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Woodruff JL, Bykalo MK, Loyo-Rosado FZ, Maissy ES, Sadek AT, Hersey M, Erichsen JM, Maxwell ND, Wilson MA, Wood SK, Hashemi P, Grillo CA, Reagan LP. Differential effects of high-fat diet on endocrine, metabolic and depressive-like behaviors in male and female rats. Appetite 2024; 199:107389. [PMID: 38697221 PMCID: PMC11139556 DOI: 10.1016/j.appet.2024.107389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/04/2024]
Abstract
The complications of obesity extend beyond the periphery to the central nervous system (CNS) and include an increased risk of developing neuropsychiatric co-morbidities like depressive illness. Preclinical studies support this concept, including studies that have examined the effects of a high-fat diet (HFD) on depressive-like behaviors. Although women are approximately two-fold more likely to develop depressive illness compared to men, most preclinical studies have focused on the effects of HFD in male rodents. Accordingly, the goal of this study was to examine depressive-like behaviors in male and female rats provided access to a HFD. In agreement with prior studies, male and female rats provided a HFD segregate into an obesity phenotype (i.e., diet-induced obesity; DIO) or a diet resistant (DR) phenotype. Upon confirmation of the DR and DIO phenotypes, behavioral assays were performed in control chow, DR, and DIO rats. In the sucrose preference test, male DIO rats exhibited significant decreases in sucrose consumption (i.e., anhedonia) compared to male DR and male control rats. In the forced swim test (FST), male DIO rats exhibited increases in immobility and decreases in climbing behaviors in the pre-test sessions. Interestingly, male DR rats exhibited these same changes in both the pre-test and test sessions of the FST, suggesting that consumption of a HFD, even in the absence of the development of an obesity phenotype, has behavioral consequences. Female rats did not exhibit differences in sucrose preference, but female DIO rats exhibited increases in immobility exclusively in the test session of the FST, behavioral changes that were not affected by the stage of the estrous cycle. Collectively, these studies demonstrate that access to a HFD elicits different behavioral outcomes in male and female rats.
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Affiliation(s)
- J L Woodruff
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA; Columbia VA Health Care System, Columbia, SC, USA
| | - M K Bykalo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - F Z Loyo-Rosado
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - E S Maissy
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - A T Sadek
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - M Hersey
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - J M Erichsen
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - N D Maxwell
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA
| | - M A Wilson
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA; Columbia VA Health Care System, Columbia, SC, USA
| | - S K Wood
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA; Columbia VA Health Care System, Columbia, SC, USA
| | - P Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA; Department of Bioengineering, Imperial College, London, SW7 2AZ, UK
| | - C A Grillo
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA; Columbia VA Health Care System, Columbia, SC, USA
| | - L P Reagan
- University of South Carolina School of Medicine, Department of Pharmacology, Physiology, and Neuroscience, Columbia, SC, USA; Columbia VA Health Care System, Columbia, SC, USA.
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2
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Rachubińska K, Cybulska AM, Kupcewicz E, Panczyk M, Ślusarska B, Grochans E, Schneider-Matyka D. The Relationship between Depressiveness and Eating Behaviors among Women. Nutrients 2024; 16:195. [PMID: 38257089 PMCID: PMC10821179 DOI: 10.3390/nu16020195] [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: 11/16/2023] [Revised: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
(1) The objective of the study was to determine the relationship between depressiveness and the occurrence of eating disorders, i.e., emotional eating, uncontrolled eating, cognitive restraint of eating, and the risk of orthorexia. (2) The study was conducted among 556 women from the West Pomeranian Voivodeship (Poland). The study employed the diagnostic survey method using a questionnaire technique: The Beck Depression Inventory, the ORTO-15 Questionnaire, the Three-Factor Eating Questionnaire, and a sociodemographic questionnaire. (3) Higher depressiveness severity is associated with a higher score on the "Cognitive Restraint of Eating" scale. The authors' original study demonstrated a statistically significant relationship only between depressiveness and the "Uncontrolled Eating" subscale (p = 0.001). (4) The results of this study suggest that depressiveness is an important factor that contributes to a better understanding of eating behaviors. In addition, the results of this study suggest that eating behaviors and psychological factors should be taken into account in psychological interventions in the treatment of eating disorders. The clinical goal can be considered to be an improvement in non-normative eating behaviors, such as a reduction in overeating episodes or eating less frequently in the absence of a feeling of hunger.
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Affiliation(s)
- Kamila Rachubińska
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Anna Maria Cybulska
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Ewa Kupcewicz
- Department of Nursing, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
| | - Mariusz Panczyk
- Department of Education and Research of Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, Litewska 14/16 St., 00-518 Warsaw, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Faculty of Health Sciences, Medical University of Lublin, Staszica 6 Street, 20-081 Lublin, Poland;
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
| | - Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (K.R.); (D.S.-M.)
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3
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Wekwejt P, Wojda U, Kiryk A. Melanotan-II reverses memory impairment induced by a short-term HF diet. Biomed Pharmacother 2023; 165:115129. [PMID: 37478579 DOI: 10.1016/j.biopha.2023.115129] [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: 05/10/2023] [Revised: 06/12/2023] [Accepted: 07/02/2023] [Indexed: 07/23/2023] Open
Abstract
A high-fat (HF) diet has been shown to increase the risk of neurological impairments and neurodegenerative disorders. The melanotropins used in this study have been associated with diet-related disorders; however, there is an absence of studies on their effect on diet-induced neurobehavioral conditions. Here, we investigated the possible relationship among diet, Melanotan-II (MT-II) targeting melanotropin receptors, and the behavior of zebrafish (Danio rerio). Surprisingly, even a short-term HF diet lasting for ∼ 1 % of the zebrafish's life had a strong developmental effect. Zebrafish fed the HF diet showed an impairment in recognition memory, elevated anxiety levels, and reduced exploratory propensity after just three weeks compared to zebrafish fed the control diet. These HF diet-induced abnormalities were reversed by MT-II. Animals fed a HF diet and treated with MT-II demonstrated recognition memory, anxiety, and exploratory behavior similar to the control group. This study provides evidence that even a short-term HF diet has an impact on memory and emotions and is the first study to show that MT-II reverses these changes.
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Affiliation(s)
- Patryk Wekwejt
- Laboratory of Preclinical Testing of Higher Standard, Nencki Institute of Experimental Biology, 3 Pasteur Street, 02-093 Warsaw, Poland
| | - Urszula Wojda
- Laboratory of Preclinical Testing of Higher Standard, Nencki Institute of Experimental Biology, 3 Pasteur Street, 02-093 Warsaw, Poland
| | - Anna Kiryk
- Laboratory of Preclinical Testing of Higher Standard, Nencki Institute of Experimental Biology, 3 Pasteur Street, 02-093 Warsaw, Poland.
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Sener ZE, Marakoglu K, Sener S. Evaluation of Excessive Daytime Sleepiness, Anxiety and Depression Symptomatologies in Obesity. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: In this study, it was aimed to evaluate the excessive daytime sleepiness, anxiety and depression symptomatology in normal-weight, overweight and obese individuals.
Methods: In the study, 605 people who applied to the family medicine outpatient clinic between 2020 November 25 and 2021 March 5 were included. The questionnaire form evaluating the sociodemographic characteristics of the participants, the Hospital Anxiety and Depression Scale and the Epworth Sleepiness Scale were administered using a face-to-face interview technique.
Results: Overweight status in primary school, high school/adolescence, and university/twenties were higher in obese than in overweight. Additionally, it was higher in overweight than in normal weight. The risk of being overweight was 2.19 times higher and the risk of being obese was 6.07 times higher than those with obesity in their family compared to those who did not. Excessive daytime sleepiness was 2.95 times higher in obese than in normal weight. Anxiety symptoms were 1.97 times higher in obese than in normal weight. Depression symptoms were 2.77 times more in overweight and 2.99 times more in obese compared to normal-weight individuals.
Conclusion: As a result of this study, it was revealed that excessive daytime sleepiness, anxiety and depression symptomatologies are more common in obese compared to normal weight.
Keywords: obesity, overweight, depression, anxiety, disorders of excessive somnolence
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Alyahya RA, Alnujaidi MA. Prevalence and Outcomes of Depression After Bariatric Surgery: A Systematic Review and Meta-Analysis. Cureus 2022; 14:e25651. [PMID: 35784972 PMCID: PMC9249077 DOI: 10.7759/cureus.25651] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2022] [Indexed: 11/05/2022] Open
Abstract
Surgeons often focus on weight loss and improvement of obesity-related conditions as a primary outcome after bariatric surgery. However, the success of bariatric surgery also relies on the improvement of mental health status. Therefore, the current meta-analysis was carried out to reveal the prevalence of depressive symptoms and their subsequent impact on bariatric surgery outcomes. This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and the recommendation of Cochrane Collaboration. All clinical studies reporting the prevalence and/or the outcomes of depression after bariatric surgery were included in the current meta-analysis. This meta-analysis encompassed 33 articles, including a total of 101,223 patients. The prevalence of post-bariatric surgery depression was 15.3% (95% confidence intervals {CI}: 15.0-15.5%, p<0.001) among which severe, moderate, and minimal depression accounted for 1.9% (95% CI: 1.5-2.4%, p<0.001), 5.1% (95% CI: 4.4-5.8%, p<0.001), and 64.9% (95% CI: 63.3-66.5%, p<0.001), respectively. Depression is negatively correlated with weight loss (correlation -0.135; 95% CI: -0.176 to 0.093; p<0.001) and positively correlated with eating disorder (correlation 0.164; 95% CI: 0.079-0.248; p<0.001). The prevalence of post-bariatric surgery depression is relatively high reaching up to 64.9%, with almost one in five patients affected by it. Depression is associated with weight regain, eating disorders, and quality of life.
