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Ramos R, Vaz A, Rodrigues TF, Pinto-Bastos A, Brandão I, Neves A, Conceição E, Machado PPP. Corrigendum: Severe and enduring' stage in anorexia nervosa: comparing eating attitudes, impairment and associated psychopathology. Front Nutr 2023; 10:1292404. [PMID: 37810916 PMCID: PMC10557252 DOI: 10.3389/fnut.2023.1292404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnut.2022.867401.].
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Affiliation(s)
- Rita Ramos
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Vaz
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Tânia F. Rodrigues
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Pinto-Bastos
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Isabel Brandão
- Psychiatry Department, Hospital of S. João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - António Neves
- Eating Disorders Unit, Psychiatry Department, Hospital of Santa Maria, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
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González A, Conceição E, Teixeira JA, Nobre C. In vitro models as a tool to study the role of gut microbiota in obesity. Crit Rev Food Sci Nutr 2023:1-12. [PMID: 37403775 DOI: 10.1080/10408398.2023.2232022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Obesity, a highly prevalent condition worldwide that leads to the development of multiple metabolic diseases, has been related to gut microbial dysbiosis. To understand this correlation, in vivo models have been extremely useful. However, its use is limited by associated ethical concerns, high costs, low representativeness, and low reproducibility. Therefore, new and improved in vitro models have been developed in recent years, representing a promising tool in the study of the role of gut microbiota modulation in weight management and metabolic health. This review aims to provide an update on the main findings obtained in vitro regarding gut microbiota modulation with probiotics, and food compounds, and its interaction with the host metabolism, associated with obesity. Available in vitro colon models currently used to study obesity are discussed, including batch and dynamic fermentation systems, and models that allow the study of microbiota-host interactions using cell cultures. In vitro models have demonstrated that homeostatic microbiota may help overcome obesity by producing satiety-related neurotransmitters and metabolites that protect the gut barrier and improve the metabolic activity of adipose tissue. In vitro models may be the key to finding new treatments for obesity-related disorders.
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Affiliation(s)
- Abigail González
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
| | - Eva Conceição
- CIPsi - Psychology Research Centre, University of Minho Campus de Gualtar, Braga, Portugal
| | - José António Teixeira
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS -Associate Laboratory, Braga, Portugal
| | - Clarisse Nobre
- CEB - Centre of Biological Engineering, University of Minho, Braga, Portugal
- LABBELS -Associate Laboratory, Braga, Portugal
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Ramalho SM, Conceição E, Tavares AC, Freitas AL, Machado BC, Gonçalves S. Loss of Control over Eating, Inhibitory Control, and Reward Sensitivity in Children and Adolescents: A Systematic Review. Nutrients 2023; 15:2673. [PMID: 37375576 DOI: 10.3390/nu15122673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
OVERVIEW In recent years, there has been increasing clinical and empirical interest in the concept of pediatric loss of control over eating, particularly about its link with the executive functions related to the concept of impulsivity, such as inhibitory control and reward sensitivity. However, there has yet to be a comprehensive literature synthesis about the associations between these variables. A comprehensive literature synthesis would help identify future research directions to advance the field in this area. Therefore, this systematic review aimed to synthesize evidence concerning the associations between loss of control over eating, inhibitory control, and reward sensitivity in children and adolescents. METHODS The systematic review was conducted according to the guidelines proposed by PRISMA in Web of Science, Scopus, PubMed, and PsycINFO. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. RESULTS Twelve studies met the selection criteria and were included in the final review. Overall, methodological heterogeneity, variability in assessment methods, and the age of participants make it difficult to draw general conclusions. Nevertheless, most studies with community samples of adolescents indicate that inhibitory control difficulties are linked to the concept of loss of control eating. The presence of obesity seems to be associated with inhibitory control difficulties, regardless of the presence of loss of control eating. Studies on reward sensitivity are scarcer. However, it has been suggested that higher reward sensitivity is related to loss of control eating behaviors in young people, particularly binge eating. CONCLUSIONS The literature on the link between loss of control eating and trait-level facets of impulsivity (low inhibitory control and higher reward sensitivity) among young people remains limited, and more studies on children are needed. Findings from this review may make healthcare professionals more aware of the potential clinical importance of targeting the trait-level facets of impulsivity and help to inform existing and future weight-loss/maintenance interventions in childhood and adolescence.
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Affiliation(s)
- Sofia Marques Ramalho
- Centro de Investigação em Psicologia para o Desenvolvimento (CIPD), 4100-346 Porto, Portugal
- Instituto de Psicologia e de Ciências da Educação, Universidade Lusíada (Porto), 4100-348 Porto, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Ana Cristina Tavares
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Ana Luísa Freitas
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
| | - Bárbara César Machado
- Research Centre for Human Development (CEDH), Faculdade de Educação e Psicologia, Portuguese Catholic University, 4169-005 Porto, Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, 4704-553 Braga, Portugal
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Conceição E, Hilbert A. Atypical anorexia nervosa after bariatric surgery and the DSM-5 diagnostic criteria: Commentary on Walsh et al. (2023). Int J Eat Disord 2023; 56:831-834. [PMID: 36727598 DOI: 10.1002/eat.23908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 02/03/2023]
Abstract
The applicability of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for anorexia nervosa (AN) and atypical AN to individuals having undergone bariatric surgery poses several challenges due to the atypical presentation of AN-like symptoms in this population. We describe these challenges, propose modifications to the corresponding diagnostic criteria, and delineate areas of research to inform possible adaptations of atypical AN criteria with applicability to postbariatric surgery populations. We discuss the utility of a strict definition of "significantly low weight" and "significant weight loss" as part of DSM-5 Criterion A for AN and atypical AN, highlighting the importance of clinical judgment. We also question the clinical distinction between AN and atypical AN based solely on weight and argue that the hallmark feature of both diagnoses in postbariatric surgery populations should be persistent energy intake restriction coupled with persistent weight-control behaviors. Finally, criteria B and C need to allow the distinction between common concerns of bariatric surgery patients regarding weight and eating, and clinically relevant symptoms of atypical AN and AN. Knowing the rates, the specificities, and the impact of atypical AN on postsurgical weight loss has important implications for the clinical attention of these often-overlooked patients.
