biochemistry, Faculty of Medicine, University of Porto, Centro de Investigação Médica, 4200-450, Porto, Portugal
| | - Rui Coelho
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Eva Conceição
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal.
| |
Collapse
|
23
|
Bylund A, Årestedt K, Benzein E, Thorell A, Persson C. Assessment of family functioning: evaluation of the General Functioning Scale in a Swedish Bariatric Sample. Scand J Caring Sci 2015; 30:614-22. [DOI: 10.1111/scs.12269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 07/01/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Ami Bylund
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Department of Surgical Science; Karolinska Institute; Danderyd Hospital; Stockholm Sweden
- Department of Surgery; Ersta Hospital; Stockholm Sweden
| | - Kristofer Årestedt
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Division of Nursing Science; Department of Medical and Health Sciences; Linköping University; Linköping Sweden
| | - Eva Benzein
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
| | - Anders Thorell
- Department of Surgical Science; Karolinska Institute; Danderyd Hospital; Stockholm Sweden
- Department of Surgery; Ersta Hospital; Stockholm Sweden
| | - Carina Persson
- School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
- Center for Collaborative Palliative Care; School of Health and Caring Sciences; Linnaeus University; Kalmar Sweden
| |
Collapse
|
24
|
Teixeira RB, Marins JCB, de Sá Junior AR, de Carvalho CJ, da Silva Moura TA, Lade CG, Rizvanov AA, Kiyasov AP, Mukhamedyarov MA, Zefirov AL, Palotás A, Lima LM. Improved cognitive, affective and anxiety measures in patients with chronic systemic disorders following structured physical activity. Diab Vasc Dis Res 2015; 12:445-54. [PMID: 26410835 DOI: 10.1177/1479164115602651] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Mental illnesses are frequent co-morbid conditions in chronic systemic diseases. High incidences of depression, anxiety and cognitive impairment complicate cardiovascular and metabolic disorders such as hypertension and diabetes mellitus. Lifestyle changes including regular exercise have been advocated to reduce blood pressure and improve glycaemic control. The purpose of this project was to evaluate the effect of physical training on the most prevalent corollary psychiatric problems in patients with chronic organic ailments. This longitudinal study assessed the mental health of hypertensive (age: 57 ± 8 years) and/or diabetic (age: 53 ± 8 years) patients using mini-mental state examination, Beck's depression inventory, Beck's anxiety inventory and self-reporting questionnaire-20 before and after a 3-month supervised resistance and aerobic exercise programme comprising structured physical activity three times a week. Clinically relevant improvement was observed in the Beck's depression inventory and Beck's anxiety inventory scores following the 12-week training (61%, p = 0.001, and 53%, p = 0.02, respectively). Even though statistically not significant (p = 0.398), the cognitive performance of this relatively young patient population also benefited from the programme. These results demonstrate positive effects of active lifestyle on non-psychotic mental disorders in patients with chronic systemic diseases, recommending exercise as an alternative treatment option.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - András Palotás
- Kazan Federal University, Kazan, Russia Asklepios-Med (Private Medical Practice and Research Center), Szeged, Hungary
| | | |
Collapse
|
25
|
Brunault P, Gohier B, Ducluzeau PH, Bourbao-Tournois C, Frammery J, Réveillère C, Ballon N. [The psychiatric, psychological and addiction evaluation in bariatric surgery candidates: What should we assess, why and how?]. Presse Med 2015; 45:29-39. [PMID: 26482489 DOI: 10.1016/j.lpm.2015.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 06/05/2015] [Accepted: 09/15/2015] [Indexed: 11/16/2022] Open
Abstract
Bariatric surgery is indicated in obese patients with a BMI ≥ 40 kg/m(2) or ≥ 35 kg/m(2) with serious comorbidities, in second intention in patients who failed to achieve significant weight loss after a well-managed medical, nutritional and psychotherapeutic treatment for 6 to 12 months, and in patients who are aware of the consequences of bariatric surgery and who agree with a long term medical and surgical follow-up. Such a treatment requires a preoperative multidisciplinary assessment and management, which includes a mandatory consultation with a psychiatrist or a psychologist that should be member of the multidisciplinary staff and participate in these staffs. Although one of this consultation's aim is to screen for the few patients who for which surgery is contra-indicated, in most cases, the main aim of this assessment is to screen for and manage psychiatric and psychopathologic disorders that could be temporary contra-indication, because these disorders could lead to poorer postoperative outcome when untreated. By explaining to the patient how these disorders could affect postoperative outcome and which benefits he could retrieve from their management, the patient will increase his motivation for change and he will be more likely to seek professional help for these disorders. In all cases, a systematic examination of the patient's personality and his/her ability to understand the postoperative instructions is essential before surgery because clinicians should check that the patient is able to be adherent to postoperative instructions. In addition to clinical interview, use of self-administered questionnaires before the consultation might help to determine which psychiatric or psychopathologic factors should be more closely screened during the consultation. Psychiatric disorders and addictions are highly prevalent in this population (e.g., mood and anxiety disorders, binge eating disorder, attention deficit hyperactivity disorder, addictions, personality disorders, pathological personality traits and dimensions), and when untreated, they can lead to poorer postoperative outcome (postoperative occurrence of psychiatric disorders, poorer quality of life, and sometimes to poorer weight loss or excessive weight rebound when the disorder is present during the postoperative period). A complementary training in addiction medicine is helpful given the higher risk for addictions in this population. Given that this evaluation is often the first meeting with a psychiatrist, an empathic and motivational approach is helpful to improve the patient's ability to request for a future psychiatric consultation during the follow-up. Some conditions are required for a high quality assessment: the objectives and expectations of the consultation should be systematically explained to the patient prior to the consultation by the physician who enquires for the assessment; it needs time; the psychiatrist should systematically be member of the multidisciplinary staff and should take part in regular multisciplinary staff meetings; patients should be seen alone to assess his/her readiness to change. After the consultation, a contact with the physician who enquires for the assessment should be systematic (e.g., use of a medical letter that sum up the main conclusions of the consultation; participation in regular multisciplinary staff meetings).
