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Reche-García C, Piernas C, García-Vizcaíno EM, Lorente-Gallego AM, Piuvezam G, Frutos MD, Hernández Morante JJ. Bariatric-Metabolic Surgery is the Most Effective Intervention in Reducing Food Addiction Symptoms: A Systematic Review and Meta-Analysis. Obes Surg 2024:10.1007/s11695-024-07107-6. [PMID: 39073676 DOI: 10.1007/s11695-024-07107-6] [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: 09/04/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 07/30/2024]
Abstract
There are different treatments for food addiction (FA) symptomatology, but a comprehensive review with a meta-analysis to determine the most effective intervention is lacking. The aim of this review is to investigate the efficacy of pharmacological, behavioral, and bariatric-metabolic surgical interventions in reducing FA symptomatology. Meta-analyses including 15 studies in adults showed a significantly positive effect (std mean difference in FA symptoms before vs after intervention 0.72 (0.58-0.95)), with bariatric-metabolic surgical interventions showing the highest efficacy in improving FA symptoms (1.17 (0.58-1.76) before vs after intervention). The existing evidence suggests a beneficial effect of bariatric-metabolic surgical, pharmacological, and behavioral interventions, in that order, on FA symptomatology in people with overweight/obesity. Weight loss and behavioral and lifestyle changes after surgery may be determinants in improving FA symptomatology.
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Affiliation(s)
- Cristina Reche-García
- Eating Disorders Research Unit, Universidad Católica de Murcia, Campus de Guadalupe, Guadalupe, 30107, Murcia, Spain
| | - Carmen Piernas
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research (CIBM), University of Granada, Granada, Spain
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Eva M García-Vizcaíno
- Eating Disorders Research Unit, Universidad Católica de Murcia, Campus de Guadalupe, Guadalupe, 30107, Murcia, Spain
| | - Ana M Lorente-Gallego
- Equipo de Valoración E Intervención en Cuidados de Salud, Universidad Católica de Murcia, Campus de Guadalupe, Guadalupe, 30107, Murcia, Spain
| | - Graziela Piuvezam
- Department of Public Health, Federal University of Rio Grande Do Norte (UFRN), Natal, Brazil
| | - María Dolores Frutos
- Bariatric Surgery Service, Hospital Virgen de La Arrixaca, Crtra. El Palmar, 30120, Murcia, Spain
| | - Juan José Hernández Morante
- Eating Disorders Research Unit, Universidad Católica de Murcia, Campus de Guadalupe, Guadalupe, 30107, Murcia, Spain.
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Müller A, Efeler S, Laskowski NM, Pommnitz M, Mall JW, Meyer G, Wunder R, Köhler H, Hüttl TP, de Zwaan M. Postoperative Dumping Syndrome, Health-Related Quality of Life, Anxiety, Depression, and Eating Disturbances: Results of a Longitudinal Obesity Surgery Study. Obes Facts 2024; 17:201-210. [PMID: 38320543 PMCID: PMC10987184 DOI: 10.1159/000536602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Given the lack of research on the relationship of post-surgery dumping syndrome and eating disturbances, the purpose of the present longitudinal study was to investigate whether dumping after obesity surgery is associated with pre-/postoperative eating disorder symptoms or addiction-like eating beyond the type of surgery, gender, health-realted quality of life (HRQoL) and anxiety/depressive symptoms. METHODS The study included 220 patients (76% women) before (t0) and 6 months after (t1) obesity surgery (sleeve gastrectomy [n = 152], Roux-en-Y gastric bypass [n = 53], omega loop gastric bypass [n = 15]). The Sigstad Dumping Score was used to assess post-surgery dumping syndrome. Participants further answered the Eating Disorder Examination Questionnaire (EDE-Q), Yale Food Addiction Scale 2.0 (YFAS 2.0), Short-Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) at t0 and t1. RESULTS The point prevalence of symptoms suggestive of post-surgery dumping syndrome was 33%. Regression analyses indicate an association of dumping with surgical procedure (bypass), female gender, reduced HRQoL, more anxiety/depressive symptoms, and potentially with binge eating but not with eating disorder symptoms in general or with addiction-like eating. CONCLUSION The current study failed to show a close relationship between the presence of self-reported dumping syndrome and eating disorder symptoms or addiction-like eating following obesity surgery. Further studies with longer follow-up periods should make use of clinical interviews to assess psychosocial variables and of objective measures to diagnose dumping in addition to standardized self-ratings.