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Affiliation(s)
- Eva Conceição
- Psychotherapy and Psychopathology Research Lab-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Ramos R, Vaz A, Rodrigues TF, Pinto-Bastos A, Brandão I, Neves A, Conceição E, Machado PPP. Severe and Enduring' Stage in Anorexia Nervosa: Comparing Eating Attitudes, Impairment and Associated Psychopathology. Front Nutr 2022; 9:867401. [PMID: 35419398 PMCID: PMC8995558 DOI: 10.3389/fnut.2022.867401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
This study aimed to assess differences in eating attitudes, impairment, and related psychopathology at treatment presentation for patients with "Non-severe and enduring Anorexia Nervosa" (illness duration of <7 years) and patients with "severe and enduring Anorexia Nervosa" (illness duration of 7 years or more). One hundred and thirty-nine patients diagnosed with Anorexia Nervosa participated in this study. Participants were interviewed with the Eating Disorder Examination (EDE) and asked to complete several questionnaires at the end of the first treatment appointment. We also explored differences at treatment presentation by considering alternative criteria to define groups, namely a composite of illness duration and clinical impairment (≥16 CIA total score). No differences were found when comparing participants based on illness duration. However, when participants were classified into a different classification scheme: "Non-severe and enduring Anorexia Nervosa" (illness duration <7 years and a CIA total score <16) vs. "severe and enduring Anorexia Nervosa" (illness duration ≥7 years and CIA total score ≥16), significant differences were found in terms of eating pathology, depressive symptomatology, psychological distress, and emotion dysregulation. Further research is needed to better understand the role of illness duration and clinical impairment in informing the course of AN.
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Affiliation(s)
- Rita Ramos
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Vaz
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Tânia F. Rodrigues
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana Pinto-Bastos
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Isabel Brandão
- Psychiatry Department, Hospital of S. João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - António Neves
- Eating Disorders Unit, Psychiatry Department, Hospital of Santa Maria, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Lab - CIPsi, School of Psychology, University of Minho, Braga, Portugal
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6
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Ramalho SM, Trovisqueira A, de Lourdes M, Gonçalves S, Ribeiro I, Vaz AR, Machado PPP, Conceição E. The impact of COVID-19 lockdown on disordered eating behaviors: the mediation role of psychological distress. Eat Weight Disord 2022; 27:179-188. [PMID: 33713336 PMCID: PMC7955211 DOI: 10.1007/s40519-021-01128-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/22/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE This study aimed to explore the early associations between the experienced psychosocial impact of the COVID-19 pandemic crisis during lockdown, depressive symptomatology, anxiety/stress levels, and disordered eating behaviors in adults during a first COVID-19 lockdown period. METHODS This was a community-based cross-sectional study assessing 254 Portuguese adults (82.7% women; 35.82 ± 11.82 years) 1 week after the end of the first mandatory COVID-19 lockdown in Portugal. An online survey was conducted to evaluate psychological distress, disordered eating, and psychosocial impact of the COVID-19 pandemic. Pearson correlations and Structural Equation Modeling were performed. RESULTS Participants reported the presence of meal skipping (52.8%), grazing eating behavior (80.9%), overeating (81.0%), loss of control over eating (47.2%), and binge eating episodes (39.2%) during lockdown. Structural equation modeling analyses, controlling for age and sex, indicated that there was a significant indirect effect of the experienced psychosocial impact of COVID-19 pandemic on disordered eating behaviors mediated through psychological distress. CONCLUSION The psychosocial impact of the COVID-19 pandemic crisis may lead to disordered eating, and this relation may occur through the elevation of psychological distress. These findings can be used to inform interventions, to enhance mental health and manage disordered eating during similar future situations. Level of evidence V: cross-sectional descriptive study.
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Affiliation(s)
- Sofia M Ramalho
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal.
| | - Ana Trovisqueira
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Marta de Lourdes
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Inês Ribeiro
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana R Vaz
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Paulo P P Machado
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057, Braga, Portugal
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Ramalho SM, Saint-Maurice PF, Félix S, Conceição E. Intuitive eating Scale-2: Factor structure and associations with disordered eating, impulsivity and quality of life in adolescents with overweight/obesity. Eat Behav 2022; 44:101593. [PMID: 34954449 DOI: 10.1016/j.eatbeh.2021.101593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 09/18/2021] [Accepted: 12/08/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The Intuitive Eating Scale-2 (IES-2) has been shown to be a valid tool to assess the capability of eating in reaction to natural hunger/satiety cues. However, its factor structure seems to differ in function of cultural/socioeconomic backgrounds, and its psychometric properties among the adolescents with overweight/obesity (BMI-for-age percentile >85th) have not been examined yet. Thus, this study aims to 1) investigating the factorial structure/psychometric properties of IES-2 in adolescents with overweight/obesity; and 2) exploring the associations between impulsivity, quality of life disordered and intuitive eating. METHODS A total of 202 Portuguese adolescents (124 girls; 78 boys; 12-19 years) under weight-loss treatment with a mean BMI z-score of 2.41 (SD = 0.75) participated in this study. The IES-2 factor structure was explored by confirmatory factor analysis and bifactor models. Test-retest reliability analyses were performed over 6 months (n = 41) and associations between the variables under study were explored. RESULTS Confirmatory factor analyses with posthoc modifications resulted in a bifactor model with acceptable fit supporting one general factor (intuitive eating) and three specific factors (IES-2 subscales). The "Unconditional Permission to Eat" subscale could not be replicated in this sample. Test-retest reliability analyses suggested good temporal stability. Intuitive eating scores were negatively associated with grazing eating behavior and impulsivity (negative urgency) and positively linked to quality of life. CONCLUSIONS An adjusted version of IES-2 can be an appropriate measure for assessing intuitive eating levels in adolescents with overweight/obesity. Research on intuitive eating has the potential to enhance pediatric weight-loss interventions.
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Affiliation(s)
- Sofia M Ramalho
- Psychotherapy and Psychopathology Research Unit - Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal.
| | - Pedro F Saint-Maurice
- National Institutes of Health, National Cancer Institute, 9609 Medical Center Drive, Room- 6E572, Rockville, MD 20850, United States of America.
| | - Sílvia Félix
- Psychotherapy and Psychopathology Research Unit - Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal.
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit - Psychology Research Centre, School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal.
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Félix S, Ramalho S, Ribeiro E, Pinheiro J, de Lourdes M, Gonçalves S, Conceição E. Experiences of parent-adolescent dyads regarding a Facebook-based intervention to improve overweight/obesity treatment in adolescents: A qualitative study. Appl Psychol Health Well Being 2021; 14:122-139. [PMID: 34286907 DOI: 10.1111/aphw.12294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 06/30/2021] [Indexed: 11/27/2022]
Abstract
APOLO-Teens is a Facebook-based psychological intervention aiming to optimize hospital treatment for adolescents with overweight/obesity. The present qualitative study aims to explore (1) how adolescents experienced participation in APOLO-Teens and (2) how parents perceived adolescents' participation. Sixteen adolescent-parent dyads were interviewed by telephone using semistructured guides. An inductive approach of thematic analysis was used to analyze data by two independent codifiers. The consensus was used to resolve differences in coding/themes, and two independent auditors reviewed the codes and the themes proposed. We identified four themes from adolescents' interviews, namely, expectations, perception of outcomes, participation in the intervention, and sharing of acquired knowledge. From parents' interviews, we identified five themes: expectations for son/daughter participation, perception of adolescents' outcomes, son/daughter participation, parental role, and use of social networks in intervention programs for adolescents. Both elements of the dyad indicated that adolescents' participation in APOLO-Teens contributed to favorable outcomes, further highlighting the use of online interventions to complement the hospital treatment of adolescents with overweight/obesity. Future studies should address the viewpoints of adolescents and parents in the design of Facebook-based interventions, namely, to implement tailored, shorter, less time-demanding interventions that favor engagement between participants and parental involvement.