Collapse
Affiliation(s)
- Paul Brunault
- CHRU de Tours, équipe de liaison et de soins en addictologie, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; CHRU de Tours, clinique psychiatrique universitaire, 37044 Tours cedex 9, France; Université François-Rabelais de Tours, département de psychologie, EA 2114 « psychologie des âges de la vie », 37041 Tours, France; CHRU de Tours, centre spécialisé pour la prise en charge de l'obésité sévère, 37000 Tours, France.
| | - Bénédicte Gohier
- CHU d'Angers, service de psychiatrie et d'addictologie, 49933 Angers, France; Université d'Angers, laboratoire de psychologie des Pays-de-la-Loire, EA 4638, 49045 Angers cedex 1, France
| | - Pierre-Henri Ducluzeau
- CHRU de Tours, centre spécialisé pour la prise en charge de l'obésité sévère, 37000 Tours, France; CHRU de Tours, service de médecine interne-nutrition, 37044 Tours cedex 9, France; Université François-Rabelais de Tours, 37041 Tours, France
| | - Céline Bourbao-Tournois
- CHRU de Tours, centre spécialisé pour la prise en charge de l'obésité sévère, 37000 Tours, France; CHRU de Tours, service de chirurgie digestive et endocrinienne, 37044 Tours cedex 9, France
| | - Julie Frammery
- CHRU de Tours, équipe de liaison et de soins en addictologie, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; CHRU de Tours, clinique psychiatrique universitaire, 37044 Tours cedex 9, France; Centre hospitalier Louis-Sevestre, 37390 La-Membrolle-sur-Choisille, France
| | - Christian Réveillère
- Université François-Rabelais de Tours, département de psychologie, EA 2114 « psychologie des âges de la vie », 37041 Tours, France
| | - Nicolas Ballon
- CHRU de Tours, équipe de liaison et de soins en addictologie, 2, boulevard Tonnellé, 37044 Tours cedex 9, France; CHRU de Tours, centre spécialisé pour la prise en charge de l'obésité sévère, 37000 Tours, France; UMR Inserm U930 ERL, 37200 Tours, France; Université François-Rabelais de Tours, 37041 Tours, France
| |
Collapse
|
26
|
Rueda-Clausen CF, Ogunleye AA, Sharma AM. Health Benefits of Long-Term Weight-Loss Maintenance. Annu Rev Nutr 2015; 35:475-516. [DOI: 10.1146/annurev-nutr-071714-034434] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Christian F. Rueda-Clausen
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
| | - Ayodele A. Ogunleye
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
| | - Arya M. Sharma
- Obesity Research & Management, Clinical Research Unit, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, T6G 2E1 Canada; , ,
| |
Collapse
|
27
|
Weineland S, Lillis J, Dahl J. Measuring experiential avoidance in a bariatric surgery population--psychometric properties of AAQ-W. Obes Res Clin Pract 2015; 7:e464-75. [PMID: 24308889 DOI: 10.1016/j.orcp.2012.06.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Revised: 05/11/2012] [Accepted: 06/04/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Valid measures capturing underlying psychological processes post surgery for obesity are needed to help identify important clinical targets and develop psychosocial interventions in conjunction with surgery. The Acceptance and Action Questionnaire for Weight (AAQ-W) measures experiential avoidance and has never been evaluated in a bariatric surgery population. METHOD Participants were recruited at a bariatric surgery clinic during follow-up care. The evaluation of psychometric properties of AAQ-W was done by repeated measurements of reliability (n = 62), convergent validity (n = 75 and n = 178), predictive validity (n = 61), factor analysis and calculation of internal consistency (n = 178). RESULTS The AAQ-W was found to have satisfactory psychometric properties. Internal consistency was high (α = .86). Results showed good stability over time (r = .77) and validity coefficients ranging from r = .36 to .71. AAQ-W scores measured six months post surgery predicted satisfaction with life, negative emotional states, emotional eating and general eating pathology measured one year post surgery. However AAQ-W measured at six months did not predict percent excess BMI Loss at one year. Factor analysis showed that a five factor solution (Food as Control, Body Acceptance, Self-Stigma, Self-Efficacy and Emotional Avoidance) might be a good fit (n = 178). CONCLUSION This study shows that the AAQ-W appears to be a psychometrically sound measure that can be used by researchers and clinicians in the context of bariatric surgery.