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Affiliation(s)
- Rayyan A Alyahya
- Pediatrics and Neonatology, Prince Sultan Military Medical City, Riyadh, SAU
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6
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Hersey M, Woodruff JL, Maxwell N, Sadek AT, Bykalo MK, Bain I, Grillo CA, Piroli GG, Hashemi P, Reagan LP. High-fat diet induces neuroinflammation and reduces the serotonergic response to escitalopram in the hippocampus of obese rats. Brain Behav Immun 2021; 96:63-72. [PMID: 34010713 PMCID: PMC8319113 DOI: 10.1016/j.bbi.2021.05.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/22/2021] [Accepted: 05/14/2021] [Indexed: 12/27/2022] Open
Abstract
Clinical studies indicate that obese individuals have an increased risk of developing co-morbid depressive illness and that these patients have reduced responses to antidepressant therapy, including selective serotonin reuptake inhibitors (SSRIs). Obesity, a condition of chronic mild inflammation including obesity-induced neuroinflammation, is proposed to contribute to decreases in synaptic concentrations of neurotransmitters like serotonin (5HT) by decreasing 5HT synthesis in the dorsal raphe nucleus (DRN) and/or affecting 5HT reuptake in DRN target regions like the hippocampus. In view of these observations, the goal of the current study was to examine inflammatory markers and serotonergic dynamics in co-morbid obesity and depression. Biochemical and behavioral assays revealed that high-fat diet produced an obesity and depressive-like phenotype in one cohort of rats and that these changes were marked by increases in key pro-inflammatory cytokines in the hippocampus. In real time using fast scan cyclic voltammetry (FSCV), we observed no changes in basal levels of hippocampal 5HT; however responses to escitalopram were significantly impaired in the hippocampus of obese rats compared to diet resistant rats and control rats. Further studies revealed that these neurochemical observations could be explained by increases in serotonin transporter (SERT) expression in the hippocampus driven by elevated neuroinflammation. Collectively, these results demonstrate that obesity-induced increases in neuroinflammation adversely affect SERT expression in the hippocampus of obese rats, thereby providing a potential synaptic mechanism for reduced SSRI responsiveness in obese subjects with co-morbid depressive illness.
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Affiliation(s)
- Melinda Hersey
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA,Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA
| | - Jennifer L. Woodruff
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA,Columbia VA Health Care System, Columbia, SC, USA
| | - Nicholas Maxwell
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA
| | - Alia T. Sadek
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA
| | - Maria K. Bykalo
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA
| | - Ian Bain
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA
| | - Claudia A. Grillo
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA,Columbia VA Health Care System, Columbia, SC, USA
| | - Gerardo G. Piroli
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA
| | - Parastoo Hashemi
- Department of Chemistry and Biochemistry, University of South Carolina, Columbia, SC, USA,Department of Bioengineering, Imperial College, London, SW7 2AZ UK
| | - Lawrence P. Reagan
- Department of Pharmacology, Physiology, and Neuroscience, University of South Carolina SOM, Columbia, SC, USA,Columbia VA Health Care System, Columbia, SC, USA,Corresponding author: Lawrence P. Reagan, Ph.D., Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, 6439 Garners Ferry Road, D40, Columbia, SC, USA 29208, Phone: 001 803 216 3515; Fax: 001 803 216 3538,
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7
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Lin JA, Jhe G, Vitagliano JA, Milliren CE, Spigel R, Woods ER, Forman SF, Richmond TK. The Association of Malnutrition, illness duration, and pre-morbid weight status with anxiety and depression symptoms in adolescents and young adults with restrictive eating disorders: a cross-sectional study. J Eat Disord 2021; 9:60. [PMID: 34001260 PMCID: PMC8127488 DOI: 10.1186/s40337-021-00415-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/28/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Restrictive eating disorders (EDs) are often comorbid with anxiety and depression symptoms, placing patients at risk for more severe disease, worse treatment outcomes, and higher rates of mortality. To identify risks for developing such co-morbidities, we assessed the association of malnutrition, ED illness duration, and pre-morbid weight status with symptoms of anxiety and depression in adolescents/young adults (AYAs) with EDs. METHODS 145 participants with restrictive EDs (anorexia nervosa [AN], other specified feeding and eating disorders [OSFED], avoidant restrictive food intake disorder [ARFID]) were included from the RECOVERY study, a longitudinal web-based registry of AYAs with EDs. We measured malnutrition as percent of expected body mass index (%eBMI), based on participants' pre-morbid growth trajectory. Outcomes were anxiety and depression scores from the Generalized Anxiety Disorder 7-item (GAD-7) and Center for Epidemiologic Studies Depression (CES-D) scales. We used multiple linear regression to examine the association of malnutrition, ED duration, and pre-morbid weight status with symptoms of anxiety and depression. RESULTS Mean (SD) age was 16.4(3.0) years; 87% were female; 89% white; 85% had AN, 6% OSFED, 10% ARFID. Of these, 2/3 had ED symptoms ≥1 year, 1/3 had previous higher level of ED care (HLOC), and half were taking psychiatric medications. Mean %eBMI was 90% (range 57-112%). Mean GAD-7 was 9.4(5.9) and CES-D was 24(13.8), indicating most participants had clinically significant anxiety and/or depression. Degree of malnutrition was not significantly associated with anxiety or depression adjusting for age, sex, sexual orientation, ED diagnosis, and use of psychiatric medication. Those with longer duration of ED symptoms had higher depression scores after adjusting for malnutrition, HLOC, length of ED symptoms, and time in our care (p = 0.038). Patients with pre-morbid BMIs ≥75th percentile had lower depression scores than those with pre-morbid BMIs <75th percentile (p = 0.014). CONCLUSIONS We find high degree of clinically relevant anxiety and depression symptoms in a population of AYAs with EDs. Our findings suggest that factors beyond malnutrition play a role in the co-morbid mood and anxiety disorders in this population. Overall, rapid ED diagnosis and comprehensive treatment for patients with EDs across the weight spectrum-and especially those with psychiatric co-morbidities-will likely aid in recovery.
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Affiliation(s)
- Jessica A Lin
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA. .,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Grace Jhe
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Julia A Vitagliano
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Carly E Milliren
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Rebecca Spigel
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Elizabeth R Woods
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Sara F Forman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
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8
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Improvement in patient-reported outcomes in Chinese adults after bariatric surgery: 1-year follow-up of a prospective cohort. Surg Obes Relat Dis 2020; 16:1563-1572. [DOI: 10.1016/j.soard.2020.04.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 11/24/2022]
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9
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Dong TS, Gupta A, Jacobs JP, Lagishetty V, Gallagher E, Bhatt RR, Vora P, Osadchiy V, Stains J, Balioukova A, Chen Y, Dutson E, Mayer EA, Sanmiguel C. Improvement in Uncontrolled Eating Behavior after Laparoscopic Sleeve Gastrectomy Is Associated with Alterations in the Brain-Gut-Microbiome Axis in Obese Women. Nutrients 2020; 12:E2924. [PMID: 32987837 PMCID: PMC7599899 DOI: 10.3390/nu12102924] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/17/2020] [Accepted: 09/21/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Bariatric surgery is proven to change eating behavior and cause sustained weight loss, yet the exact mechanisms underlying these changes are not clearly understood. We explore this in a novel way by examining how bariatric surgery affects the brain-gut-microbiome (BGM) axis. METHODS Patient demographics, serum, stool, eating behavior questionnaires, and brain magnetic resonance imaging (MRI) were collected before and 6 months after laparoscopic sleeve gastrectomy (LSG). Differences in eating behavior and brain morphology and resting-state functional connectivity in core reward regions were correlated with serum metabolite and 16S microbiome data. RESULTS LSG resulted in significant weight loss and improvement in maladaptive eating behaviors as measured by the Yale Food Addiction Scale (YFAS). Brain imaging showed a significant increase in brain volume of the putamen (p.adj < 0.05) and amygdala (p.adj < 0.05) after surgery. Resting-state connectivity between the precuneus and the putamen was significantly reduced after LSG (p.adj = 0.046). This change was associated with YFAS symptom count. Bacteroides, Ruminococcus, and Holdemanella were associated with reduced connectivity between these areas. Metabolomic profiles showed a positive correlation between this brain connection and a phosphatidylcholine metabolite. CONCLUSION Bariatric surgery modulates brain networks that affect eating behavior, potentially through effects on the gut microbiota and its metabolites.
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Affiliation(s)
- Tien S. Dong
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90025, USA
| | - Arpana Gupta
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
| | - Jonathan P. Jacobs
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90025, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
| | - Venu Lagishetty
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90025, USA
| | - Elizabeth Gallagher
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
| | - Ravi R. Bhatt
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine at USC, University of Southern California, Los Angeles, CA 90033, USA
| | - Priten Vora
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
| | - Vadim Osadchiy
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
| | - Jean Stains
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
| | - Anna Balioukova
- UCLA Center for Obesity and METabolic Health (COMET), Los Angeles, CA 90024, USA;
| | - Yijun Chen
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
- UCLA Center for Obesity and METabolic Health (COMET), Los Angeles, CA 90024, USA;
| | - Erik Dutson
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
- UCLA Center for Obesity and METabolic Health (COMET), Los Angeles, CA 90024, USA;
| | - Emeran A. Mayer
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
| | - Claudia Sanmiguel
- The Vatche and Tamar Manoukian Division of Digestive Diseases, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA; (T.S.D.); (A.G.); (J.P.J.); (V.L.); (E.A.M.)
- UCLA Microbiome Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA
- Division of Gastroenterology, Hepatology and Parenteral Nutrition, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90025, USA
- G. Oppenheimer Center for Neurobiology of Stress and Resilience, University of California, Los Angeles, CA 90095, USA; (E.G.); (R.R.B.); (P.V.); (V.O.); (J.S.)
- David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (Y.C.); (E.D.)
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10
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Canheta ABDS, Santos ASEADC, Souza JDD, Silveira EA. Traditional Brazilian diet and extra virgin olive oil reduce symptoms of anxiety and depression in individuals with severe obesity: Randomized clinical trial. Clin Nutr 2020; 40:404-411. [PMID: 32675019 DOI: 10.1016/j.clnu.2020.05.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
RATIONAL & OBJECTIVE Although the relationship between obesity, anxiety and depression is known, the clinical benefits of nutrition therapy in individuals with obesity have been scarcely studied. This study assessed the effectiveness of a traditional Brazilian diet (DieTBra) and extra virgin olive oil (EVOO) on the symptoms of anxiety and depression in severe obese participants. METHOD This was a parallel randomized clinical trial in adults with severe obesity (Body Mass Index - BMI ≥ 35 kg/m2), DietBra Trial. Participants were randomized into three intervention groups in a ratio of 1: 1: 1 and followed up for 12 weeks. The three intervention groups were: 1) DieTBra, 2) 52 mL/day EVOO, and 3) DieTBra +52 mL/day EVOO. The symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. The outcome variables were: anxiety, depression and simultaneous anxiety and depression in the same individual. RESULTS 149 severe obese individuals were randomized. The mean BMI was 46.3 ± 6.5 kg/m2 with a mean age of 38.9 ± 8.7 years. After randomization, individuals on medication for depression and anxiety were excluded, totaling 129 at baseline, with 44:43:42 per group. At the end of 12 weeks 113 individuals completed the study. There was a significant reduction of symptoms for the three groups: EVOO, DieTBra and DieTBra + EVOO, respectively: anxiety 38.23% (p = 0.019), 45.83% (p=<0.014), 33.33% (p < 0.013) depression 55.17% (p=<0.001), 50.00% (p=<0.007), 34.61% (p=<0.035), and anxiety/depression 57.69% (p=<0.001), 66.67% (p=<0.014), 27.78% (p=<0.013). CONCLUSIONS Both DieTBra and olive oil interventions were effective in reducing symptoms of anxiety and depression in severe obese adults. These interventions can be integrated with clinical protocols for treatment of symptoms of anxiety and depression in severe obese individuals. TRIAL REGISTRATION Clinicaltrials.gov NCT02463435.