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Affiliation(s)
- Sílvia Félix
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Sofia Ramalho
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Eugénia Ribeiro
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Joana Pinheiro
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Marta de Lourdes
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit-Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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de Lourdes M, Cerqueira L, Pinto-Bastos A, Marôco J, Palmeira L, Brandão I, Vaz AR, Conceição E. Understanding Uncontrolled Eating after Bariatric Surgery: The Role of Excessive Skin and Body Image Shame. J Clin Med 2021; 10:jcm10132967. [PMID: 34279452 PMCID: PMC8268132 DOI: 10.3390/jcm10132967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 12/03/2022] Open
Abstract
Excess skin and disordered eating behaviors are referred to as some of the major negative consequences of bariatric surgery as well as body image shame. This study sought to explore how discomfort with excessive skin, body image shame, psychological distress, eating-related psychopathology, and negative urgency interact to understand uncontrolled eating among woman submitted to bariatric surgery. A cross-sectional sample of 137 women was evaluated postoperatively through self-report questionnaires assessing discomfort with excess skin, body image shame, eating-related psychopathology, negative urgency, and uncontrolled eating in a hospital center in the north of Portugal. Pearson correlations and Structural Equation Modeling (SEM) were performed. Body image shame mediated the relationship between discomfort with excess skin and eating-related psychopathology. In turn, the relationship between eating-related psychopathology and uncontrolled eating was mediated by negative urgency. This study highlights the impact of excess skin and body image shame on eating behavior post-bariatric-surgery. Considering the proven impact of uncontrolled eating on weight-loss results post-surgery, understanding the mechanisms underlying this problem is highly important. Our findings provide helpful insight for multidisciplinary teams committed to providing care to bariatric patients struggling with body image and eating difficulties.
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Affiliation(s)
- Marta de Lourdes
- School of Psychology, University of Minho, 4710-057 Braga, Portugal; (M.d.L.); (L.C.); (A.P.-B.); (A.R.V.)
| | - Luísa Cerqueira
- School of Psychology, University of Minho, 4710-057 Braga, Portugal; (M.d.L.); (L.C.); (A.P.-B.); (A.R.V.)
| | - Ana Pinto-Bastos
- School of Psychology, University of Minho, 4710-057 Braga, Portugal; (M.d.L.); (L.C.); (A.P.-B.); (A.R.V.)
| | - João Marôco
- William James Centre for Research, ISPA–Instituto Universitário, 1100-304 Lisboa, Portugal;
| | - Lara Palmeira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, 3001-802 Coimbra, Portugal;
| | - Isabel Brandão
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal;
- University Hospital Center of São João, 4200-319 Porto, Portugal
| | - Ana Rita Vaz
- School of Psychology, University of Minho, 4710-057 Braga, Portugal; (M.d.L.); (L.C.); (A.P.-B.); (A.R.V.)
| | - Eva Conceição
- School of Psychology, University of Minho, 4710-057 Braga, Portugal; (M.d.L.); (L.C.); (A.P.-B.); (A.R.V.)
- Correspondence:
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10
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Félix S, de Lourdes M, Ribeiro I, Cunha B, Ramalho S, Vaz AR, Machado PPP, Conceição E. A preliminary study on the psychosocial impact of COVID-19 lockdown in post-bariatric surgery women: the importance of eating behavior, health care access, and social support. Curr Psychol 2021; 40:6275-6281. [PMID: 33679113 PMCID: PMC7914114 DOI: 10.1007/s12144-021-01529-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 12/11/2022]
Abstract
This study aims to characterize the psychosocial impact of COVID-19 lockdown for post-bariatric surgery (≥ 36 months) women and its association with disordered eating and psychological distress. The medium to long-time follow up is a period of increased susceptibility for poorer weight outcomes which might be triggered by the lockdown. Twenty-four participants responded to an online questionnaire and a telephone interview. About half (n = 14; 58.3%) reported perceived weight gain during the lockdown, 13 (54.1%) limited access to social support, and 12 (50%) limited access to medical care. Co-habiting with a higher number of persons during lockdown was associated with fewer difficulties in dealing with emotionally activating situations, less fear of gaining weight, less fear of losing control over eating, and less disordered eating. The global perceived psychosocial impact of lockdown was significantly correlated with difficulties in dealing with emotionally activating situations and stress symptoms. Results highlight the need to monitor post-bariatric patients, facilitate health care access, and promote social support during the lockdown period.
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Affiliation(s)
- Sílvia Félix
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Inês Ribeiro
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Bruna Cunha
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Sofia Ramalho
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Ana R Vaz
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Paulo P P Machado
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
| | - Eva Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4710-057 Braga, Portugal
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11
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Conceição E, de Lourdes M, Ramalho S, Félix S, Pinto-Bastos A, Vaz AR. Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19. Surg Obes Relat Dis 2021; 17:1165-1174. [PMID: 33812789 PMCID: PMC7908843 DOI: 10.1016/j.soard.2021.02.025] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/10/2021] [Accepted: 02/18/2021] [Indexed: 12/13/2022]
Abstract
Background Recent studies suggest that eating habits are an area particularly affected by the lockdown imposed by many countries to curb the COVID-19 epidemic. Individuals that received bariatric surgery may represent a particularly susceptible population to the adverse effects of lockdown for its potential impact on eating, psychological, and weight loss outcomes. Objectives This study seeks to investigate the incremental impact of COVID-19 lockdown on treatment outcomes of postbariatric patients in the risk period for weight regain. Setting Main hospital center. Methods This work uses data from an ongoing longitudinal study of bariatric patients assessed before surgery (T0), 1.5 years after sugery (T1), and 3 years after surgery (T2). Two independent groups were compared: the COVID-19_Group (n = 35) where T0 and T1 assessments were conducted before the pandemic started and T2 assessment was conducted at the end of the mandatory COVID-19 lockdown; and the NonCOVID-19_Group (n = 66), covering patients who completed T0, T1, and T2 assessments before the epidemic began. Assessment included self-report measures for disordered eating, negative urgency, depression, anxiety, stress, and weight outcomes. Results General linear models for repeated measures showed that the COVID-19_Group presented significantly higher weight concern (F = 8.403, P = .005, ƞ2p = .094), grazing behavior (F = 7.166, P = .009, ƞ2p = .076), and negative urgency (F = 4.522, P = .036, ƞ2p = .05) than the NonCOVID-19_Group. The COVID-19_Group also showed less total weight loss (F = 4.029, P = .05, ƞ2p = .04) and larger weight regain at T2, with more COVID-19_Group participants experiencing excessive weight regain (20% versus 4.5%). Conclusion These results show evidence for the impact of the coronavirus outbreak on eating-related psychopathology and weight outcomes in postbariatric surgery patients.