Collapse
Affiliation(s)
- Sandra Weineland
- Department of Psychology, University of Uppsala, Uppsala, Sweden.
| | | | | |
Collapse
|
28
|
Matthews-Ewald MR, Myers VH, Newton RL, Beyl R, Waldo K, Dufour CM, Donato SG, Champagne CM, Church T, Ryan DH, Brantley PJ. Predictors for selection of insurance-funded weight loss approaches in individuals with severe obesity. Obesity (Silver Spring) 2015; 23:1151-8. [PMID: 25959516 PMCID: PMC4536570 DOI: 10.1002/oby.21116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 03/13/2015] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine whether there are differences in baseline psychological and behavioral characteristics between individuals with severe obesity who chose a surgical or nonsurgical intervention for weight loss. METHODS The current study utilized data from a larger study funded by a state insurance company and is unique in that the insurance company funded the weight loss interventions. Participants indicated their preferred method of weight loss, and completed several self-report psychological questionnaires, as well as demographic information. RESULTS Participants (N = 605) were 58.8% Caucasian and mostly (86%) female. Logistic regression results indicated that an increased number of weight loss attempts, and select other measures of eating behavior and quality of life may influence individuals' selection for either surgical or nonsurgical treatments for weight loss. CONCLUSIONS Practitioners should pay particular attention to these baseline characteristics that influence choice to examine potential characteristics that may influence the success of these weight loss treatments.
Collapse
Affiliation(s)
- Molly R. Matthews-Ewald
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | | | - Robert L. Newton
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Robbie Beyl
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Krystal Waldo
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Cody M. Dufour
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Sheletta G. Donato
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Catherine M. Champagne
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Timothy Church
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Donna H. Ryan
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| | - Phillip J. Brantley
- Pennington Biomedical Research Center, Louisiana State University System, Behavioral, Medicine Laboratory, Baton Rouge, LA
| |
Collapse
|
29
|
Konttinen H, Peltonen M, Sjöström L, Carlsson L, Karlsson J. Psychological aspects of eating behavior as predictors of 10-y weight changes after surgical and conventional treatment of severe obesity: results from the Swedish Obese Subjects intervention study. Am J Clin Nutr 2015; 101:16-24. [PMID: 25527746 DOI: 10.3945/ajcn.114.095182] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND There is a need for a better understanding of the factors that influence long-term weight outcomes after bariatric surgery. OBJECTIVE We examined whether pretreatment and posttreatment levels of cognitive restraint, disinhibition, and hunger and 1-y changes in these eating behaviors predict short- and long-term weight changes after surgical and conventional treatments of severe obesity. DESIGN Participants were from an ongoing, matched (nonrandomized) prospective intervention trial of the Swedish Obese Subjects (SOS) study. The current analyses included 2010 obese subjects who underwent bariatric surgery and 1916 contemporaneously matched obese controls who received conventional treatment. Physical measurements (e.g., weight and height) and questionnaires (e.g., Three-Factor Eating Questionnaire) were completed before the intervention and 0.5, 1, 2, 3, 4, 6, 8, and 10 y after the start of the treatment. Structural equation modeling was used as the main analytic strategy. RESULTS The surgery group lost more weight and reported greater decreases in disinhibition and hunger at 1- and 10-y follow-ups (all P < 0.001 in both sexes) than the control group did. Pretreatment eating behaviors were unrelated to subsequent weight changes in surgically treated patients. However, patients who had lower levels of 6-mo and 1-y disinhibition and hunger (β = 0.13-0.29, P < 0.01 in men; β = 0.11-0.28, P < 0.001 in women) and experienced larger 1-y decreases in these behaviors (β = 0.31-0.48, P < 0.001 in men; β = 0.24-0.51, P < 0.001 in women) lost more weight 2, 6, and 10 y after surgery. In control patients, larger 1-y increases in cognitive restraint predicted a greater 2-y weight loss in both sexes. CONCLUSION A higher tendency to eat in response to various internal and external cues shortly after surgery predicted less-successful short- and long-term weight outcomes, making postoperative susceptibility for uncontrolled eating an important indicator of targeted interventions.