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Affiliation(s)
- Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Salih Efeler
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Nora M. Laskowski
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
- University Clinic for Psychosomatic Medicine and Psychotherapy, Medical Faculty, Campus East-Westphalia, Ruhr-University Bochum, Luebbecke, Germany
| | - Melanie Pommnitz
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Julian W. Mall
- Department of General, Visceral, Vascular, and Bariatric Surgery, Klinikum Nordstadt, Hanover, Germany
| | - Günther Meyer
- Department of General, Visceral, and Bariatric Surgery, AMC-WolfartKlinik, Graefeling, Germany
| | - Ruth Wunder
- Department of General, Visceral, and Bariatric Surgery, DRK-Krankenhaus Clementinenhaus, Hanover, Germany
| | - Hinrich Köhler
- Department of General, Visceral, and Bariatric Surgery, Herzogin Elisabeth Hospital, Brunswick, Germany
| | - Thomas P. Hüttl
- Department of General, Visceral, and Bariatric Surgery, Dr. Lubos Kliniken Bogenhausen, Munich, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hanover, Germany
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White GE, Steers MN, Bernardi K, Kalarchian MA. Food and alcohol disturbance among people who have undergone bariatric surgery. Obes Sci Pract 2024; 10:e738. [PMID: 38293562 PMCID: PMC10825622 DOI: 10.1002/osp4.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/03/2024] [Accepted: 01/14/2024] [Indexed: 02/01/2024] Open
Abstract
There have been numerous investigations of aberrant eating and substance abuse among patients who have undergone bariatric surgery, which affects the metabolism and the pharmacokinetics of alcohol. However, there is a dearth of literature considering the complex interplay between changes in post-surgery food and alcohol consumption. Furthermore, despite the increasing recognition of issues surrounding replacing food consumption with alcohol consumption (Food and Alcohol Disturbance [FAD]), most emerging research has focused on young adult populations. This perspective reviews and synthesizes the small but growing body of research on the interplay between food and alcohol consumption, particularly FAD, and considers its application to bariatric surgery in general. There are unique considerations for patients who have undergone bariatric surgery. Patients experience altered gastric anatomy, which affects food and alcohol metabolism, and are advised to abstain from drinking alcohol after surgery. After reviewing the available literature, this perspective highlights future directions for research and practice in bariatric surgery.
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Affiliation(s)
- Gretchen E. White
- Institute for Clinical Research EducationUniversity of Pittsburgh Schools of the Health SciencesPittsburghPennsylvaniaUSA
| | | | - Karla Bernardi
- Department of SurgeryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
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Er E, Durieux N, Vander Haegen M, Flahault C, Etienne AM. Patients' perceptions of the mechanisms underlying alcohol use problems after bariatric surgery: A qualitative systematic review. Clin Obes 2023; 13:e12551. [PMID: 36096544 DOI: 10.1111/cob.12551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 01/19/2023]
Abstract
Alcohol-related problems increase after bariatric surgery. The objective of this review was to synthesize findings of qualitative studies on patients' perceptions of the mechanisms leading to problematic alcohol consumption after bariatric surgery. This review followed the Joanna Briggs Institute methodology for systematic review of qualitative evidence. A comprehensive search strategy was performed in MEDLINE, PsycInfo, Scopus and Google Scholar. Study selection, data extraction and critical appraisal of included studies were undertaken by two independent reviewers. Confidence in review findings was assessed using the ConQual approach. Four studies were included in this review and led to the development of four synthesized results: (1) persistence or reappearance of psychological problems after bariatric surgery; (2) using alcohol as a coping strategy, sometimes as a replacement for food; (3) changes in the physiological response to alcohol; and (4) importance of increased information about alcohol-related risks and long-term counselling. Confidence in the synthesized results ranged from moderate to low. The results indicated postoperative problematic alcohol consumption is a complex issue, involving psychological and physiological mechanisms. Several recommendations are formulated based on the results obtained. More qualitative and quantitative studies are needed to better understand this phenomenon given the few existing qualitative studies on this topic and some divergent results found between qualitative and previous quantitative research.