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Affiliation(s)
- Eva Conceição
- School of Psychology, University of Minho, Braga, Portugal.
| | | | - Sofia Ramalho
- School of Psychology, University of Minho, Braga, Portugal
| | - Sílvia Félix
- School of Psychology, University of Minho, Braga, Portugal
| | | | - Ana Rita Vaz
- School of Psychology, University of Minho, Braga, Portugal
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de Lourdes M, Pinto-Bastos A, Machado PP, Conceição E. Problematic eating behaviors in patients undergoing bariatric surgery: Studying their relationship with psychopathology. J Health Psychol 2021; 27:1535-1546. [PMID: 33406896 DOI: 10.1177/1359105320986889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study explored the associations between individuals presenting different problematic eating behaviors (Objective/Subjective binge-eating-OBE/SBE-and Compulsive/Non-compulsive grazing-C_Grazing/NC_Grazing) and eating disorder related symptoms. About 163 pre- and 131 post-bariatric patients were assessed. Assessment included: Face-to-face clinical interview to assess binge-eating and grazing episodes, and self-report measures to assess eating disorder symptomatology, psychological distress, and negative urgency. OBE and NC_Grazing were the problematic eating behaviors most and least associated with psychopathology, respectively. OBE and C_Grazing uniquely accounted for the significant variance in the most disordered eating variables. Our findings emphasize the need for the conceptualization of grazing behavior in the spectrum of disordered eating.
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Conceição E. Comment on: Interrater reliability of the eating disorder examination among postbariatric patients. Surg Obes Relat Dis 2020; 17:e5-e6. [PMID: 33153964 DOI: 10.1016/j.soard.2020.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/06/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Eva Conceição
- School of Psychology, University of Minho, Braga, Portugal
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Abstract
Este estudo teve como objetivo analisar as percepções de satisfação dos participantes sobre o APOLO-Teens e fatores comportamentais/psicológicos associados. O APOLO-Teens é um programa psicoeducacional, implementado no Facebook®, durante seis meses, como complemento ao tratamento hospitalar convencional para adolescentes com excesso de peso/obesidade. Participaram 52 adolescentes (71,2% do sexo feminino; M = 14,98 anos, DP = 1,63) que foram alvo do programa APOLO-Teens. Foram avaliados com recurso a medidas de autorrelato quanto à sintomatologia depressiva, qualidade de vida e comportamento alimentar no início, no meio (3 meses) e final da intervenção (6 meses) e preencheram o questionário que avaliou as percepções sobre a participação no programa de intervenção aos 6 meses. Em geral, os participantes revelaram percepções positivas e satisfação com o programa. As sessões de chat tiveram baixa adesão e a maioria dos participantes preferia uma intervenção mais curta. O tema preferido foi “atividade física” e o preterido “alimentação saudável”. Verificou-se uma correlação negativa entre satisfação com os resultados e sintomatologia depressiva e comportamento alimentar disfuncional. Como conclusões vale ressaltar alguns aspectos importantes: 1) reconsiderar a duração do programa e tornar as sessões de chat e o tema “alimentação saudável” mais atraentes; 2) priorizar a sintomatologia depressiva e os comportamentos alimentares disfuncionais como forma de otimizar a adesão a estas intervenções.
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Rodrigues T, Vaz AR, Silva C, Conceição E, Machado PP. Eating Disorder‐15 (ED‐15): Factor structure, psychometric properties, and clinical validation. Eur Eat Disorders Rev 2019; 27:682-691. [DOI: 10.1002/erv.2694] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/26/2019] [Accepted: 05/21/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Tânia Rodrigues
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of PsychologyUniversity of Minho Braga Portugal
| | - Ana R. Vaz
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of PsychologyUniversity of Minho Braga Portugal
| | - Cátia Silva
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of PsychologyUniversity of Minho Braga Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of PsychologyUniversity of Minho Braga Portugal
| | - Paulo P.P. Machado
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of PsychologyUniversity of Minho Braga Portugal
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Conceição E, Teixeira F, Rodrigues T, Lourdes M, Bastos AP, Vaz A, Ramalho S. [Problematic Eating Behaviors after Bariatric Surgery: A National Study with a Portuguese Sample]. ACTA MEDICA PORT 2018; 31:633-640. [PMID: 30521456 DOI: 10.20344/amp.9237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 08/02/2018] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Bariatric surgery is the most effective method for the treatment of morbid obesity. However, the development of eating psychopathology and the emergence of problematic eating behaviours have been reported in the literature. The aim of this crosssectional study was to characterize the post-bariatric population in terms of the frequency of problematic eating behaviours over time and to understand the related psychological features. MATERIAL AND METHODS This sample was composed of 155 bariatric patients that responded to several self-reported instruments assessing eating psychopathology, problematic eating behaviours, anxiety, depression and stress and impulsive behaviour. RESULTS Results showed that grazing, binge eating, concerns about body weight and shape, and negative urgency are significantly more frequent at 24 months after bariatric surgery (when compared to earlier postoperative assessments). Correlational analyses showed that eating psychopathology and problematic eating behaviours were significantly and positively associated with levels of anxiety, depression, stress and negative urgency. This study also reinforces the mediating role of negative urgency in the relationship between time elapsed since surgery and psychological distress, and problematic eating behaviours, accounting for a total of 32.3% and 27.2% of its variance, respectively. DISCUSSION The results suggest a growing trend of problematic eating behaviours and levels of impulsivity being reported by bariatric patients over time. CONCLUSION Given the established evidence that supports its impact on weight variability, early identification of problematic eating behaviours and of patients with a tendency to act impulsively in situations of negative emotionality should be a central concern in the follow-up of the bariatric population.