Collapse
Affiliation(s)
- Hanna Konttinen
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Markku Peltonen
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Lars Sjöström
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Lena Carlsson
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| | - Jan Karlsson
- From the Department of Social Research, University of Helsinki, Helsinki, Finland (HK); the Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland (MP); the Institute of Medicine, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (LS and LC); and the Center for Health Care Sciences, Örebro University Hospital, and the Department of Medical Sciences, Örebro University, Örebro, Sweden (JK)
| |
Collapse
|
30
|
Winsby AB, Thomlinson RP. Behavioral Health Problems among Postsurgical Bariatric Patients: The Need for Continuing Behavioral Health Interventions. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amelia B. Winsby
- The School of Professional Psychology at Forest Institute, Springfield, Missouri
| | - R. Paul Thomlinson
- The School of Professional Psychology at Forest Institute, Springfield, Missouri
| |
Collapse
|
31
|
Matini D, Ghanbari Jolfaei A, Pazouki A, Pishgahroudsari M, Ehtesham M. The comparison of severity and prevalence of major depressive disorder, general anxiety disorder and eating disorders before and after bariatric surgery. Med J Islam Repub Iran 2014; 28:109. [PMID: 25664310 PMCID: PMC4301202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 03/15/2014] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Severe obesity is highly co-morbid with psychiatric disorders and may have effect on the quality of life. This study aimed to compare severity and prevalence rate of depression, anxiety and eating disorders and quality of life in severe obese patients before and 6 months after the gastric bypass surgery. METHODS This was a prospective observational study which conducted at Hazarat Rasool-Akram Hospital in Tehran, 2012. Questionnaires included demographic questions, eating disorder Inventory (EDI), The Short Form Health Survey (SF-36) for quality of life, Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I) and Hamilton Rating Scale for Depression (HRSD) and anxiety (HRSA). Participants were interviewed two times, before surgery and six months after, to determine changes of the disorders. Patients with the history of bariatric surgery, individuals younger than 18 year old and those who disagreed to join the study were excluded. RESULTS In assessing the eating disorder inventory-3rd version (EDI-3), Significant reduction in drive for thinness (DT) (p= 0.010), bulimia (B) (p< 0.0001) and body dissatisfaction mean (BD) (0.038) was observed at the 6-month follow-up. At this period, the mean for physical component summary of SF36, significantly decreased (p< 0.0001), however mental component summary did not significantly differ (p= 0.368); Also differences in severity of anxiety (p= 0.852), and depression in HRSD (p= 0.311), prevalence of depression (p= 0.189) and prevalence of general anxiety disorder according to SCID (p=0.167) did not differ significantly, at this period. CONCLUSION Although weight loss after bariatric surgery improved the physical component of quality of life, this improvement did not affect the mental aspect of life, depression and anxiety and it seems that these psychopathologies need attention and treatment in addition to weight loss treatments in patients with obesity.
Collapse
Affiliation(s)
- Diana Matini
- 1. MD, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Atefeh Ghanbari Jolfaei
- 2. Assistant Professor of Psychiatry, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Abdolreza Pazouki
- 3. Assistant Professor of Surgery, Minimally Invasive surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohadeseh Pishgahroudsari
- 4. BS, Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Ehtesham
- 5. Epidemiologist, Shaheed Rajaei Cardiovascular center.
| |
Collapse
|
32
|
Grimaldi D, McEnany GP, Berninger A, Nannini A, Morgan B, Ameri D. Association of Psychiatric History, Attendance at Postoperative Support Groups, and Outcomes Following Gastric Bypass Surgery: A Pilot Study. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | - Betty Morgan
- University of Massachusetts, Lowell, Massachusetts
| | - Darius Ameri
- University of Massachusetts, Lowell, Massachusetts
| |
Collapse
|
33
|
Gilmartin J, Bath-Hextall F, Maclean J, Stanton W, Soldin M. Quality of life among adults following body contouring surgery after bariatric surgery: a systematic review protocol. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
34
|
Calvo D, Galioto R, Gunstad J, Spitznagel MB. Uncontrolled eating is associated with reduced executive functioning. Clin Obes 2014; 4:172-9. [PMID: 25826773 DOI: 10.1111/cob.12058] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 02/05/2014] [Accepted: 03/11/2014] [Indexed: 01/07/2023]
Abstract
Accumulating evidence indicates obesity is associated with reduced cognitive functioning, particularly attention and executive function, as well as maladaptive eating behaviour such as uncontrolled eating. The current study examined relationships between eating patterns and attention/executive function test performance in lean and obese individuals. Sixty-two (32 lean, 30 obese) healthy young adults (21.13 ± 2.31 years; 56.5% female) completed the abbreviated Three-Factor Eating Questionnaire (TFEQ-R18) to assess eating patterns, including uncontrolled eating, cognitive restraint, and emotional eating. The Go/No-Go (GNG), Running Memory Continuous Performance Test (RCMPT) and Standard Continuous Performance Test from the Automated Neuropsychological Assessment Metrics-4 were administered as measures of executive functioning and attention. An independent samples t-test revealed greater report of uncontrolled eating in obese compared with lean participants (t[60] = -2.174, P < 0.05; d = -0.55) but no differences in cognitive restraint or emotional eating. Multivariate analysis of variance revealed cognitive differences between lean and obese groups (F[6, 54] = 3.86, P < 0.005; λ = 0.70; ηp(2) = 0.30), which were driven by GNG reaction time (F[1, 59] = 8.36, P < 0.01, d = 0.74). Pearson bivariate correlations revealed a positive correlation between uncontrolled eating and reaction time on GNG (r = 0.343, P < 0.05) and RMCPT (r = 0.267, P < 0.05) in all participants. Relative to lean participants, obese individuals reported higher levels of uncontrolled eating and exhibited slower performance on a task of inhibitory control. In the full sample, greater self-reported dyscontrol in eating behaviour was related to slower inhibitory control and working memory. Results support a link between executive function and control of eating behaviour. Obese individuals may be more vulnerable to difficulties in these domains relative to those who are lean.