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Affiliation(s)
- Andrea Batista de Sousa Canheta
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás (UFG), Brazil; Faculty of Education, Federal University of Goiás (UFG), Brazil
| | | | - Jacqueline Danésio de Souza
- Course of Nutrition, University of North Paraná (UNOPAR - Londrina/PR), Brazil; Faculty of Education, Federal University of Goiás (UFG), Brazil
| | - Erika Aparecida Silveira
- Graduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás (UFG), Brazil.
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11
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Spirou D, Raman J, Smith E. Psychological outcomes following surgical and endoscopic bariatric procedures: A systematic review. Obes Rev 2020; 21:e12998. [PMID: 31994311 DOI: 10.1111/obr.12998] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 11/25/2019] [Accepted: 12/12/2019] [Indexed: 12/16/2022]
Abstract
Obesity is a leading global epidemic. Bariatric surgery is the only treatment demonstrating substantial long-term weight loss and medical benefits. However, there is limited research on the psychological outcomes following surgery. Therefore, the primary aim of this study was to systematically review depression, anxiety, and binge eating outcomes at different time points following bariatric surgery and identify whether bariatric surgery significantly reduces psychological symptoms over time. These outcomes were also examined among endoscopic bariatric procedures as a secondary aim. Forty-eight studies met inclusion criteria. Findings suggested that most patients experience a short-term reduction in anxiety and depression symptoms from pre-surgery. Over time, however, these symptoms increase and may even return to pre-surgery levels. Furthermore, while binge eating was uncommon after surgery, other disordered eating patterns may emerge. Binge eating may also restart over time as the stomach enlarges again. Overall, the complex psychological difficulties faced by individuals with obesity continue after surgery and may contribute to longer-term weight recidivism. More comprehensive and standardised psychological assessment procedures, including clinical interviews and longer-term follow-up, may provide insight into the psychological mechanisms maintaining weight management issues, and may serve as a starting point for improving the long-term success of patients with obesity.
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Affiliation(s)
- Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Jayanthi Raman
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Evelyn Smith
- School of Social Sciences and Psychology, Western Sydney University, Sydney, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
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12
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Li Q, Yang J, He Y, Wang T, Zhong L, Zhu Z, Wang T, Ling S. Investigation of the psychological health of first-year high school students with myopia in Guangzhou. Brain Behav 2020; 10:e01594. [PMID: 32147959 PMCID: PMC7177566 DOI: 10.1002/brb3.1594] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the differences in anxiety and depression between adolescents with myopia and those with normal vision and to examine the relationship between the level of anxiety and depression and the degree of myopia. METHODS A total of 1,103 first-year high school students aged 14-17 years were included in the study. The study group comprised 916 persons with myopia, while the control group comprised 187 persons without refractive error. Volunteers underwent routine eye examinations and completed a set of questionnaires about anxiety and depression. Then, the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were compared between groups, and the relationships between anxiety and the degree of myopia and between depression and the degree of myopia were analyzed. RESULTS There was a significant difference in anxiety rate between the students with normal vision and those with myopia. The SAS scores among students with mild, moderate, and severe myopia were also significantly different. However, compared with the students with normal vision, the rate of depression was not significantly increased in the students with myopia, except in cases of severe myopia. Additionally, the SAS scores correlated closely with the diopters of the participants' glasses (r = 0.43, p = .045), while the relationship between SDS scores and the diopters of glasses was not significant (r = 0.19, p = .325). CONCLUSION There was a correlation between myopia and mental health in adolescent students, especially in terms of anxiety.
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Affiliation(s)
- Qiaoli Li
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.,Department of Ophthalmology, Nanhai Hospital of Southern Medical University, Guangzhou, China
| | - Jiezheng Yang
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yan He
- Department of English, Guangzhou Pui Ching Middle School, Guangzhou, China
| | - Ting Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Zhong
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ziqian Zhu
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Tao Wang
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Shiqi Ling
- Department of Ophthalmology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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13
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Aoun C, Nassar L, Soumi S, El Osta N, Papazian T, Rabbaa Khabbaz L. The Cognitive, Behavioral, and Emotional Aspects of Eating Habits and Association With Impulsivity, Chronotype, Anxiety, and Depression: A Cross-Sectional Study. Front Behav Neurosci 2019; 13:204. [PMID: 31555108 PMCID: PMC6742717 DOI: 10.3389/fnbeh.2019.00204] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/20/2019] [Indexed: 12/20/2022] Open
Abstract
Background and objectives: Understanding behavioral issues associated with eating would provide important insight into obesity development and possibly procure ways to prevent its occurrence or to treat it. This study's objectives were to examine links between cognitive, behavioral, and emotional aspects of eating habits and chronotype, impulsivity, anxiety, and depression among university students. Subjects and methods: The following questionnaires were used: TFEQ-R 18, UPPS-short, HADS, and MEQ. All participants gave their informed written consent prior to enrolment. Results: Among females, increased BMI was associated to uncontrolled eating and emotional eating, while in males, BMI was associated to emotional eating only. In males, no associations of BMI with impulsivity were found while in females they were present. Chronotype scores were positively correlated to cognitive restraint and negatively to uncontrolled eating among males. No associations were found for females. CR was lower among females with higher depression scores, while higher anxiety scores were associated to UE among males. Conclusions: This was a cross-sectional study of three cognitive and emotional domains related to eating habits among university students (young adults). Results showed significant correlations between BMI, TFEQ-R18 scores, impulsivity and anxiety or depression. Future studies should replicate findings in samples of individuals with different aspects of eating disorders such as binge eating disorder, food addiction or bulimia nervosa.
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Affiliation(s)
- Carla Aoun
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Lynn Nassar
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Stéphanie Soumi
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nada El Osta
- Department of Public Health, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.,Department of Prosthodontics, Faculty of Dental Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Tatiana Papazian
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Lydia Rabbaa Khabbaz
- Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de qualité des médicaments, Faculty of pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon.,Department of Nutrition, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
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14
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Bieliński M, Lesiewska N, Junik R, Kamińska A, Tretyn A, Borkowska A. Dopaminergic Genes Polymorphisms and Prefrontal Cortex Efficiency Among Obese People - Whether Gender is a Differentiating Factor? Curr Mol Med 2019; 19:405-418. [PMID: 31032750 DOI: 10.2174/1566524019666190424143653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 04/16/2019] [Accepted: 04/16/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Obesity is a chronic condition associated with poorer cognitive functioning. Wisconsin Card Sorting Test (WCST) is a useful tool for evaluating executive functions. In this study, we assessed the association between dopaminergic gene polymorphisms: DAT1 (SLC6A3), COMTVal158Met, DRD4 (48-bp variable number of tandem repeats - VNTR) and WCST parameters to investigate the functions of the frontal lobes in obese individuals. OBJECTIVE To find the significant correlations between polymorphisms of DAT1, COMTVal158Met, DRD4 and executive functions in obese subjects. METHODS The analysis of the frequency of individual alleles was performed in 248 obese patients (179 women, 69 men). Evaluation of the prefrontal cortex function (operating memory and executive functions) was measured with the Wisconsin Card Sorting Test (WCST). Separate analyzes were performed in age subgroups to determine different activities and regulation of genes in younger and older participants. RESULTS Scores of WCST parameters were different in the subgroups of women and men and in the age subgroups. Regarding the COMT gene, patients with A/A and G/A polymorphisms showed significantly better WCST results in WCST_P, WCST_CC and WCST_1st. Regarding DAT1 men with L/L and L/S made less non-perseverative errors, which was statistically significant. In DRD4, significantly better WCST_1st results were found only in older women with S allele. CONCLUSION Obtained results indicate the involvement of dopaminergic transmission in the regulation of prefrontal cortex function. Data analysis indicates that prefrontal cortex function may ensue, from different elements such as genetic factors, metabolic aspects of obesity, and hormonal activity (estrogen).
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Affiliation(s)
- Maciej Bieliński
- Chair and Department of Clinical Neuropsychology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Natalia Lesiewska
- Chair and Department of Clinical Neuropsychology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Roman Junik
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Anna Kamińska
- Department of Endocrinology and Diabetology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
| | - Andrzej Tretyn
- Department of Biotechnology, Nicolaus Copernicus University in Torun, Poland
| | - Alina Borkowska
- Chair and Department of Clinical Neuropsychology, Nicolaus Copernicus University in Torun, Collegium Medicum in Bydgoszcz, Poland
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15
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Ho K, Hawa R, Wnuk S, Okrainec A, Jackson T, Sockalingam S. The Psychosocial Effects of Perioperative Complications After Bariatric Surgery. PSYCHOSOMATICS 2018; 59:452-463. [DOI: 10.1016/j.psym.2018.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/13/2018] [Accepted: 03/19/2018] [Indexed: 11/25/2022]
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16
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Ribeiro GANDA, Giapietro HB, Belarmino LB, Salgado-Junior W. DEPRESSION, ANXIETY, AND BINGE EATING BEFORE AND AFTER BARIATRIC SURGERY: PROBLEMS THAT REMAIN. ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA : ABCD = BRAZILIAN ARCHIVES OF DIGESTIVE SURGERY 2018; 31:e1356. [PMID: 29947690 PMCID: PMC6050001 DOI: 10.1590/0102-672020180001e1356] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/01/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND As the number of surgeries increases and the elapsed time of the realization increases as well, the postoperative evaluations would become increasingly necessary. AIM To assess the psychological profile before and after surgery. METHODS Were evaluated 281 patients from the public service of bariatric surgery. In this study, 109 patients completed the evaluations before surgery (T0) and up to 23 months after surgery (T1); 128 completed the evaluations in T0 and between 24 months and 59 months after surgery (T2); and 44 completed the evaluations in T0 and 60 months after surgery (T3). A semi-structured interview, the Beck Depression Inventory (BDI), Beck Anxiety (BAI), and the Binge Eating Scale (BES) were used. RESULTS There was a higher prevalence of female (83%), patients with less than 12 years of education (83%), and patients who have a partner (64%). Analyzing all times of evaluation, regarding anxiety, depression, and binge eating, there was a reduction in all symptoms in T1, pointing to significant improvements in the first 23 months after surgery. Already, in T2 and T3, there was an increase in all indicators of anxiety, depression, and binge eating pointing to the transient impact of weight loss or bariatric surgery on these symptoms. CONCLUSIONS This study shows the importance of the continuous psychological evaluation and needs for the appropriate interventions for these patients who have undergone bariatric surgery, even after weight loss.