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Affiliation(s)
- Eva Conceição
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga
| | - Flávia Teixeira
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
| | - Tânia Rodrigues
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
| | - Marta Lourdes
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
| | - Ana Pinto Bastos
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
| | - Ana Vaz
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
| | - Sofia Ramalho
- Centro de Investigação em Psicologia. Escola de Psicologia. Universidade do Minho. Braga. Portugal
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Pinto-Bastos A, Conceição E, de Lourdes M, Arrojado F, Brandão I, Machado PPP. Psychological and Behavioral Aspects of Primary and Reoperative Surgery: a 6-Month Longitudinal Study. Obes Surg 2018; 28:3984-3991. [PMID: 30105661 DOI: 10.1007/s11695-018-3452-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Problematic eating behaviors and general psychopathology have been associated with poor weight loss after bariatric surgery. However, little is known about how these aspects impact weight loss outcomes for the increasing number of patients undergoing reoperative surgeries. This study compares disordered eating and weight-related outcomes before and 6 months after surgery in patients undergoing primary (P-Group) and reoperative bariatric surgery (R-Group). METHODS This longitudinal study assessed 122 P-Group and 116 R-Group patients before and 6 months after surgery. The assessment included the eating disorder examination diagnostic items, and a set of self-report measures assessing eating disorder symptomatology, grazing, depression, anxiety, and negative urgency. RESULTS Preoperatively, no differences were found between the R- and P-Groups in terms of disordered eating-related variables (except for shape concern, which was higher for the R-Group). At 6 months after surgery, the R-Group revealed significantly higher values for restraint (F(1,219) = 5.84, p = 0.016), shape (F(1,219) = 5.59, p = 0.019), weight concerns (F(1,219) = 13.36, p = 0.000), depression (F(1,219) = 7.17, p = 0.008), anxiety (F(1,219) = 6.94, p = - 0.009), and compulsive grazing (F(1,219) = 6.13, p = 0.014). No significant pre- or post-surgery predictors of weight loss were found for the P-Group (χ2 = 0.70, p = 0.872). In the R-Group, post-surgery anxiety (Waldχ2(1) = 6.19, p = 0.01) and the post-surgery number of days with grazing in the previous month (Waldχ2(1) = 3.90, p = 0.04) were significant predictors of weight loss. CONCLUSION At 6 months after surgery, the R-Group presented more problematic eating and general psychological distress, which may put these patients at greater risk of poorer long-term weight outcomes.
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Affiliation(s)
- Ana Pinto-Bastos
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Eva Conceição
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal.
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Filipa Arrojado
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
| | - Isabel Brandão
- Faculty of Medicine, University of Porto, Centro Hospitalar de São João, Porto, Portugal
| | - Paulo P P Machado
- School of Psychology, University of Minho, Campus Gualtar, 4010-057, Braga, Portugal
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Mogo S, López JF, Cachorro VE, de Frutos A, Zocca R, Barroso A, Mateos D, Conceição E. Comparison between the optical properties of aerosols in the fine and coarse fractions over Valladolid, Spain. Environ Sci Process Impacts 2017; 19:123-133. [PMID: 28078345 DOI: 10.1039/c6em00629a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Continuous measurements of the optical properties of aerosol particles have been made at Valladolid, Spain, covering the period from June 2011 to July 2012. The measurements were made at two size cuts: sub-10 μm and sub-1 μm (PM10 and PM1). The data measured were the scattering and backscattering coefficients, σs and σbs, obtained from an integrating nephelometer, and the absorption coefficient, σa, obtained from a particle soot absorption photometer. Spectrally resolved data were obtained from both instruments at 3 wavelengths (blue/green/red) at low relative humidity (RH < 40%). The statistical data for the instruments were calculated based on the hourly averages. For the PM10 fraction, the hourly mean values of σs and σa at 550 nm were 33 Mm-1 (StD = 30 Mm-1) and 4 Mm-1 (StD = 3 Mm-1), respectively. For the PM1 fraction, σs and σa mean values were 16 Mm-1 (StD = 14 Mm-1) and 4 Mm-1 (StD = 3 Mm-1), also at 550 nm. The derived parameters analyzed were the single scattering albedo, ω0, the backscatter fraction, σbs/σs, and the Ångström exponents of scattering, absorption and single scattering albedo, αs, αa and αω0. The contribution of the PM10 and the PM1 fractions for all these parameters plays a central role throughout the paper, allowing an improved classification of aerosol types. Our data are dominated by elemental carbon (EC) and elemental carbon/organic carbon mixed (EC/OC). For the PM10 data, dust dominated aerosol is also observed. Although we found that fine particles contribute more than coarse particles for decreasing the ω0 values, results suggest that it is also necessary to quantify the effect of coarse particles. Fine particles were found to produce ω0 spectra that decrease with the wavelength, αω0 > 0, while PM10 fractions were found to produce spectra that can decrease or increase with the wavelength, 0 < αω0 < 0. Both daily cycle and monthly variations are analyzed and related to local features as well as the transport of particles from elsewhere. A diurnal pattern characteristic of urban areas is observed, but it is less evident on weekends. The main long range transport influences are Atlantic advection, anthropogenic events from Central Europe and dust events.
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Affiliation(s)
- S Mogo
- Dpto. de Física, Univ. da Beira Interior, Covilhã, Portugal. and Grupo de Óptica Atmosférica, Univ. de Valladolid, Valladolid, Spain and Instituto Dom Luiz, Portugal
| | - J F López
- Grupo de Óptica Atmosférica, Univ. de Valladolid, Valladolid, Spain and Signal and Image Centre, Royal Military Academy, Brussels, Belgium
| | - V E Cachorro
- Grupo de Óptica Atmosférica, Univ. de Valladolid, Valladolid, Spain
| | - A de Frutos
- Grupo de Óptica Atmosférica, Univ. de Valladolid, Valladolid, Spain
| | - R Zocca
- Dpto. de Física, Univ. da Beira Interior, Covilhã, Portugal.
| | - A Barroso
- Dpto. de Física, Univ. da Beira Interior, Covilhã, Portugal.
| | - D Mateos
- Grupo de Óptica Atmosférica, Univ. de Valladolid, Valladolid, Spain
| | - E Conceição
- Dpto. de Física, Univ. da Beira Interior, Covilhã, Portugal.