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Affiliation(s)
- Esin Er
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Faculty of Psychology, Speech and Language Therapy and Educational Sciences, University of Liège, Liège, Belgium
| | - Nancy Durieux
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Faculty of Psychology, Speech and Language Therapy and Educational Sciences, University of Liège, Liège, Belgium
- Belgian Interuniversity Collaboration for Evidence-based Practice (BICEP): A JBI Affiliated Group, Leuven, Belgium
| | - Marie Vander Haegen
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Faculty of Psychology, Speech and Language Therapy and Educational Sciences, University of Liège, Liège, Belgium
| | - Cécile Flahault
- Laboratoire de Psychopathologie et Processus de la santé, Université de Paris, Paris, France
| | - Anne-Marie Etienne
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Faculty of Psychology, Speech and Language Therapy and Educational Sciences, University of Liège, Liège, Belgium
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Praxedes DR, Silva-Júnior AE, Macena ML, Gearhardt AN, Bueno NB. Prevalence of food addiction among patients undergoing metabolic/bariatric surgery: A systematic review and meta-analysis. Obes Rev 2023; 24:e13529. [PMID: 36415030 DOI: 10.1111/obr.13529] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/01/2022] [Accepted: 10/23/2022] [Indexed: 11/24/2022]
Abstract
Candidates for metabolic/bariatric surgery show a high prevalence of food addiction (FA). However, few studies have investigated FA prevalence after bariatric surgery, especially using longitudinal studies. This systematic review with a meta-analysis aimed to determine pre- and postoperative prevalence of FA among patients undergoing metabolic/bariatric surgery. It included both cross-sectional and longitudinal studies that used the Yale Food Addiction Scale (YFAS). The following databases were searched: MEDLINE, ScienceDirect, LILACS, PsycArticles, CENTRAL, greylit.org, and opengrey.eu. Studies that used the YFAS to evaluate FA in pre- or postoperative patients were included. A random-effects meta-analysis was performed with cross-sectional studies to calculate the weighted prevalence of FA at the pre- and postoperative moments. For longitudinal studies, which measured FA at both time points for the same individuals, absolute prevalence reduction (APR) was calculated. Of the 6626 records, 40 studies were included in the meta-analysis. The preoperative weighted prevalence of FA was 32% (95% CI: 27-37%; 33 groups), whereas the postoperative prevalence was 15% (95% CI: 12-18%; 14 groups). Seven longitudinal studies showed a weighted APR of 26 p.p. (95% CI: 10-41 p.p.). Observational data suggest a reduction in the prevalence of FA among patients that undergo bariatric surgery. Interventional studies are needed to confirm these findings.
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Affiliation(s)
- Dafiny R Praxedes
- Programa de Pós-Graduação em Nutrição (PPGNUT), Faculdade de Nutrição (FANUT), Universidade Federal de Alagoas (UFAL), Campus AC Simões, Av. Lourival Melo Mota, s/n, Cidade Universitária, Maceió, 57072-900, Brazil
| | - André E Silva-Júnior
- Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Sena Madureira, n.° 1.500, Vila Clementino, São Paulo, 04021-001, Brazil
| | - Mateus L Macena
- Programa de Pós-Graduação em Nutrição (PPGNUT), Faculdade de Nutrição (FANUT), Universidade Federal de Alagoas (UFAL), Campus AC Simões, Av. Lourival Melo Mota, s/n, Cidade Universitária, Maceió, 57072-900, Brazil
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church Street, Ann Arbor, Michigan, 48109-1043, USA
| | - Nassib B Bueno
- Programa de Pós-Graduação em Nutrição (PPGNUT), Faculdade de Nutrição (FANUT), Universidade Federal de Alagoas (UFAL), Campus AC Simões, Av. Lourival Melo Mota, s/n, Cidade Universitária, Maceió, 57072-900, Brazil.,Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Sena Madureira, n.° 1.500, Vila Clementino, São Paulo, 04021-001, Brazil