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Affiliation(s)
| | - Helenice Brizolla Giapietro
- Service of Bariatric Surgery, Hospital das Clínicas, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, SP, Brazil
| | - Lídia Barbieri Belarmino
- Service of Bariatric Surgery, Hospital das Clínicas, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, SP, Brazil
| | - Wilson Salgado-Junior
- Service of Bariatric Surgery, Hospital das Clínicas, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, SP, Brazil
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17
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Health-Related Quality of Life, Anxiety, and Depression in Bariatric Surgery Candidates Compared to Patients from a Psychosomatic Inpatient Hospital. Obes Surg 2018; 27:2378-2387. [PMID: 28285469 DOI: 10.1007/s11695-017-2629-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM Past research indicated high psychiatric comorbidity and poor health-related quality of life (HRQOL) in patients seeking surgical treatment for obesity. This study investigated if preoperative bariatric surgery patients perceive equally poor HRQOL and increased levels of anxiety and depression as mentally ill patients. METHODS The study included four groups: 192 bariatric surgery candidates (PRE, 71% women, BMI 48.35 ± 8.98 kg/m2), 96 psychotherapy inpatients with mental disorders (PSY, 77% women, BMI 27.12 ± 9.17 kg/m2), 103 postoperative bariatric surgery patients (POST, 78% women, BMI 30.38 ± 2.88 kg/m2), and a convenience sample of 96 non-clinical volunteers with pre-obesity or obesity grade 1 (CG, 52% women, BMI 29.22 ± 2.64 kg/m2). HRQOL was measured using the 12-item short form health survey (SF-12), and psychopathology was assessed with the hospital anxiety and depression scale (HADS). RESULTS The PRE group exhibited the lowest physical HRQOL, and the PSY group the lowest mental HRQOL. The highest mental/physical HRQOL was reported by the POST group and the CG, without significant differences between these two groups. While the PSY group scored higher on HADS-anxiety scale than the PRE group, neither group differed with regards to symptoms of depression. The lowest levels of HADS-depression were found in the POST group and the CG. CONCLUSIONS The present findings suggest that bariatric surgery candidates may suffer from equally high levels of depression as psychotherapy inpatients, but they perceive better mental well-being. Routine mental health evaluation should incorporate assessments for both psychopathology and HRQOL. TRIAL REGISTRATION DRKS00009901.
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18
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Abstract
OBJECTIVE The aim of this study is to identify psychosocial variables associated with the relationship between weight loss and change in depressive symptoms following gastric banding surgery. METHODS Ninety-nine adults completed self-report questionnaires assessing depressive symptoms and other psychosocial variables (self-esteem, body image dissatisfaction, perceived physical health, and perceived weight-based stigmatisation) prior to gastric-band surgery and monthly for 6-month post-surgery. RESULTS Weight, depressive symptoms, and other psychosocial variables improved significantly 1-month post-surgery and remained lower to 6 months. Weight loss from baseline to 1- and 6-months post-surgery significantly correlated with change in depressive symptoms. Body image dissatisfaction and self-esteem accounted for some of the variance in change in depressive symptoms from baseline to 1-month and baseline to 6-months post-surgery. CONCLUSIONS Depressive symptoms improved significantly and rapidly after bariatric surgery, and body image dissatisfaction and self-esteem predicted change in depressive symptoms. Interventions targeting body image and self-esteem may improve depressive symptoms for those undergoing weight loss interventions.
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19
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Van Doorn C, Macht VA, Grillo CA, Reagan LP. Leptin resistance and hippocampal behavioral deficits. Physiol Behav 2017; 176:207-213. [PMID: 28267584 PMCID: PMC10538552 DOI: 10.1016/j.physbeh.2017.03.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/02/2017] [Accepted: 03/02/2017] [Indexed: 01/05/2023]
Abstract
The adipocyte-derived hormone leptin is an important regulator of body weight and metabolism through activation of brain leptin receptors expressed in regions such as the hypothalamus. Beyond these well described and characterized activities of leptin in the hypothalamus, it is becoming increasingly clear that the central activities of leptin extend to the hippocampus. Indeed, leptin receptors are expressed in the hippocampus where these receptors are proposed to mediate various aspects of hippocampal synaptic plasticity that ultimately impact cognitive function. This concept is supported by studies demonstrating that leptin promotes hippocampal-dependent learning and memory, as well as studies indicating that leptin resistance is associated with deficits in hippocampal-dependent behaviors and in the induction of depressive-like behaviors. The effects of leptin on cognitive/behavioral plasticity in the hippocampus may be regulated by direct activation of leptin receptors expressed in the hippocampus; additionally, leptin-mediated activation of synaptic networks that project to the hippocampus may also impact hippocampal-mediated behaviors. In view of these previous observations, the goal of this review will be to discuss the mechanisms through which leptin facilitates cognition and behavior, as well as to dissect the loci at which leptin resistance leads to impairments in hippocampal synaptic plasticity, including the development of cognitive deficits and increased risk of depressive illness in metabolic disorders such as obesity and type 2 diabetes mellitus (T2DM).
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Affiliation(s)
- Catherine Van Doorn
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, United States
| | - Victoria A Macht
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, United States
| | - Claudia A Grillo
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, United States
| | - Lawrence P Reagan
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, United States; W.J.B. Dorn VA Medical Center, Columbia, SC 29208, United States.
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20
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Macht VA, Vazquez M, Petyak CE, Grillo CA, Kaigler K, Enos RT, McClellan JL, Cranford TL, Murphy EA, Nyland JF, Solomon G, Gertler A, Wilson MA, Reagan LP. Leptin resistance elicits depressive-like behaviors in rats. Brain Behav Immun 2017; 60:151-160. [PMID: 27743935 DOI: 10.1016/j.bbi.2016.10.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/22/2016] [Accepted: 10/10/2016] [Indexed: 12/13/2022] Open
Abstract
There is a growing appreciation that the complications of obesity extend to the central nervous system (CNS) and include increased risk for development of neuropsychiatric co-morbidities such as depressive illness. The neurological consequences of obesity may develop as a continuum and involve a progression of pathological features which is initiated by leptin resistance. Leptin resistance is a hallmark feature of obesity, but it is unknown whether leptin resistance or blockage of leptin action is casually linked to the neurological changes which underlie depressive-like phenotypes. Accordingly, the aim of the current study was to examine whether chronic administration of a pegylated leptin receptor antagonist (Peg-LRA) elicits depressive-like behaviors in adult male rats. Peg-LRA administration resulted in endocrine and metabolic features that are characteristic of an obesity phenotype. Peg-LRA rats also exhibited increased immobility in the forced swim test, depressive-like behaviors that were accompanied by indices of peripheral inflammation. These results demonstrate that leptin resistance elicits an obesity phenotype that is characterized by peripheral immune changes and depressive-like behaviors in rats, supporting the concept that co-morbid obesity and depressive illness develop as a continuum resulting from changes in the peripheral endocrine and metabolic milieu.
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Affiliation(s)
- V A Macht
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA; Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
| | - M Vazquez
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - C E Petyak
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - C A Grillo
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - K Kaigler
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - R T Enos
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - J L McClellan
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - T L Cranford
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - E A Murphy
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - J F Nyland
- Department of Pathology, Microbiology and Immunology, University of South Carolina School of Medicine, Columbia, SC 29208, USA
| | - G Solomon
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - A Gertler
- Institute of Biochemistry, Food Science and Nutrition, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - M A Wilson
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA; W.J.B. Dorn VA Medical Center, Columbia, SC 29208, USA
| | - L P Reagan
- Department of Pharmacology, Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29208, USA; W.J.B. Dorn VA Medical Center, Columbia, SC 29208, USA.
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Rørtveit K, Furnes B, Dysvik E, Ueland V. Struggle for a Meaningful Life after Obesity Treatment—A Qualitative Systematic Literature Review. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojn.2017.712103] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Argun Baris S, Tuncel D, Ozerdem C, Kutlu H, Onyilmaz T, Basyigit I, Boyaci H, Yildiz F. The effect of positive airway pressure therapy on neurocognitive functions, depression and anxiety in obesity hypoventilation syndrome. Multidiscip Respir Med 2016; 11:35. [PMID: 27766147 PMCID: PMC5057438 DOI: 10.1186/s40248-016-0071-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 07/18/2016] [Indexed: 01/22/2023] Open
Abstract
Background The aim of this study is to evaluate the presence of neurocognitive dysfunctions, depression and anxiety and the effect of positive airway pressure (PAP) therapy on these alterations in Obesity Hypoventilation Syndrome (OHS) patients. Methods Ten healthy normal and obese controls, 10 OHS and 10 OSAS patients were included in the study. Short form-36, Beck Depression Scale and State-Trade Anxiety Inventory (STAI 1-2) were performed. Wisconsin Card Sorting Test (WCST), Montreal Cognitive Assessment Scale (MOCA), Enhanced Cued Recall (ECR) and Mini Mental Test (MMT) were used for neurocognitive evaluation. All tests were repeated after one night PAP therapy in OHS and OSAS groups. Results OHS patients had the lowest scores of physical (PF) and social functioning (SF) in SF-36. The total number of persistent errors and incorrect answers were the highest in OHS group in WCST. The scores of MOCA, ECR and MMT were lower; depression and anxiety scores were higher in OHS group than in controls (p = 0,00). There was a significant increase in the completed categories in OHS after PAP therapy (p = 0,03). There were also significant increases in MOCA, ECR and MMT scores and significant decreases in depression and anxiety scores with respect to PAP therapy. Conclusions Cognitive dysfunction, depression and anxiety are important under-recognized comorbidities in OHS. It is suggested that short term PAP therapy had positive effects on neurocognitive functions, depression and anxiety but further multicentre, prospective studies with large number of cases are needed to evaluate the effect of long term PAP therapy on these parameters.