Collapse
Affiliation(s)
- D Calvo
- Department of Psychology, Kent State University, Kent, OH, USA
| | | | | | | |
Collapse
|
35
|
Galioto R, Gunstad J, Heinberg LJ, Spitznagel MB. Adherence and weight loss outcomes in bariatric surgery: does cognitive function play a role? Obes Surg 2014; 23:1703-10. [PMID: 23934274 DOI: 10.1007/s11695-013-1060-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although bariatric surgery is the most effective intervention for severe obesity, a significant minority of participants fail to achieve or maintain optimal weight loss at extended follow-up. Accumulating evidence suggests that adherence to prescribed postoperative recommendations, including attendance at follow-up appointments and dietary and physical activity, is related to improved weight loss outcomes. However, adherence to these guidelines presents a significant challenge for many patients, potentially due in part to deficits in cognitive function. In this paper, we briefly examine current literature of adherence on postoperative weight loss outcomes, and review emerging evidence that the cognitive dysfunction present in a subset of obese individuals is related to weight loss outcomes following bariatric procedures. We then extend these findings, positing a role for cognitive function in moderating the relationship between adherence and postoperative outcomes.
Collapse
Affiliation(s)
- Rachel Galioto
- Department of Psychology, Kent State University, Kent, OH, 44242, USA,
| | | | | | | |
Collapse
|
36
|
De Panfilis C, Generali I, Dall’Aglio E, Marchesi F, Ossola P, Marchesi C. Temperament and one-year outcome of gastric bypass for severe obesity. Surg Obes Relat Dis 2014; 10:144-8. [DOI: 10.1016/j.soard.2013.09.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 09/17/2013] [Accepted: 09/29/2013] [Indexed: 11/16/2022]
|
37
|
Gade H, Rosenvinge JH, Hjelmesæth J, Friborg O. Psychological correlates to dysfunctional eating patterns among morbidly obese patients accepted for bariatric surgery. Obes Facts 2014; 7:111-9. [PMID: 24685661 PMCID: PMC5644889 DOI: 10.1159/000362257] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/08/2013] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To examine the relationships between dysfunctional eating patterns, personality, anxiety and depression in morbidly obese patients accepted for bariatric surgery. DESIGN The study used cross-sectional data collected by running a randomized controlled trial (http://clinicaltrials.gov/ct2/show/NCT01403558). SUBJECTS A total of 102 patients (69 women, 33 men) with a mean (SD) age of 42.6 (9.8) years and a mean BMI of 43.5 (4.4) kg/m(2) participated. MEASUREMENTS Measurements included the NEO-PI-R (personality: neuroticism, extroversion, openness, conscientiousness and agreeableness), the TFEQ-R-21 (dysfunctional eating: emotional eating (EE), uncontrolled eating (UE) and cognitive restraint of eating (CR)) and the HADS (anxiety and depression). RESULTS The personality traits neuroticism and conscientiousness were more strongly correlated with dysfunctional eating than anxiety and depression. These differences were most pronounced for emotional and cognitive restraint of eating. Emotional eating occurred more often in female than in male patients, a finding that was partially mediated by neuroticism but not by anxiety and depression. CONCLUSION Personality traits may be important to address in the clinical management of morbidly obese patients seeking bariatric surgery as neuroticism is particularly salient in female patients displaying an emotional eating behaviour.