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Özkan M, Kavak M. Cross-Addiction in Bariatric Surgery Candidates. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Food Addiction and Binge Eating Impact on Weight Loss Outcomes Two Years Following Sleeve Gastrectomy Surgery. Obes Surg 2022; 32:1193-1200. [PMID: 35048249 DOI: 10.1007/s11695-022-05917-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/01/2022] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Emerging evidence suggest that problematic eating behaviors such as food addiction (FA) and binge eating (BE) may alter following bariatric surgery (BS) and impact weight outcomes. We aimed to examine the prevalence of FA and BE and their associations with weight outcomes 2 years post-sleeve gastrectomy (SG). METHODS Forty-five women (mean age 32.4 ± 10.9 years) who underwent SG and completed 24 months of follow-up were evaluated prospectively at pre-, 3-, 6-, 12-, and 24-month post-SG. Data collected included anthropometrics, nutritional intake, and lifestyle patterns. The Yale Food Addiction Scale (YFAS) and the Binge Eating Scale (BES) were used to characterize FA and BE, respectively. RESULTS Pre-surgery FA and BE were identified in 40.0% and 46.7% of participants, respectively. Following SG, FA and BE prevalence was 10.0%, 5.0%, 29.4%, and 14.2% (P = 0.007), and 12.5%, 4.9%, 18.4%, and 19.4% (P < 0.001) at 3, 6, 12, and 24 months, respectively. Women with BE at baseline gained significantly more weight from the nadir compared to non-BE women at baseline (P = 0.009). There was no relationship between FA at baseline and weight (P = 0.090). Weight regained from the nadir positively correlated with BES scores at baseline (r = 0.374, P = 0.019). CONCLUSIONS FA and BE tend to decrease during the early postoperative period, but remains in a notable rates return by 2 years post-SG. Moreover, pre-surgical BE was related to higher weight-regain. Proper management pre-BS should include a comprehensive eating pathologies assessment, as these pathologies may remain or re-emerge post-surgery and lead to worse weight outcomes.
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Dickhut C, Hase C, Gruner-Labitzke K, Mall JW, Köhler H, de Zwaan M, Müller A. No addiction transfer from preoperative food addiction to other addictive behaviors during the first year after bariatric surgery. EUROPEAN EATING DISORDERS REVIEW 2021; 29:924-936. [PMID: 34460134 DOI: 10.1002/erv.2857] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/03/2021] [Accepted: 08/12/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The aim of the present study was to investigate whether the remission of preoperative food addiction is associated with increases or new onset of other addictions within the first year following bariatric surgery. METHODS One hundred and twenty-five bariatric surgery patients were assessed before surgery (t1) and at 6 months (t2) and 1 year (t3) follow-ups. The assessments included the Yale Food Addiction Scale 2.0 (YFAS 2.0) and standardized questionnaires to measure symptoms of problematic alcohol use, gambling disorder, internet-use disorder, buying-shopping disorder, hypersexual disorder and exercise dependence. RESULTS Forty-nine (39.2%) patients were assigned to the food addiction (FA+ ) and 76 patients (60.8%) to the non-food addiction group (FA- ) based on their preoperative YFAS scores. Overall, BMI and symptoms of food addiction decreased significantly from baseline to follow-ups. Preoperative food addiction status was not associated with postoperative increases or new onset of other addictions. Elevated symptoms of buying-shopping disorder, internet-use and hypersexual behaviour at baseline in the FA+ -group decreased over time and were comparable to the FA- -group at follow-ups. CONCLUSION The 'addiction transfer' or 'cross addiction' hypothesis was not supportive for alcohol addiction, gambling addiction or other behaviours that may be addictive. Further studies are needed that investigate larger samples and longer observation periods, as well as other substance-use disorders.
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Affiliation(s)
- Clemens Dickhut
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology & Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Carolin Hase
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | | | - Julian W Mall
- Department of General, Vascular and Bariatric Surgery, KRH Klinikum Nordstadt, Hannover, Germany
| | - Hinrich Köhler
- Department of Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany
| | - Martina de Zwaan
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Astrid Müller
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover, Germany
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