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Affiliation(s)
- Serap Argun Baris
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Umuttepe, İzmit, Kocaeli Turkey
| | - Dilek Tuncel
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Umuttepe, İzmit, Kocaeli Turkey
| | - Cigdem Ozerdem
- Department of Neurology, Derince Training and Research Hospital, İzmit, Kocaeli Turkey
| | - Huseyin Kutlu
- Department of Pyschiatry, Kocaeli University School of Medicine, İzmit, Kocaeli Turkey
| | - Tugba Onyilmaz
- Department of Pulmonary Diseases, Private Konak Hospital, İzmit, Kocaeli Turkey
| | - Ilknur Basyigit
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Umuttepe, İzmit, Kocaeli Turkey
| | - Hasim Boyaci
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Umuttepe, İzmit, Kocaeli Turkey
| | - Fusun Yildiz
- Department of Pulmonary Diseases, Kocaeli University School of Medicine, Umuttepe, İzmit, Kocaeli Turkey
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Ten-year changes in health-related quality of life after biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis 2016; 12:1594-1600. [DOI: 10.1016/j.soard.2016.04.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/14/2016] [Accepted: 04/30/2016] [Indexed: 11/20/2022]
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Jantaratnotai N, Mosikanon K, Lee Y, McIntyre RS. The interface of depression and obesity. Obes Res Clin Pract 2016; 11:1-10. [PMID: 27498907 DOI: 10.1016/j.orcp.2016.07.003] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/03/2016] [Accepted: 07/18/2016] [Indexed: 12/24/2022]
Abstract
Depression and obesity are both highly prevalent and are leading public health problems. These foregoing disorders independently have great impact on morbidity and mortality affecting patients' health and well-being as well as on the socioeconomic aspect of functional impairment and healthcare expenditure. Results from epidemiological studies, clinical trials and recent meta-analyses support the association between mood disorders and obesity as both frequently co-occur in all races of populations examined. It is now well-established through longitudinal studies that obesity is a risk factor for mood disorders and vice versa. In the current review, we aim to address the evidence regarding 4 questions: (1) does obesity moderate response to antidepressants among patients with depressive disorders?, (2) does the presence of depressive disorders moderate the progression or outcome of obesity?, (3) does treatment of obesity moderate outcomes among patients with depressive disorders?, and (4) does treatment of depressive disorders moderate outcomes of obesity? In order to improve the interpretability of the results we confined the evaluations to studies where patients met the criteria for depressive disorders or obesity (i.e. BMI>30). Extant evidence supports the association between obesity and adverse health outcomes among individuals with depressive disorders. In addition, the treatment of one condition (i.e. obesity or depressive disorders) appears to improve the course of the other condition. It might be beneficial to check for the other condition in patients presenting with one condition and treatment should be administered to treat both conditions.
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Affiliation(s)
- Nattinee Jantaratnotai
- Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Department of Pharmacology, Faculty of Science, Mahidol University, Bangkok, Thailand.
| | - Kanokwan Mosikanon
- Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Yena Lee
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, ON, Canada
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Moore DD, Cooper CE. Life After Bariatric Surgery: Perceptions of Male Patients and Their Intimate Relationships. JOURNAL OF MARITAL AND FAMILY THERAPY 2016; 42:495-508. [PMID: 26804931 DOI: 10.1111/jmft.12155] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This study explores the experiences of 20 men who have had bariatric surgery, focusing on their couple or marital relationships. The researcher concentrates on men's perspectives regarding relationship satisfaction, sexual intimacy, and social support after surgical intervention. Phenomenology and family systems theory were used to guide the study from which emerged three themes: (a) Unintended consequences (unpredicted problems occurring within intimate relationships); (b) Intimacy as bittersweet (experiencing increasing levels of intimacy, while still desiring more); and (c) Inconsistent social support (experiencing instances where social support is provided, while simultaneously experiencing other areas where social support is not provided). The study includes a rich description of the data, critical analysis, and discussion of clinical implications for therapists and other healthcare professionals.
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Tae B, Pelaggi ER, Moreira JG, Waisberg J, de Matos LL, D'Elia G. Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life. Rev Col Bras Cir 2016; 41:155-60. [PMID: 25140645 DOI: 10.1590/s0100-69912014000300004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 03/30/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To assess psychiatric symptoms, substance use, quality of life and eating behavior of patients undergoing bariatric surgery before and after the procedure. METHODS We conducted a prospective longitudinal study of 32 women undergoing bariatric surgery. To obtain data, the patients answered specific, self-administered questionnaires. RESULTS We observed a reduction in depressive and anxious symptoms and also in bulimic behavior, as well as an improved quality of life in the physical, psychological and environmental domains. There was also a decrease in use of antidepressants and appetite suppressants, but the surgery was not a cessation factor in smoking and / or alcoholism. CONCLUSION a decrease in psychiatric symptoms was observed after bariatric surgery, as well as the reduction in the use of psychoactive substances. In addition, there was an improvement in quality of life after surgical treatment of obesity.
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Assari S. Psychosocial Correlates of Body Mass Index in the United States: Intersection of Race, Gender and Age. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2016; 10:e3458. [PMID: 27822270 PMCID: PMC5097345 DOI: 10.17795/ijpbs-3458] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/11/2015] [Accepted: 04/28/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Studies on the association between psychosocial factors and obesity have provided mixed findings. OBJECTIVES Current study used a nationally representative sample of U.S. adults to investigate how intersection of race, gender and age alters the psychosocial correlates of body mass index (BMI). MATERIALS AND METHODS Data came from the national health measurement study (NHMS), a cross-sectional study with nationally representative sample of Black and White (n = 3,648) adults ages 35 - 89. We tested bivariate correlations between BMI and physical and mental quality of life, purpose in life, number of chronic medical conditions, and discrimination across race × gender × age groups. RESULTS Higher purpose in life was associated with lower BMI among middle aged and older White women, middle aged Black men, middle aged Black women, and older Black women but not middle aged or older White men and older Black men. There was a positive association between multi-morbidity and BMI in all groups other than older White men. High BMI was associated with poor mental quality of life among older White women, older Black men and women, but not any of middle aged groups, and older White men. High BMI was associated with poor physical quality of life among all groups. Everyday discrimination was positively associated with BMI among older White women but not any other group. Lifetime discrimination was not associated with BMI among any of the groups. CONCLUSIONS Race, gender, and age shape psychosocial and health related correlates of BMI. There is a need for further research on group differences in psychosocial correlates of obesity.
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Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, USA; Center for Research on Ethnicity, Culture and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, USA
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Pini RTB, Ferreira do Vales LDM, Braga Costa TM, Almeida SS. Effects of cafeteria diet and high fat diet intake on anxiety, learning and memory in adult male rats. Nutr Neurosci 2016; 20:396-408. [DOI: 10.1080/1028415x.2016.1149294] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Renata Tavares Beschizza Pini
- Laboratory of Nutrition and behavior, FFLCLRP, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14040-901, Brazil
| | | | - Telma Maria Braga Costa
- Nutrition Course, UNAERP, University of Ribeirão Preto, Avenida Costabile Romano, 2201, Ribeirão Preto, SP 14096-900, Brazil
| | - Sebastião Sousa Almeida
- Laboratory of Nutrition and behavior, FFLCLRP, University of São Paulo, Avenida dos Bandeirantes, 3900, Ribeirão Preto, SP 14040-901, Brazil
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Hayes S, Stoeckel N, Napolitano MA, Collins C, Wood GC, Seiler J, Grunwald HE, Foster GD, Still CD. Examination of the Beck Depression Inventory-II Factor Structure Among Bariatric Surgery Candidates. Obes Surg 2016; 25:1155-60. [PMID: 25392078 DOI: 10.1007/s11695-014-1506-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND The Beck Depression Inventory-II (BDI-II) is frequently used to evaluate bariatric patients in clinical and research settings; yet, there are limited data regarding the factor structure of the BDI-II with a bariatric surgery population. METHODS Exploratory factor analysis (EFA) using principal axis factoring with oblimin rotation was employed with data from 1228 consecutive presurgical bariatric candidates. Independent t tests were used to examine potential differences between sexes. Confirmatory factor analysis (CFA) was conducted with the next 383 consecutive presurgical patients to evaluate the proposed model based on EFA results. RESULTS EFA revealed three factors: negative perceptions, diminished vigor, and cognitive dysregulation, each with adequate internal consistency. Six BDI-II items did not load significantly on any of the three factors. CFA results largely supported the proposed model. CONCLUSIONS Results suggest that dimensions of depression for presurgical bariatric candidates vary from other populations and raise important caveats regarding the utility of the BDI-II in bariatric research.
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Affiliation(s)
- Sharon Hayes
- Department of Psychology, Keiser University, Port Saint Lucie Campus, 10330 South Federal Highway, Port St. Lucie, FL, 34952, USA,
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Edwards-Hampton SA, Wedin S. Preoperative psychological assessment of patients seeking weight-loss surgery: identifying challenges and solutions. Psychol Res Behav Manag 2015; 8:263-72. [PMID: 26604844 PMCID: PMC4639515 DOI: 10.2147/prbm.s69132] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Preoperative psychosocial assessment is the standard of care for patients seeking weight-loss surgery (WLS). However, the assessment procedure varies widely by surgery site. Comprehensive assessments can provide a wealth of information that assists both the patient and the treatment team, anticipate and prepare for challenges associated with extensive behavioral and lifestyle changes that are required postsurgery. In this review, we provide an overview of the purpose of the preoperative psychosocial assessment and domains to be included. Challenges commonly identified in the assessment are discussed, including maladaptive eating behaviors, psychiatric comorbidities, and alcohol use. Potential solutions and approaches to these challenges are provided. Additionally, patient populations requiring special consideration are presented to include adolescents, those with cognitive vulnerabilities, and aging adults.
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Affiliation(s)
- Shenelle A Edwards-Hampton
- Department of General Surgery, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, USA
| | - Sharlene Wedin
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Hayden MJ, Murphy KD, Brown WA, O'Brien PE. Axis I disorders in adjustable gastric band patients: the relationship between psychopathology and weight loss. Obes Surg 2015; 24:1469-75. [PMID: 24570091 DOI: 10.1007/s11695-014-1207-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Bariatric surgery candidates have higher rates of co-morbid psychological illnesses than those in the general population. The effect of weight loss on these illnesses is unclear. METHODS This prospective observational study explored psychiatric co-morbidities and weight loss outcomes in 204 gastric banding surgery candidates. Psychiatric co-morbidities were assessed prior to surgery and 2 years post-surgery. One hundred and fifty patients (74%) completed assessments at both time points. RESULTS At baseline, 39.7% of the patients met the criteria for a current axis I disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). Mood disorders were the most frequent (26.5%), followed by anxiety disorders (15.2%) and binge eating disorder (13.2%). Preoperative psychopathology predicted clinical psychopathology at 2 years. No preoperative or post-operative axis I disorder was significantly related to weight loss at 2 years. The frequency of current axis I disorders decreased significantly from 39.7% preoperatively to 20% 2 years post-surgery. CONCLUSIONS The point prevalence of psychopathology in this sample of Australian bariatric candidates is high. Psychopathology, preoperatively and at 2 years of follow-up, was not associated with weight loss at 2 years.