Collapse
Affiliation(s)
- Hege Gade
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Tromsø, Tromsø, Norway
- *Hege Gade, Morbid Obesity Centre, Vestfold Hospital Trust, P.B. 2168, 3103 Tønsberg (Norway),
| | | | - Jøran Hjelmesæth
- Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Oddgeir Friborg
- Department of Psychology, University of Tromsø, Tromsø, Norway
| |
Collapse
|
38
|
Marihart CL, Brunt AR, Geraci AA. Older adults fighting obesity with bariatric surgery: Benefits, side effects, and outcomes. SAGE Open Med 2014; 2:2050312114530917. [PMID: 26770722 PMCID: PMC4607185 DOI: 10.1177/2050312114530917] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 03/12/2014] [Indexed: 12/14/2022] Open
Abstract
The aging population is growing exponentially worldwide. Associated with this greater life expectancy is the increased burden of chronic health conditions, many of which are exacerbated by the continued rise in obesity. In the US, the prevalence of obesity in adults aged 60 years and older increased from 23.6% to 37% in 2010.
Collapse
Affiliation(s)
- Cindy L Marihart
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Ardith R Brunt
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Angela A Geraci
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| |
Collapse
|
39
|
Hofmann B. Bariatric surgery for obese children and adolescents: a review of the moral challenges. BMC Med Ethics 2013; 14:18. [PMID: 23631445 PMCID: PMC3655839 DOI: 10.1186/1472-6939-14-18] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 04/22/2013] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Bariatric surgery for children and adolescents is becoming widespread. However, the evidence is still scarce and of poor quality, and many of the patients are too young to consent. This poses a series of moral challenges, which have to be addressed both when considering bariatric surgery introduced as a health care service and when deciding for treatment for young individuals. A question based (Socratic) approach is applied to reveal underlying moral issues that can be relevant to an open and transparent decision making process. DISCUSSION A wide range of moral issues with bariatric surgery for children and adolescents is identified in the literature. There is a moral imperative to help obese minors avoiding serious health problems, but there is little high quality evidence on safety, outcomes, and cost-effectiveness for bariatric surgery in this group. Lack of maturity and family relations poses a series of challenges with autonomy, informed consent, assent, and assessing the best interest of children and adolescents. Social aspects of obesity, such as medicalization, prejudice, and discrimination, raise problems with justice and trust in health professionals. Conceptual issues, such as definition of obesity and treatment end-points, present moral problems. Hidden interests of patients, parents, professionals, industry, and society need to be revealed. SUMMARY Performing bariatric surgery for obese children and adolescents in order to discipline their behavior warrants reflection and caution. More evidence on outcomes is needed to be able to balance benefits and risks, to provide information for a valid consent or assent, and to advise minors and parents.
Collapse
Affiliation(s)
- Bjørn Hofmann
- Section for Health, Technology, and Society, University College of Gjøvik, PO Box 191, Gjøvik, N-2802, Norway.
| |
Collapse
|
40
|
Latner JD, Ebneter DS, O'Brien KS. Residual obesity stigma: an experimental investigation of bias against obese and lean targets differing in weight-loss history. Obesity (Silver Spring) 2012; 20:2035-8. [PMID: 22395810 DOI: 10.1038/oby.2012.55] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study investigated stigma directed at formerly obese persons who lost weight and became lean (through behavioral or surgical methods), or lost weight but remained obese, relative to weight-stable obese and weight-stable lean persons. This study also compared stigma directed at obese persons following exposure to descriptions of persons who lost weight vs. remained weight stable. In a between-subject experimental design, participants (n = 273) were randomly assigned to read vignettes describing targets varying across two dimensions, weight stability (i.e., weight stable or weight lost) and current weight (i.e., currently obese or currently lean). Participants completed measures of stigma against specific targets and measures of stigma against obese individuals in general. Lean individuals who were formerly obese were stigmatized more on attractiveness than weight-stable lean individuals, and as much as currently obese individuals. Stigma across domains was greater among currently obese individuals (regardless of whether they had lost weight from a higher weight) than among currently lean individuals. After reading vignettes describing weight loss, participants demonstrated greater obesity stigma than after reading vignettes describing weight-stable individuals. These results suggest that residual stigma remains against people who have previously been obese, even when they have lost substantial amounts of weight and regardless of their weight-loss method. Exposure to portrayals of the malleability of body weight, such as those promoted in the popular media, may significantly worsen obesity stigma.
Collapse
Affiliation(s)
- Janet D Latner
- Department of Psychology, University of Hawaii at Manoa, Honolulu, Hawaii, USA
| | | | | |
Collapse
|
41
|
Ramos-de la Medina A, Forcada-Arens H. Acute postgastric reduction syndrome. Surg Obes Relat Dis 2012. [DOI: 10.1016/j.soard.2012.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
42
|
Abstract
Enhanced recovery after surgery (ERAS) programs have been shown to minimise morbidity in other types of surgery, but comparatively less data exist investigating ERAS in bariatric surgery. This article reviews the existing literature to identify interventions which may be included in an ERAS program for bariatric surgery. A narrative literature review was conducted. Search terms included 'bariatric surgery', 'weight loss surgery', 'gastric bypass', 'ERAS', 'enhanced recovery', 'enhanced recovery after surgery', 'fast-track surgery', 'perioperative care', 'postoperative care', 'intraoperative care' and 'preoperative care'. Interventions recovered by the database search, as well as interventions garnered from clinical experience in ERAS, were used as individual search terms. A large volume of evidence exists detailing the role of multiple interventions in perioperative care. However, efficacy and safety for a proportion of these interventions for ERAS in bariatric surgery remain unclear. This review concludes that there is potential to implement ERAS programs in bariatric surgery.