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Brandão I, Marques Pinho A, Arrojado F, Pinto-Bastos A, Maia da Costa J, Coelho R, Calhau C, Conceição E. [Type 2 Diabetes Mellitus, Depression and Eating Disorders in Patients Submitted to Bariatric Surgery]. ACTA MEDICA PORT 2016; 29:176-81. [PMID: 27285093 DOI: 10.20344/amp.6399] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 09/28/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Obesity is associated with a great number of complications, including type 2 diabetes mellitus and psychiatric pathology. Bariatric surgery is the best solution to weight loss and improvement of complications in morbid obese patients. This study aims to analyze the evolution of type 2 diabetes mellitus and psychopathologic variables before and after bariatric surgery and assess the importance of different variables in weight loss. MATERIAL AND METHODS This is a longitudinal study, which evaluates 75 patients before and after bariatric surgery (47 - LAGB - laparoscopic adjustable gastric band; 19 - RYGB - Roux-en-Y gastric bypass; 9 - sleeve) with a follow-up time between 18 and 46 months. A clinical interview and self report questionnaires were applied - Eating Disorder Examination questionnaire - EDE-Q and Beck Depression Inventory - BDI. RESULTS Results show an improvement in type 2 diabetes mellitus after surgery (X2 (1) = 26.132, p < 0.001). There was not a significant improvement among psychiatric pathology when we controlled the analysis for the type of surgery. It was verified that type 2 diabetes mellitus, depression and eating disorders in post-operative period are associated with less weight loss. This model explains 27% of weight variance after surgery (R2 = 0.265) and it is significant F (3.33) = 2.981, p = 0.038. DISCUSSION Type 2 diabetes mellitus, psychiatric pathology and eating disorders after surgery influenced weight loss. It was not clear in what way this relation was verified, neither the relation that these metabolic and psychological variables may have during the postoperative period. CONCLUSION Type 2 diabetes mellitus improved after surgery. Type 2 diabetes mellitus, depression and eating disorders influenced weight loss in the postoperative period. These variables did not influence weight loss in the preoperative period.
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Affiliation(s)
- Isabel Brandão
- Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Centro Hospitalar de São João. Porto
| | | | - Filipa Arrojado
- Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Centro Hospitalar de São João. Porto
| | - Ana Pinto-Bastos
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga
| | | | - Rui Coelho
- Departamento de Neurociências Clínicas e Saúde Mental. Faculdade de Medicina. Universidade do Porto. Centro Hospitalar de São João. Porto
| | - Conceição Calhau
- Departamento de Bioquímica. Faculdade de Medicina. Universidade do Porto. Porto
| | - Eva Conceição
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga
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Brandão I, Ramalho S, Pinto-Bastos A, Arrojado F, Faria G, Calhau C, Coelho R, Conceição E. Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes. Eat Weight Disord 2015; 20:513-8. [PMID: 26122195 DOI: 10.1007/s40519-015-0199-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Accepted: 06/11/2015] [Indexed: 01/27/2023] Open
Abstract
PURPOSE This study aims to examine associations between metabolic profile and psychological variables in post-bariatric patients and to investigate if metabolic and psychological variables, namely high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glycated hemoglobin (HbA 1c), impulsivity, psychological distress, depressive and eating disorder symptoms are independently associated with percentage of excess weight loss (%EWL) after bariatric surgery. METHODS One hundred and fifty bariatric patients (BMI = 33.04 ± 5.8 kg/m(2)) who underwent to bariatric surgery for more than 28.63 ± 4.9 months were assessed through a clinical interview, a set of self-report measures and venous blood samples. Pearson's correlations were used to assess correlations between %EWL, metabolic and psychological variables. Multiple linear regression was conducted to investigate which metabolic and psychological variables were independently associated with %EWL, while controlling for type of surgery. RESULTS Higher TG blood levels were associated with higher disordered eating, psychological distress and depression scores. HDL-C was associated with higher depression scores. Both metabolic and psychological variables were associated with %EWL. Regression analyses showed that, controlling for type of surgery, higher % EWL is significantly and independently associated with less disordered eating symptoms and lower TG and HbA_1c blood concentrations (R (2) aj = 0.383, F (4, 82) = 14.34, p < 0.000). CONCLUSION An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.
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Affiliation(s)
- Isabel Brandão
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Sofia Ramalho
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Ana Pinto-Bastos
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Filipa Arrojado
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.,University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal
| | - Gil Faria
- CINTESIS-Center for Research in Health Technologies and Information Systems, 4200-450, Porto, Portugal.,Department of General Surgery, Oporto Hospital Center, Porto, Portugal
| | - Conceição Calhau
- Department of General Surgery, Oporto Hospital Center, Porto, Portugal.,Department of Biochemistry, Faculty of Medicine, University of Porto, Centro de Investigação Médica, 4200-450, Porto, Portugal
| | - Rui Coelho
- Faculty of Medicine, University of Porto, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Eva Conceição
- University of Minho, School of Psychology, Campus Gualtar, 4710-057, Braga, Portugal.
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Silva C, Fassnacht DB, Ali K, Gonçalves S, Conceição E, Vaz A, Crosby RD, Machado PPP. Promoting health behaviour in Portuguese children via Short Message Service: The efficacy of a text-messaging programme. J Health Psychol 2015; 20:806-15. [DOI: 10.1177/1359105315577301] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A Short Message Service programme was adapted to monitor three health behaviours and provide supportive feedback. The study aimed to evaluate the effectiveness of the programme to increase fruit/vegetable consumption and physical activity and to decrease screen time. A total of 139 Portuguese children, aged 8–10 years, grouped by classroom, were randomly assigned to an intervention (8 weeks of monitoring/feedback) or a control condition. Participants had their key behaviours assessed at baseline, post-intervention and follow-up. A three-level hierarchical linear model was developed. Results showed that the monitoring and feedback programme significantly increased fruit and vegetable consumption over time.
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Affiliation(s)
- Cátia Silva
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
| | - Daniel B Fassnacht
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
- James Cook University, Australia
| | - Kathina Ali
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
| | - Ana Vaz
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
| | - Ross D Crosby
- Neuropsychiatric Research Institute, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA
| | - Paulo PP Machado
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Portugal
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Coutinho J, Ramos AF, Maia L, Castro L, Conceição E, Geliebter A, Machado PPP, Gonçalves Ó, Sampaio A. Volumetric alterations in the nucleus accumbens and caudate nucleus in bulimia nervosa: a structural magnetic resonance imaging study. Int J Eat Disord 2015; 48:206-14. [PMID: 24634102 DOI: 10.1002/eat.22273] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Bulimia nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating and inappropriate compensatory behaviors (such as purging, fasting, or excessive exercise) to prevent weight gain. BN has been associated with deficits in inhibitory control processes. The basal ganglia specifically, the nucleus accumbens (NAc) and the caudate nucleus (CN) are part of the frontostriatal circuits involved in inhibitory control. The main goal of this study was to investigate the presence of morphological alterations in the NAc and the CN in a sample of patients diagnosed with BN. METHOD Forty-one female participants, 21 diagnosed with BN and 20 healthy matched controls (HC), underwent a structural magnetic resonance imaging (MRI) acquisition and clinical assessment. The NAc and the CN were manually segmented using the software Slicer 3D. RESULTS The results reveal a significant volumetric decrease in the CN and a preserved NAc volume in BN compared to the control group. DISCUSSION These findings suggest a contributory role of the caudate nucleus part of the dorsal striatum in the psychopathology of BN.