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Affiliation(s)
- M J Hayden
- Centre for Obesity Research and Education, Monash University, Melbourne, Australia,
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Burgmer R, Legenbauer T, Müller A, de Zwaan M, Fischer C, Herpertz S. Psychological outcome 4 years after restrictive bariatric surgery. Obes Surg 2015; 24:1670-8. [PMID: 24682804 DOI: 10.1007/s11695-014-1226-x] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Extreme obesity is associated with severe psychiatric and somatic comorbidity and impairment of psychosocial functioning. Bariatric surgery is the most effective treatment not only with regard to weight loss but also with obesity-associated illnesses. Health-related psychological and psychosocial variables have been increasingly considered as important outcome variables of bariatric surgery. However, the long-term impact of bariatric surgery on psychological and psychosocial functioning is largely unclear. The aim of this study was to evaluate the relationship between the course of weight and psychological variables including depression, anxiety, health-related quality of life (HRQOL), and self-esteem up to 4 years after obesity surgery.By standardized questionnaires prior to (T1) and 1 year (T2), 2 years (T3), and 4 years (T4) after surgery, 148 patients (47 males (31.8 %), 101 females (68.2 %), mean age 38.8 ± 10.2 years) were assessed.On average, participants lost 24.6 % of their initial weight 1 year after surgery, 25.1 % after 2 years, and 22.3 % after 4 years. Statistical analysis revealed significant improvements in depressive symptoms, physical dimension of quality of life, and self-esteem with peak improvements 1 year after surgery. These improvements were largely maintained. Significant correlations between weight loss and improvements in depression, physical aspects of HRQOL (T2, T3, and T4), and self-esteem (T3) were observed.Corresponding to the considerable weight loss after bariatric surgery, important aspects of mental health improved significantly during the 4-year follow-up period. However, parallel to weight regain, psychological improvements showed a slow but not significant decline over time.
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Affiliation(s)
- Ramona Burgmer
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Hospital, Ruhr University Bochum, Alexandrinenstraße 1-3, 44791, Bochum, Germany,
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Castanon N, Luheshi G, Layé S. Role of neuroinflammation in the emotional and cognitive alterations displayed by animal models of obesity. Front Neurosci 2015; 9:229. [PMID: 26190966 PMCID: PMC4490252 DOI: 10.3389/fnins.2015.00229] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/11/2015] [Indexed: 12/15/2022] Open
Abstract
Obesity is associated with a high prevalence of mood disorders and cognitive dysfunctions in addition to being a significant risk factor for important health complications such as cardiovascular diseases and type 2 diabetes. Identifying the pathophysiological mechanisms underlying these health issues is a major public health challenge. Based on recent findings, from studies conducted on animal models of obesity, it has been proposed that inflammatory processes may participate in both the peripheral and brain disorders associated with the obesity condition including the development of emotional and cognitive alterations. This is supported by the fact that obesity is characterized by peripheral low-grade inflammation, originating from increased adipose tissue mass and/or dysbiosis (changes in gut microbiota environment), both of which contribute to increased susceptibility to immune-mediated diseases. In this review, we provide converging evidence showing that obesity is associated with exacerbated neuroinflammation leading to dysfunction in vulnerable brain regions associated with mood regulation, learning, and memory such as the hippocampus. These findings give new insights to the pathophysiological mechanisms contributing to the development of brain disorders in the context of obesity and provide valuable data for introducing new therapeutic strategies for the treatment of neuropsychiatric complications often reported in obese patients.
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Affiliation(s)
- Nathalie Castanon
- Nutrition and Integrative Neurobiology, INRA, UMR 1286, Université de Bordeaux Bordeaux, France
| | - Giamal Luheshi
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University Montreal, Canada
| | - Sophie Layé
- Nutrition and Integrative Neurobiology, INRA, UMR 1286, Université de Bordeaux Bordeaux, France
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Alizai PH, Akkerman MK, Kaemmer D, Ulmer F, Klink CD, Ernst S, Mathiak K, Neumann UP, Perlitz V. Presurgical assessment of bariatric patients with the Patient Health Questionnaire (PHQ)--a screening of the prevalence of psychosocial comorbidity. Health Qual Life Outcomes 2015; 13:80. [PMID: 26059334 PMCID: PMC4460674 DOI: 10.1186/s12955-015-0278-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 05/28/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Bariatric surgery has gained increasing relevance due to the dramatic rise in morbid obesity prevalence. A sound body of scientific literature demonstrates positive long-term outcome of bariatric surgery in decreasing mental and physical health morbidity. Still, there is a need for a manageable presurgical screening to assess major mental disorders. The aim of this study was to assess the frequency of common psychiatric syndromes in bariatric surgery candidates using a computerized version of the Patient Health Questionnaire (PHQ). METHODS In a prospective cohort study from August 2009 to July 2011 morbidly obese individuals seeking bariatric treatment were evaluated for mental health disorders using the PHQ (computerized German version). RESULTS A total of 159 patients were included in this study. The median age of participants was 42 years, the median BMI was 49 kg/m(2). The PHQ revealed a prevalence of 84 % for mental health disorders, 50 % of the participants had three or more mental health disorders. A high somatic symptom burden (46 %), depressive syndromes (62 %) and anxiety disorders (29 %) were the most frequent psychiatric syndromes. The median number of psychiatric syndromes was 3 for women and 1 for men (p = 0.007). No correlation between BMI and a single syndrome or the sum of syndromes was observed. CONCLUSION 84 % of the patients seeking bariatric treatment were screened positive for at least one mental health disorder. The computerized PHQ with automated reporting appears to be a useful instrument for presurgical assessment of bariatric patients in routine medical settings.
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Affiliation(s)
- Patrick H Alizai
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Maren K Akkerman
- Department of Medicine, Luisenhospital Aachen, Academic teaching hospital of the RWTH Aachen University, Boxgraben 99, 52064, Aachen, Germany.
| | - Daniel Kaemmer
- Department of Surgery, St. Elisabeth Hospital Geilenkirchen, Martin-Heyden-Str. 32, 52511, Geilenkirchen, Germany.
| | - Florian Ulmer
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Christian D Klink
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Sabine Ernst
- Institute of Medical Statistics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Ulf P Neumann
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Volker Perlitz
- Department of General-, Visceral- and Transplantation Surgery, RWTH Aachen University Hospital, Pauwelsstr. 30, 52074, Aachen, Germany.
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Edwards-Hampton SA, Madan A, Wedin S, Borckardt JJ, Crowley N, Byrne KT. A closer look at the nature of anxiety in weight loss surgery candidates. Int J Psychiatry Med 2014; 47:105-13. [PMID: 25084797 DOI: 10.2190/pm.47.2.b] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Depression among weight loss surgery (WLS) candidates is common. Anxiety in this population is less studied. Untreated anxiety persists post-surgery and is associated with poor surgical outcomes. The current study sought to explore the nature of anxiety in WLS candidates. Given shared symptoms of anxiety and obesity, we hypothesized that physiological symptoms of anxiety would be most common. METHODS In this retrospective study, the medical records of 174 pre-WLS candidates at a large medical center were reviewed. Each completed a comprehensive medical, surgical, and psychological evaluation as part of standard of care. Data from these evaluations were abstracted. One hundred forty-three candidates completed the Beck Anxiety Inventory (BAI). A Principal Components Analysis (PCA) with varimax rotation was used to identify the factor structure of the BAI. RESULTS The sample consisted of primarily middle-aged (46.0 ± 13.24 years), married (60.8%), Caucasian (65.7%), females (79%) with Class III obesity (Body Mass Index = 50.1 ± 10.68) and mild anxiety (8.86 ± 8.70). Forty-four percent of the sample endorsed clinically significant anxiety. PCA revealed a four-factor structure that explained 56.28% of the variance in the BAI. The four factors were: 1) cognitive-emotional distress, 2) autonomic hyperarousal, 3) neurophysiologic concerns, and 4) body temperature. CONCLUSIONS Clinically significant anxiety is common among WLS candidates. Cognitive-emotional clustering of anxiety symptoms was more common than hypothesized. This is notable given the overlap of physiological symptoms of anxiety and obesity. Findings lend support for the utility of psychotherapeutic approaches tailored to address maladaptive thoughts to address anxiety and potentially improve WLS outcomes.
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Affiliation(s)
| | - Alok Madan
- The Menninger Clinic and Baylor College of Medicine, Houston, Texas
| | | | | | - Nina Crowley
- Medical University of South Carolina, Charleston
| | - Karl T Byrne
- Medical University of South Carolina, Charleston
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Danielsen KK, Sundgot-Borgen J, Mæhlum S, Svendsen M. Beyond weight reduction: improvements in quality of life after an intensive lifestyle intervention in subjects with severe obesity. Ann Med 2014; 46:273-82. [PMID: 24491067 DOI: 10.3109/07853890.2013.874660] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION We examined the effects of 10-14 weeks of inpatient intensive lifestyle intervention (ILI), including a minimum of 90 minutes of adapted physical activity 5 days/week, with regard to changes in quality of life and associations with weight loss in subjects with severe obesity. METHODS A total of 100 severely obese subjects (BMI 42.6 ± 5.3 kg/m(2); 42.7 ± 10.6 years) were included. Quality of life was assessed by Binge Eating Scale, Hospital Anxiety, and Depression Scale, and SF- 36. The ILI group completed the questionnaires at inclusion, after 10-14 weeks and 12 months, and controls at inclusion and after 10-14 weeks. RESULTS Compared to controls, self-reported binge eating (-6.4, P < 0.0001), anxiety (-1.7, P = 0.005), and depression (-3.0, P < 0.0001) were reduced, and physical (8.0, P < 0.0001) and mental (7.6, P < 0.0001) health increased in the ILI group. After 12 months, reduction in self-reported binge eating (-7.2, P < 0.0001) and depression (-3.4, P < 0.0001) and increase in physical (8.9, P < 0.0001) and mental (3.6, P = 0.035) health were maintained. Decreased self-reported binge eating (β = 0.555, P = 0.010) and increased physical health (β = -0.554, P = 0.003) were associated with weight loss. CONCLUSION ILI including a high volume of physical activity in subjects with severe obesity improved quality of life by favorable changes in self-reported binge eating, depression, and mental and physical health. Improvements in binge eating and physical health were associated with weight loss.