Collapse
|
43
|
|
44
|
Weineland S, Hayes SC, Dahl J. Psychological flexibility and the gains of acceptance-based treatment for post-bariatric surgery: six-month follow-up and a test of the underlying model. Clin Obes 2012; 2:15-24. [PMID: 25586043 DOI: 10.1111/j.1758-8111.2012.00041.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED Research highlights • Bariatric surgery is associated with dramatic weight loss. • Follow-up studies show that many surgery patients continue to struggle with self-stigma, body dissatisfaction and emotional eating. • To date we are aware of only three published randomized controlled trials evaluating psychological interventions in combination with bariatric surgery. • Acceptance and Commitment Therapy (ACT) targets psychological flexibility: acceptance to have difficult feelings and thoughts, while at the same time engaging in vital healthy activities. • The present study shows significant improvements in the ACT group as compared with (TAU) after treatment as usual at a 6-month follow-up and shows that the mechanism of change may be psychological flexibility. • Results from this study indicate the possibility of optimizing bariatric surgery outcomes by adding interventions targeting psychological flexibility. SUMMARY The current article presents and evaluates an Acceptance and Commitment Therapy (ACT) approach for obesity-related psychological struggles post-bariatric surgery. Some patients who have undergone bariatric surgery report loss of control over eating and distress concerning body figure and shape, which can affect other outcomes such as weight loss and quality of life post surgery. A recent randomized trial (n = 39) evaluating a 6-week treatment package of ACT following bariatric surgery found large and significant effects as compared with treatment as usual (TAU) on eating disordered behaviours, body dissatisfaction, psychological flexibility and quality of life. Though effects were found, questions remain regarding maintenance of outcomes and the process changes related to outcomes. The present study examines both the maintenance of behavioural change at a 6-month follow-up for the original study and the processes that may be involved in the outcomes. ACT led to gains in quality of life (es = 0.88) and body dissatisfaction (es = 0.77), as compared with TAU at follow-up. Both groups improved in eating disordered behaviours (ACT; es = 0.86 and TAU; es = 0.55). A series of multiple mediator tests supported the role of enhanced psychological flexibility in the changes seen in body dissatisfaction, eating disordered behaviour and quality of life. This study provides preliminary support for the ACT treatment model in terms of optimizing bariatric surgery outcomes.
Collapse
Affiliation(s)
- S Weineland
- Department of Psychology, University of Uppsala, Uppsala, SwedenDepartment of Psychology, University of Nevada, Reno, NV, USA
| | | | | |
Collapse
|
45
|
Kinzl JF, Lanthaler M, Stuerz K, Aigner F. Long-term outcome after laparoscopic adjustable gastric banding for morbid obesity. Eat Weight Disord 2011; 16:e250-6. [PMID: 21613809 DOI: 10.1007/bf03327468] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study was performed to determine the long-term consequences of laparoscopic gastric banding on weight loss, body image, and life quality in morbidly obese patients. After a minimum follow-up of 9 years (mean follow-up 10 years; range 9-12 years) several questionnaires concerning weight loss, body image, and life quality were mailed to 180 morbidly obese patients following laparoscopic adjustable gastric banding. One hundred and twelve (62%) patients (92 females, 20 males) completed and returned the questionnaires. Of the entire sample, 73 (64.9%) patients still had the first band, 17 (15.3%) a second band, and in 22 (19.8%) probands the band had been removed for various reasons. Average weight loss, calculated as change in body mass index, was 13.9 kg/m². Average excess weight loss (EWL) was 30.6%. A total of 10% patients accounted for >50% of EWL. Half of the probands were completely satisfied with their weight loss and about half had reached their planned weight. Lowest post-operative weight was reached at different times, in nearly half of the probands after 2 years, in one-fourth after 4-5 years, and in about 20% at a later time. More than 90% of the probands experienced longer interruptions in weight loss; about half knew why. The findings indicate that overall quality of life was rated good to excellent by two-thirds of the probands, and fair to poor by one-third. A close correlation was seen between extent of weight loss and quality of life and body image. Despite some limitations, laparoscopic adjustable gastric banding is an effective and safe long-term surgical treatment for a majority of morbidly obese individuals, resulting in long-term weight loss and health-related quality of life. However, there is also a minority of morbidly obese subjects who do not benefit enough from this kind of bariatric surgery. Future research should investigate what kind of bariatric surgery is best for the particular obese individual in order to minimize unsatisfying post-operative results.