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Affiliation(s)
- Joana Coutinho
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
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Nascimento D, Olímpio A, Conceição E, Campos B, Fraga E, Barros M. Phylogeny of Marmosops and the occurrence of Marmosops pinheiroi (Pine, 1981) (Didelphimorphia, Didelphidae) in the Cerrado savanna of Maranhão, Brazil. Genet Mol Res 2015; 14:304-13. [DOI: 10.4238/2015.january.23.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ramalho S, Bastos AP, Silva C, Vaz AR, Brandão I, Machado PPP, Conceição E. Excessive Skin and Sexual Function: Relationship with Psychological Variables and Weight Regain in Women After Bariatric Surgery. Obes Surg 2014; 25:1149-54. [DOI: 10.1007/s11695-014-1514-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Conceição E, Mitchell JE, Vaz AR, Bastos AP, Ramalho S, Silva C, Cao L, Brandão I, Machado PPP. The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain. Eat Behav 2014; 15:558-62. [PMID: 25213792 DOI: 10.1016/j.eatbeh.2014.08.010] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/21/2014] [Accepted: 08/21/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maladaptive eating behaviors after bariatric surgery are thought to compromise weight outcomes, but little is known about their frequency over time. OBJECTIVE This study investigates the presence of subjective binge eating (SBE), objective binge eating (OBE) and picking and nibbling (P&N) before surgery and at different time periods postoperative, and their association with weight outcomes. METHODS This cross-sectional study assessed a group of patients before surgery (n=61), and three post-operative groups: 1) 90 patients (27 with laparoscopic adjustable gastric band (LAGB) and 63 with Laparoscopic Roux-en-Y Gastric Bypass (LRYGB)) assessed during their 6month follow-up medical appointment; 2) 96 patients (34 LAGB and 62 LRYGB) assessed during their one year follow-up medical appointment; and 3) 127 patients (62 LAGB and 55 LRYGB) assessed during their second year follow-up medical appointment. Assessment included the Eating Disorders Examination and a set of self-report measures. RESULTS In the first ten months after surgery fewer participants reported maladaptive eating behaviors. No OBEs were reported at 6months. SBE episodes were present in all groups. P&N was the most frequently reported eating behavior. Eating behavior (P&N) was significantly associated with weight regain, and non-behavioral variables were associated with weight loss. CONCLUSIONS This study is cross-sectional study which greatly limits the interpretation of outcomes and no causal association can be made. However, a subgroup of postoperative patients report eating behaviors that are associated with greater weight regain. The early detection of these eating behaviors might be important in the prevention of problematic outcomes after bariatric surgery.
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Affiliation(s)
- Eva Conceição
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal.
| | - James E Mitchell
- University of North Dakota, School of Medicine and Health Sciences, Fargo, ND, United States; Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND 58103, United States
| | - Ana R Vaz
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal
| | - Ana P Bastos
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal
| | - Sofia Ramalho
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal
| | - Cátia Silva
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal
| | - Li Cao
- University of North Dakota, School of Medicine and Health Sciences, Fargo, ND, United States; Neuropsychiatric Research Institute, 120 Eighth Street South, Fargo, ND 58103, United States
| | - Isabel Brandão
- University of Porto, Faculty of Medicine, Hospital de São João, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Paulo P P Machado
- University of Minho, School of Psychology, Campus Gualtar, 4710-057 Braga, Portugal
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Machado PPP, Martins C, Vaz AR, Conceição E, Bastos AP, Gonçalves S. Eating Disorder Examination Questionnaire: Psychometric Properties and Norms for the Portuguese Population. Eur Eat Disorders Rev 2014; 22:448-53. [DOI: 10.1002/erv.2318] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/21/2014] [Accepted: 06/19/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Carla Martins
- Human Cognition Lab, CIPsi, School of Psychology; University of Minho; Portugal
| | - Ana R. Vaz
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Ana Pinto Bastos
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
| | - Sónia Gonçalves
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Portugal
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Sousa P, Bastos AP, Venâncio C, Vaz AR, Brandão I, Costa JMD, Machado P, Conceição E. Compreender a Sintomatologia Depressiva após a Cirurgia Bariátrica: o Papel do Peso, da Alimentação e da Imagem Corporal. ACTA MEDICA PORT 2014. [DOI: 10.20344/amp.4907] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
<strong>Introduction:</strong> Depressive symptoms have been reported as prevalent after bariatric surgery. This study aims to analyze the role of weight, eating behaviors and body image in depressive symptomatology in bariatric surgery patients assessed post- operatively.<br /><strong>Material and Methods:</strong> This is a cross-sectional study including 52 bariatric surgery patients assessed post-operatively with a follow-up time ranging from 22 to 132 months. Psychological assessment included a clinical interview (Eating Disorder Examination) to assess eating disorders psychopathology, and three self-report measures: Outcome Questionnaire 45 – general distress; Beck Depression Inventory – depressive symptoms; and Body Shape Questionnaire – body image.<br /><strong>Results: </strong>Our data show that depressive symptoms after surgery are associated with loss of control over eating, increased concerns with body image, and body mass index regain. Multiple linear regressions was tested including these variables and showed that body mass index regain after surgery, loss of control over eating and concerns with body image significantly explained 50% of the variance of post-operative depressive symptoms, being the concern with body image the most significant variable: greater dissatisfaction with body image was associated with more depressive symptoms.<br /><strong>Discussion:</strong> The results of this study showed that a subgroup of patients presents a significant weight gain after bariatric surgery, which is associated with episodes of loss of control over eating, concerns with body image and depressive symptoms.<br /><strong>Conclusion:</strong> These results stress the relevance of body image concerns after surgery and the importance of clinically addressing these issues to optimize psychological functioning after bariatric surgery.<br /><strong>Keywords:</strong> Depression; Preoperative Care; Psychiatric Status Rating Scales; Obesity, Morbid; Body Image; Bariatric Surgery.
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Sousa P, Bastos AP, Venâncio C, Vaz AR, Brandão I, Costa JM, Machado P, Conceição E. [Understanding depressive symptoms after bariatric surgery: the role of weight, eating and body image]. ACTA MEDICA PORT 2014; 27:450-457. [PMID: 25203953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Accepted: 05/19/2014] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Depressive symptoms have been reported as prevalent after bariatric surgery. This study aims to analyze the role of weight, eating behaviors and body image in depressive symptomatology in bariatric surgery patients assessed post-operatively. MATERIAL AND METHODS This is a cross-sectional study including 52 bariatric surgery patients assessed post-operatively with a follow-up time ranging from 22 to 132 months. Psychological assessment included a clinical interview (Eating Disorder Examination) to assess eating disorders psychopathology, and three self-report measures: Outcome Questionnaire 45--general distress; Beck Depression Inventory--depressive symptoms; and Body Shape Questionnaire--body image. RESULTS Our data show that depressive symptoms after surgery are associated with loss of control over eating, increased concerns with body image, and body mass index regain. Multiple linear regressions was tested including these variables and showed that body mass index regain after surgery, loss of control over eating and concerns with body image significantly explained 50% of the variance of post-operative depressive symptoms, being the concern with body image the most significant variable: greater dissatisfaction with body image was associated with more depressive symptoms. DISCUSSION The results of this study showed that a subgroup of patients presents a significant weight gain after bariatric surgery, which is associated with episodes of loss of control over eating, concerns with body image and depressive symptoms. CONCLUSION These results stress the relevance of body image concerns after surgery and the importance of clinically addressing these issues to optimize psychological functioning after bariatric surgery.