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Affiliation(s)
- Kjersti Karoline Danielsen
- Department of Sports Medicine, The Norwegian School of Sport Sciences , PO Box 4014 Ullevaal Stadion, 0806 Oslo , Norway
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Kapadia SG, Wei C, Bartlett SJ, Lang J, Wise RA, Dixon AE. Obesity and symptoms of depression contribute independently to the poor asthma control of obesity. Respir Med 2014; 108:1100-7. [PMID: 24947900 DOI: 10.1016/j.rmed.2014.05.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 05/23/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
Abstract
UNLABELLED Obesity is a major risk factor for poorly controlled asthma, but the reasons for poor asthma control in this patient population are unclear. Symptoms of depression have been associated with poor asthma control, and increase with higher body mass index (BMI). The purpose of this study was to assess whether depressive symptoms underlie poor asthma control in obesity. METHODS We determined the relationship between BMI, psychological morbidity and asthma control at baseline in a well-characterized patient population participating in a clinical trial conducted by the American Lung Association-Asthma Clinical Research Centers. RESULTS Obese asthmatic participants had increased symptoms of depression (Center for Epidemiologic Studies Depression Scale score in lean 10.1 ± 8.1, overweight 10.0 ± 8.1, obese 12.4 ± 9.9; p = 0.03), worse asthma control (Juniper Asthma Control Questionnaire score in lean 1.43 ± 0.68, overweight 1.52 ± 0.71, obese 1.76 ± 0.75; p < 0.0001), and worse asthma quality of life (scores in lean 5.21 ± 1.08, overweight 5.08 ± 1.05, obese 4.64 ± 1.09; p < 0.0001). Asthmatics with obesity and those with symptoms of depression both had a higher risk of having poorly controlled asthma (adjusted odds ratio of 1.83 CI 1.23-3.52 for obesity, and 2.08 CI 1.23-3.52 for depression), but there was no interaction between the two. CONCLUSION Obesity and symptoms of depression are independently associated with poor asthma control. As depression is increased in obese asthmatics it may be an important co-morbidity contributing to poor asthma control in this population, but factors other than depression also contribute to poor asthma control in obesity.
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Affiliation(s)
- S G Kapadia
- University of Vermont College of Medicine, Burlington, VT, USA
| | - C Wei
- Johns Hopkins University, Baltimore, MD, USA
| | | | - J Lang
- Nemours Children's Hospital, Orlando, FL, USA
| | - R A Wise
- Johns Hopkins University, Baltimore, MD, USA
| | - A E Dixon
- University of Vermont College of Medicine, Burlington, VT, USA.
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Health-related quality of life in morbid obesity: the impact of laparoscopic sleeve gastrectomy. Open Med (Wars) 2014. [DOI: 10.2478/s11536-013-0294-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
AbstractOur aim in this prospective study was to determine the impact of laparoscopic sleeve gastrectomy on the quality of life of patients with morbid obesity in comparison with population standards. The study evaluated 76 morbidly obese patients who underwent laparoscopic sleeve gastrectomy. The short version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF) was used to evaluate quality of life in the following four areas: physical health, mental health, social relations, and environment. Patients completed the questionnaire before their planned operation and again 3 and 6 months after surgery. Compared with the population standard, patients with morbid obesity had significantly lower quality of life scores in the physical and mental health domains, including on independent questions related to of overall health and quality of life (p<0.001). Women scored lower on indicators of mental health than men. Three and 6 months following surgery a significant trend of body mass index (BMI) reduction was seen, as well as increased quality of life in all indicated areas (p<0.001). Laparoscopic sleeve gastrectomy treatment in morbidly obese patients reduced BMI on a long-term basis, a change seen as early as 3 months after surgery. By 6 months after surgery, patients had the same quality of life scores as the reference population.
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Aasprang A, Andersen JR, Våge V, Kolotkin RL, Natvig GK. Five-year changes in health-related quality of life after biliopancreatic diversion with duodenal switch. Obes Surg 2014; 23:1662-8. [PMID: 23722527 PMCID: PMC3769581 DOI: 10.1007/s11695-013-0994-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Background Long-term data of health-related quality of life (HRQL) after biliopancreatic diversion with duodenal switch (BPDDS) procedure are lacking. The aim of this study was to evaluate changes in HRQL from baseline to 5 years after BPDDS. Methods Fifty morbidly obese patients were followed for 5 years after BPDDS procedure. The sample consisted of 27 women and 23 men, the mean age was 37.8 years, and the mean body mass index (BMI) was 51.7 units. HRQL was measured with the Short Form 36 questionnaire (SF-36). Anxiety and depression were measured with the Hospital Anxiety and Depression Scale (HADS). Linear mixed model was used to investigate the change scores. The SF-36 scores and HADS scores of the sample were also compared with a Norwegian population norm, adjusted for age, gender, and BMI. Results Mental summary scores (MCS) and physical summary scores (PCS) were very low preoperatively but significantly improved (P < 0.05) 5 years after surgery. The PCS was comparable to the population norm, while MCS was lower. Depression improved significantly from baseline to the 5-year follow-up (P = 0.004), but anxiety did not (P = 0.595). Conclusions This study demonstrates a sustained weight loss and improved, although somewhat fading, HRQL scores 5 years after BPDDS. The study also shows that BPDDS is associated with a sustained reduction in depression symptoms but not in anxiety symptoms.
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Affiliation(s)
- Anny Aasprang
- Faculty of Health Studies, Sogn og Fjordane University College, Vievegen 2, 6800, Førde, Norway,
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Assari S. Additive Effects of Anxiety and Depression on Body Mass Index among Blacks: Role of Ethnicity and Gender. Int Cardiovasc Res J 2014; 8:44-51. [PMID: 24936480 PMCID: PMC4058483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 01/21/2014] [Accepted: 02/05/2014] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Most studies on mental health associates of obesity have focused on depression and less is known about the role of anxiety in obesity. OBJECTIVES This study compared the additive effects of General Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) on Body Mass Index (BMI) across sub-populations of Blacks based on the intersection of ethnicity and gender. METHODS Data came from the National Survey of American Life (NSAL), 2001 - 2003. The participants consisted of 3,570 African Americans and 1,621 Caribbean Blacks. Twelve-month MDD and GAD were determined using the World Mental Health Composite International Diagnostic Interview (CIDI). Levels of BMI were categorized based on being equal to or larger than 25, 30, 35, and 40 kg/m(2). We fitted linear regression models specific for our groups, which were defined based on the intersection of ethnicity and gender. Additionally, age, education, marital status, employment, and region were controlled. RESULTS Among Caribbean Black men and African American women, lifetime GAD, but not MDD, was associated with high BMI. Among Caribbean Black women, lifetime MDD, but not GAD, was associated with high BMI. CONCLUSIONS Intersection of ethnicity and gender may determine how anxiety and depression are associated with BMI among Blacks. Sub-populations of Blacks (e.g. based on ethnicity and gender) may have specific mental health determinants or consequences of obesity. Future research should investigate how and why the additive effects of anxiety and depression on obesity vary across ethnic and gender groups of Blacks.
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Affiliation(s)
- Shervin Assari
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Dietary restriction reverses obesity-induced anhedonia. Physiol Behav 2014; 128:126-32. [PMID: 24518861 DOI: 10.1016/j.physbeh.2014.01.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/22/2014] [Accepted: 01/24/2014] [Indexed: 01/21/2023]
Abstract
Obesity-induced changes in the metabolic and endocrine milieu elicit deficits in neuroplasticity, including increased risk for development of neuropsychiatric disorders such as depressive illness. We previously demonstrated that downregulation of hypothalamic insulin receptors (hypo-IRAS) elicits a phenotype that is consistent with features of the metabolic syndrome (MetS) and that rats with this phenotype exhibit deficits in neuronal plasticity, including depressive-like behaviors such as anhedonia. Since food restriction paradigms effectively inhibit obesity-induced neuroplasticity deficits, the aim of the current study was to determine whether food restriction could reverse obesity-induced anhedonia in hypo-IRAS rats. Compared to hypo-IRAS rats provided ad lib food access, food restriction paradigms that were initiated either prior to increases in body weight or following development of the MetS/obesity phenotype effectively restored sucrose intake in hypo-IRAS rats. Moreover, food restriction paradigms were able to prevent and reverse the changes in the endocrine/metabolic/inflammatory milieu observed in hypo-IRAS, such as increases in plasma leptin and triglyceride levels and increases in pro-inflammatory cytokines such as IL-1α, IL-6 and C-reactive protein (CRP). Collectively, these results demonstrate that obesity-induced anhedonia is a reversible process and identify some potential mechanistic mediators that may be responsible for co-morbid depression in obesity.
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Assari S. Association Between Obesity and Depression Among American Blacks: Role of Ethnicity and Gender. J Racial Ethn Health Disparities 2014. [DOI: 10.1007/s40615-014-0007-5] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Castanon N, Lasselin J, Capuron L. Neuropsychiatric comorbidity in obesity: role of inflammatory processes. Front Endocrinol (Lausanne) 2014; 5:74. [PMID: 24860551 PMCID: PMC4030152 DOI: 10.3389/fendo.2014.00074] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 05/02/2014] [Indexed: 01/22/2023] Open
Abstract
Neuropsychiatric symptoms are frequent in obesity. In addition to their substantial economic and health impact, these symptoms significantly interfere with the quality of life and social function of obese individuals. While the pathophysiological mechanisms underlying obesity-related neuropsychiatric symptoms are still under investigation and remain to be clearly identified, there is increasing evidence for a role of inflammatory processes. Obesity is characterized by a chronic low-grade inflammatory state that is likely to influence neuropsychiatric status given the well-known and highly documented effects of inflammation on brain activity/function and behavior. This hypothesis is supported by recent findings emanating from clinical investigations in obese subjects and from experimentations conducted in animal models of obesity. These studies converge to show that obesity-related inflammatory processes, originating either from the adipose tissue or gut microbiota environment, spread to the brain where they lead to substantial changes in neurocircuitry, neuroendocrine activity, neurotransmitter metabolism and activity, and neurogenesis. Together, these alterations contribute to shape the propitious bases for the development of obesity-related neuropsychiatric comorbidities.