Collapse
Affiliation(s)
- J F Kinzl
- Department of Psychosomatic Medicine, Innsbruck Medical University Hospital, Anichstrasse 35, A-6020 Innsbruck, Austria.
| | | | | | | |
Collapse
|
46
|
van de Laar A, de Caluwé L, Dillemans B. Relative outcome measures for bariatric surgery. Evidence against excess weight loss and excess body mass index loss from a series of laparoscopic Roux-en-Y gastric bypass patients. Obes Surg 2011; 21:763-7. [PMID: 21197603 DOI: 10.1007/s11695-010-0347-0] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Bariatric results expressed in the relative measure excess weight loss (%EWL) vary significantly by initial body mass index (BMI): the heavier the patient, the lower the %EWL. We examine if this variation is caused by using a wrong outcome measure and argue that no relative weight loss measure can express bariatric or metabolic goals unequivocally. METHODS Nadir weight loss results after laparoscopic gastric bypass in 168 women with initial BMI ≥35 to <60 kg/m2 are calculated for %EWL and 61 different relative measures using the formula 100% × (initial BMI - nadir BMI) / (initial BMI-a), with a ranging from -30 to +30. Standard deviations are compared mutually and with those reported in the literature. For each relative measure, the significance of any variation by initial BMI is determined with the Mann-Whitney U test. RESULTS Mean initial BMI was 44.9 ± 6.7 (35.0-59.7) kg/m2. Mean nadir BMI was 28.8 ± 5.8 (18.5-44.4) kg/m2. Mean nadir excess BMI loss (%EBL; a = 25) was 87.0 ± 28.0 (19.4-155.1)%. Mean nadir (total) weight loss (%TWL; a = 0) was 35.9 ± 8.5 (9.5-57.1)%. Mean nadir %EWL was 77.3 ± 22.8 (17.7-135.2)%. The smallest variation coefficient was 23.7% at a ranging from -1 to +3, including %TWL (a = 0). This is lower than variation coefficients of %EWL results in our series and in the literature. Variation by initial BMI is significant using relative measures with a ≥3, including %EBL and %EWL (both p < 0.0001) and not significant with a <3, including %TWL (p = 0.13). CONCLUSIONS In contrast to their widespread use, %EBL and %EWL are not suited for comparing different patients or nonrandomized groups. They cause variation by initial BMI, which disappears using %TWL. In general, absolute terms should be preferred for bariatric outcome and goals. The power of bariatric procedures is best represented by their mean %TWL value.
Collapse
Affiliation(s)
- Arnold van de Laar
- Slotervaartziekenhuis, Louwesweg 6, 1066 EC, Amsterdam, The Netherlands.
| | | | | |
Collapse
|
47
|
Abstract
PURPOSE OF REVIEW Morbid obesity is associated with a high prevalence of psychopathological conditions that might have an impact on postsurgery outcomes. This review summarizes recent data about psychological disorders in obese patients before and after bariatric surgery as well as the assessment and impact of these factors on postsurgery outcomes. RECENT FINDINGS Psychological health and quality of life were found to improve after bariatric surgery. Weight loss could not be clearly related to any specific psychological condition prior to surgery, but the presence of more than one psychiatric condition might play a role. A multi-intervention treatment, including approaches for lifestyle changes after bariatric surgery showed positive long-term results in term of weight loss and weight loss maintenance. Recent studies focused on eating behavior changes following bariatric surgery providing important information on the topic of eating disorders after bariatric surgery. SUMMARY Psychological assessment before bariatric surgery and systematic follow-up are necessary to guarantee optimal weight loss and weight loss maintenance. The field of psychological factors in bariatric surgery is still in need of controlled randomized prospective trials to better understand relation between psychological presurgery conditions and surgical outcomes. Self-monitoring and cognitive behavioral programs could prevent weight regain.
Collapse
|
48
|
Effect of atorvastatin, vitamin E and C on nonalcoholic fatty liver disease: is the combination required? Am J Gastroenterol 2011; 106:78-80. [PMID: 21212755 DOI: 10.1038/ajg.2010.310] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Nonalcoholic fatty liver disease is associated with the metabolic syndrome. The current standard of care, healthy diet and weight loss, has limited effect. The benefits of pharmacological treatments are unclear due to the difficulty of using liver histology as the main outcome in large randomized controlled trials (RCTs). In this issue, an RCT with atorvastatin and antioxidants (vitamins E+C) vs. placebo shows improvement in liver steatosis based on computed tomography scans. The questions are is this beneficial effect due to the combined treatment or the effect of an individual compound; does this intervention improve nonalcoholic steatohepatitis.
Collapse
|
49
|
Affiliation(s)
- Anke Hinney
- *PD Dr. Anke Hinney, Department of Child and Adolescent Psychiatry, University of Duisburg-Essen, Virchowstraβe 174, 45147 Essen, Germany, Tel. +49 201-9597025, Fax -7227302,
| | | |
Collapse
|