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Affiliation(s)
- Paula Sousa
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga. Portugal
| | - Ana Pinto Bastos
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga. Portugal
| | - Carla Venâncio
- Unidade de Bariatria. Clínica Dr. António Sérgio. Instituto CUF Porto. Senhora da Hora. Portugal
| | - Ana Rita Vaz
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga. Portugal
| | - Isabel Brandão
- Departamento de Psicologia. Faculdade de Medicina. Universidade do Porto. Hospital de São João. Porto. Portugal
| | - José Maia Costa
- Departamento de Psicologia. Hospital de Braga. Braga. Portugal
| | - Paulo Machado
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga. Portugal
| | - Eva Conceição
- Escola de Psicologia. Centro de Investigação em Psicologia. Universidade do Minho. Braga. Portugal
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Meany G, Conceição E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev 2014; 22:87-91. [PMID: 24347539 PMCID: PMC4420157 DOI: 10.1002/erv.2273] [Citation(s) in RCA: 196] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 11/09/2022]
Abstract
There is increasing evidence that patients who have problems with binge eating (BE) or BE disorder (BED) are quite common among the severely obese, including bariatric surgery candidates. The literature suggests that in many cases such eating behaviours improve after bariatric surgery, although this is not uniformly true. The current paper reviews the data on the development of BE, BED and loss of control (LOC) eating after bariatric surgery and the impact of these problems on long-term weight outcome. A search was made of various databases regarding evidence of BE, BED and LOC eating post-operatively in bariatric surgery patients. The data extracted from the literature suggests that 15 research studies have now examined this question. Fourteen of the available 15 studies suggest that the development of problems with BE, BED or LOC eating post-bariatric surgery is associated with less weight loss and/or more weight regain post-bariatric surgery. These data suggests that it is important to identify individuals at high risk for these problems, to follow them post-operatively, and, if appropriate interventions can be developed if such behaviours occur in order to maximize weight loss outcomes.
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Affiliation(s)
- Gavin Meany
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | | | - James E. Mitchell
- Department of Clinical Neuroscience, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
- Neuropsychiatric Research Institute, Fargo, North Dakota, USA
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Ribeiro M, Conceição E, Vaz AR, Machado PPP. The prevalence of binge eating disorder in a sample of college students in the north of Portugal. Eur Eat Disord Rev 2014; 22:185-90. [PMID: 24729194 DOI: 10.1002/erv.2283] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 12/30/2013] [Accepted: 01/02/2014] [Indexed: 11/09/2022]
Abstract
Binge eating disorder (BED) has important associated comorbidities and has been recently considered as a diagnostic category in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition. This study investigates the prevalence of BED in a sample of college students using a two-stage design. Between October 2008 and July 2009, 805 students attending a public college campus completed the Questionnaire on Eating and Weight Patterns - Revised to screen for possible cases. Eighty-five students meeting key criteria for BED were invited for a second stage interview using the Eating Disorder Examination. At stage 1, 9.6% of the subjects reported binge eating episodes. At stage 2, a prevalence rate of 0.5% for BED was found, and 1% if the criterion for large amount of food was excluded.
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Affiliation(s)
- Mónica Ribeiro
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology, University of Minho, Braga, Portugal
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Vaz AR, Conceição E, Machado PPP. Early Response as a Predictor of Success in Guided Self-help Treatment for Bulimic Disorders. Eur Eat Disorders Rev 2013; 22:59-65. [DOI: 10.1002/erv.2262] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/05/2013] [Accepted: 09/08/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Ana R. Vaz
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Braga Portugal
| | - Eva Conceição
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Braga Portugal
| | - Paulo P. P. Machado
- Psychotherapy and Psychopathology Research Unit, CIPsi, School of Psychology; University of Minho; Braga Portugal
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Vaz AR, Conceição E, Machado PP. Guided self-help CBT treatment for bulimic disorders: Effectiveness and clinically significant change. Psychother Res 2013; 23:324-32. [DOI: 10.1080/10503307.2013.796424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Conceição E, Orcutt M, Mitchell J, Engel S, Lahaise K, Jorgensen M, Woodbury K, Hass N, Garcia L, Wonderlich S. Eating disorders after bariatric surgery: a case series. Int J Eat Disord 2013; 46:274-9. [PMID: 23192683 PMCID: PMC3596455 DOI: 10.1002/eat.22074] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/08/2012] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A significant number of post-bariatric surgery (BS) patients present with eating disorders (EDs) symptoms that require specialized treatment. These cases are thought to be underreported due to their frequent sub-syndromal presentation. This article describes ED syndromes that develop subsequent to BS. METHOD The clinical charts of 12 individuals who were hospitalized on a specialized inpatient EDs unit were reviewed. RESULTS Based on the new DSM-5 proposed criteria, six patients would meet criteria for an anorexia nervosa (AN) diagnosis: three with binge eating/purge AN subtype and three with restrictive AN subtype. An additional four met criteria for atypical AN, since they were at a normal weight, and two patients met criteria for bulimia nervosa. DISCUSSION Several similarities to the classical EDs were found. The findings that most distinguished these patients from those with classical EDs were their ages, and the age of onset of the ED for some patients.
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Affiliation(s)
- Eva Conceição
- CIPsi - Center for Research in Psychology, University of Minho, School of Psychology, Braga, Portugal.
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Abstract
Surgical treatment for morbid obesity can be very effective in terms of weight loss and reduction of psychopathology. But the (re)emergence of eating problems after surgery is still poorly understood and may be underreported. We describe three cases in which eating disorder symptoms developed after bariatric surgery. The accelerated weight loss and heightened dieting restraint, as well as the systematic reminders to control the amount of food eaten which are crucial for treatment success, might trigger the development of eating disorders after surgery. Implications for pre-surgery assessment and preparation are discussed.
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Affiliation(s)
- Eva Conceição
- School of Psychology, University of Minho, Braga, Portugal.
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Castro L, Conceição E, Vaz A, Osório E, Brandão I, Bastos-Leite A, Machado P. 877 – Structural neuroimaging studies in bulimia nervosa: a review. Eur Psychiatry 2013. [DOI: 10.1016/s0924-9338(13)76044-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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