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Affiliation(s)
- Nathalie Castanon
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), French National Institute for Agricultural Research (INRA), Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), University of Bordeaux, Bordeaux, France
| | - Julie Lasselin
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), French National Institute for Agricultural Research (INRA), Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), University of Bordeaux, Bordeaux, France
- Stress Research Institute (Stressforskningsinstitutet), Stockholm University, Stockholm, Sweden
| | - Lucile Capuron
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), French National Institute for Agricultural Research (INRA), Bordeaux, France
- UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), University of Bordeaux, Bordeaux, France
- *Correspondence: Lucile Capuron, UMR 1286, Laboratory of Nutrition and Integrative Neurobiology (NutriNeuro), INRA, University of Bordeaux, 146 rue Léo Saignat, F-33076 Bordeaux, France e-mail:
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Deliopoulou K, Konsta A, Penna S, Papakostas P, Kotzampassi K. The impact of weight loss on depression status in obese individuals subjected to intragastric balloon treatment. Obes Surg 2013; 23:669-75. [PMID: 23299506 DOI: 10.1007/s11695-012-0855-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Although depression is considered to be significantly related to morbid obesity disorder, no information exists on the evolution of depression status after weight loss, in particular when an intragastric balloon is used. This prospective 6-month study examines both the effect on depression status and the relation of weight loss to depression in morbidly obese patients treated by intragastric balloon. METHODS One hundred consecutive females fulfilling criteria for balloon treatment were assessed for depression and divided into two groups (65 depressed, 35 non-depressed). Obesity-related parameters were comparable. RESULTS During the treatment period, the depression status of the mildly, moderately, and severely depressed patients improved from 40, 32.3, and 27.7 % to 20, 7.7, and 1.5 %, respectively, with 70.8 % finally exhibiting no depression at all. During the same period, body weight, BMI, body fat, and excess weight loss (EWL) were comparable between all groups, the range of BMI affecting neither the depression score nor the reduction of obesity parameters. However, there was a significant [percentage of EWL >30] weight loss difference in favor of those who were less severely depressed initially. CONCLUSION The degree of weight loss observed in obese depressed females-being comparable to that achieved by non-depressed females-after intragastric balloon insertion was found to positively affect their depression status.
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Affiliation(s)
- Kyriaki Deliopoulou
- Department of Surgery, Aristotle's University of Thessaloniki, Thessaloniki, Greece
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Coulman KD, Abdelrahman T, Owen-Smith A, Andrews RC, Welbourn R, Blazeby JM. Patient-reported outcomes in bariatric surgery: a systematic review of standards of reporting. Obes Rev 2013; 14:707-20. [PMID: 23639053 DOI: 10.1111/obr.12041] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 03/20/2013] [Accepted: 04/01/2013] [Indexed: 12/01/2022]
Abstract
Bariatric surgery is increasingly being used to treat severe obesity, but little is known about its impact on patient-reported outcomes (PROs). For PRO data to influence practice, well-designed and reported studies are required. A systematic review identified prospective bariatric surgery studies that used validated PRO measures. Risk of bias in randomized controlled trials (RCTs) was assessed, and papers were examined for reporting of (i) who completed PRO measures; (ii) missing PRO data and (iii) clinical interpretation of PRO data. Studies meeting all criteria were classified as robust. Eighty-six studies were identified. Of the eight RCTs, risk of bias was high in one and unclear in seven. Sixty-eight different PRO measures were identified, with the Short Form (SF)-36 questionnaire most commonly used. Forty-one (48%) studies explicitly stated measures were completed by patients, 63 (73%) documented missing PRO data and 50 (58%) interpreted PRO data clinically. Twenty-six (30%) met all criteria. Although many bariatric surgery studies assess PROs, study design and reporting is often poor, limiting data interpretation and synthesis. Well-designed studies that include agreed PRO measures are needed with reporting to include integration with clinical outcomes to inform practice.
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Affiliation(s)
- K D Coulman
- Centre for Surgical Research, School of Social and Community Medicine, University of Bristol, Bristol, UK; Department of Bariatric and Upper GI Surgery, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, Taunton, Somerset, UK
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Predictive factors for comorbid psychiatric disorders and their impact on vision-related quality of life in patients with high myopia. Int Ophthalmol 2013; 34:171-83. [PMID: 23783655 DOI: 10.1007/s10792-013-9805-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 05/21/2013] [Indexed: 12/22/2022]
Abstract
To determine the incidence of depression and anxiety disorders in patients with high myopia as well as the factors that would predict the development of psychiatric complications and their impact on vision-related quality of life (VR-QoL). Two hundred and five patients with pathologic myopia (axial length ≥26.50 mm) were studied. Incidence of depression and anxiety disorders was determined using the Hospital Anxiety and Depression Scale (HADS). VR-QoL was determined by the 25-item National Eye Institute Visual Function Questionnaire. Incidence of depression was 22.0 % and incidence of anxiety disorder was 25.9 %. Absence of children was the only factor significantly associated with the presence of depression, and a past history of cataract surgery was the only factor significantly associated with the presence of anxiety disorder. Factors which decreased the VR-QoL were in order of importance--anxiety disorder, decreased visual acuity in the best eye, depression, and being female. Responses of the subjects to two HADS statements 'I can laugh and see the funny side of things' and 'I can enjoy a good book or radio or television program' identified 82.2 % of depressed patients, and 'I get sudden feelings of panic' and 'I can sit at ease and feel relaxed' identified 71.7 % of patients with anxiety disorder. Twenty-two to 26 % of highly myopic patients had psychiatric disorders which had a strong negative impact on their VR-QoL. Two statements from the HADS questionnaire can be used to screen highly myopic patients for depression or anxiety disorders.
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The biliopancreatic diversion with a duodenal switch (BPDDS): how is it optimally performed? Obes Surg 2012; 21:1864-9. [PMID: 21874519 DOI: 10.1007/s11695-011-0496-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The biliopancreatic diversion with duodenal switch can be performed by different combinations of restriction and malabsorption. The aim of this study was to evaluate weight loss and potential side effects for two variants of the procedure. METHODS All patients eligible for a 2-year follow-up (n = 182) was included in the study. Thirty-five patients (group A) had a gastric remnant with a volume of approximately 200 ml, an alimentary limb (AL) of 250 cm, and a common channel (CC) of 100 cm, while 147 patients (group B) had a gastric remnant of 100-120 ml, an AL of 40%, and a CC of 10% of the small bowel length. Preoperative variables, such as body mass index (BMI), sex, age, and factors that might influence weight loss, and postoperative weight loss and side effects were registered and compared. RESULTS Preoperatively, the BMI was 50.6 in group A and 52.1 in group B (ns), with no difference in age, sex, or variables that might influence weight loss. At 2 years, the BMI was 33.1 in group A (n = 34) and 28.5 in group B (n = 119) with an adjusted difference in weight loss of 5.6 BMI units between the groups (p < 0.001). Vitamin D status was also better in group B than in group A at follow-up, while there was no difference in side effects. CONCLUSIONS Patients with a remnant stomach of 100-120 ml, and AL and CC with individually adapted lengths had a larger weight loss and better vitamin D status postoperatively without an increase in side effects.
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Lund RS, Karlsen TI, Hofsø D, Fredheim JM, Røislien J, Sandbu R, Hjelmesæth J. Employment is associated with the health-related quality of life of morbidly obese persons. Obes Surg 2012; 21:1704-9. [PMID: 20953731 PMCID: PMC3215889 DOI: 10.1007/s11695-010-0289-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background We aimed to investigate whether employment status was associated with health-related quality of life (HRQoL) in a population of morbidly obese subjects. Methods A total of 143 treatment-seeking morbidly obese patients completed the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) and the Obesity and Weight-Loss Quality of Life (OWLQOL) questionnaires. The former (SF-36) is a generic measure of physical and mental health status and the latter (OWLQOL) an obesity-specific measure of emotional status. Multiple linear regression analyses included various measures of the HRQoL as dependent variables and employment status, education, marital status, gender, age, body mass index (BMI), type 2 diabetes, hypertension, obstructive sleep apnea, and treatment choice as independent variables. Results The patients (74% women, 56% employed) had a mean (SD, range) age of 44 (11, 19–66) years and a mean BMI of 44.3 (5.4) kg/m2. The employed patients reported significantly higher HRQoL scores within all eight subscales of SF-36, while the OWLQOL scores were comparable between the two groups. Multiple linear regression confirmed that employment was a strong independent predictor of HRQoL according to the SF-36. Based on part correlation coefficients, employment explained 16% of the variation in the physical and 9% in the mental component summaries of SF-36, while gender explained 22% of the variation in the OWLQOL scores. Conclusion Employment is associated with the physical and mental HRQoL of morbidly obese subjects, but is not associated with the emotional aspects of quality of life.
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Affiliation(s)
- Randi Størdal Lund
- Morbid Obesity Centre, Vestfold Hospital Trust, Boks 2168, 3103, Tønsberg, Norway.
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Toulabi T, Khosh Niyat Nikoo M, Amini F, Nazari H, Mardani M. The influence of a behavior modification interventional program on body mass index in obese adolescents. J Formos Med Assoc 2012; 111:153-9. [PMID: 22423669 DOI: 10.1016/j.jfma.2011.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Revised: 02/01/2011] [Accepted: 05/04/2011] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND/PURPOSE The prevalence of obesity and overweight among children and adolescents is increasing rapidly. The present research was performed to determine the influence of a ''behavior modification'' program on body mass index (BMI) in obese public high school students in Iran. METHODS In this study, 152 adolescence and their parents were selected from 12 high schools of Khorram Abad from 2004 to 2006, and they were randomly assigned to either the intervention or the control groups. The "behavior modification" interventional program consisted of nutritional education, modifying dietary habits, teaching exercise programs, teaching nutritional facts to the parents, and performing exercises 3 days a week. The height and weight as well as waist, hip, and wrist circumferences of the participants were measured before and after implementing the interventional program. BMI and waist to hip ratio (WHR) were calculated. The adolescents and parents completed a nutrition knowledge questionnaire. Adolescents also completed the Beck's Depression Questionnaire. RESULTS Adolescent's mean weight, BMI, and waist and hip circumferences decreased significantly after implementing the interventional program, in the intervention group (p≤0.001). In addition, the students' and parents' nutrition knowledge increased in the intervention group after implementing the interventional program (p<0.046). The symptoms of depression decreased and the frequency of students without symptoms of depression increased in the case group, but it did not reveal a statistically significant difference between case and control groups. CONCLUSION The ''behavior modification'' interventional program is effective in reducing BMI in obese students, and therefore, school principals and planners can play an important role in controlling obesity by implementing this program via the students, their parents, and the school staff.
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Affiliation(s)
- Tahereh Toulabi
- Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorram Abad, Iran.
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