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Gao H, Wang G, Zhang X, Guo H, Pang L, Gu J. Meta-Analysis of the Effects of Cognitive Behavioral Therapy on Dietary Habits and Emotional Outcomes in Patients With Obesity Undergoing Metabolic and Bariatric Surgery. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2025:S1499-4046(25)00309-4. [PMID: 40493004 DOI: 10.1016/j.jneb.2025.05.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Revised: 05/07/2025] [Accepted: 05/11/2025] [Indexed: 06/12/2025]
Abstract
INTRODUCTION To evaluate the effects of cognitive behavioral therapy (CBT) on physical, behavioral, and psychosocial outcomes in patients with obesity undergoing metabolic and bariatric surgery (MBS) through a meta-analysis. METHOD Randomized controlled trials assessing the therapeutic effects of CBT in patients undergoing MBS were searched in databases including PubMed, Embase, Cochrane Library, and Web of Science. The search cutoff date was February 7, 2025. Data analysis was performed using Stata (version 16.0, StataCorp, 2019). RESULTS A total of 7 randomized controlled trials were included in the final analysis. The meta-analysis indicated that CBT appeared to significantly decrease anxiety, depressive symptoms, uncontrolled eating, and emotional eating immediately after the intervention, but these effects seemed to disappear at the 1-year follow-up. In addition, CBT seemed not to affect weight, body mass index, physical quality of life, and mental quality of life at any time. DISCUSSION CBT may alleviate anxiety, depressive symptoms, uncontrolled eating, and emotional eating in the short term. IMPLICATIONS AND CONCLUSIONS Our findings suggest that CBT may enhance psychosocial and behavioral health among patients with obesity undergoing MBS. Future randomized controlled trials with larger sample sizes and longer follow-ups are needed to evaluate their long-term impacts.
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Affiliation(s)
- Haowen Gao
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Guiqi Wang
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xinxin Zhang
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Haobing Guo
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Liyun Pang
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jingfeng Gu
- Department of Gastroenterology Diagnosis and Treatment I (Weight Loss and Metabolic Diseases), The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
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Pearl ES, Murray MF, Haley EN, Snodgrass M, Braciszewski JM, Carlin AM, Miller-Matero LR. Weight and shape overvaluation and its relation to anxiety, depression, and maladaptive eating symptoms for patients up to 4 years after bariatric surgery. Surg Obes Relat Dis 2025; 21:580-586. [PMID: 39710526 PMCID: PMC11949718 DOI: 10.1016/j.soard.2024.11.019] [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: 06/14/2024] [Revised: 10/28/2024] [Accepted: 11/23/2024] [Indexed: 12/24/2024]
Abstract
BACKGROUND Weight and shape overvaluation (WSO; undue influence of weight and shape on self-evaluation) is common among individuals undergoing bariatric surgery. Little is known about how WSO relates to poorer outcomes for patients remote from surgery. OBJECTIVES To examine associations between WSO with anxiety and depression symptoms and various maladaptive eating behaviors in patients up to 4 years post-bariatric surgery. SETTING Henry Ford Health, United States. METHODS Patients who underwent surgery between 2018 and 2021 were invited to complete the study between 2021 and 2022. Participants (N = 765) completed anxiety and depression symptom and eating behavior measures. RESULTS Participants endorsed moderate WSO (M = 3.62, standard deviation = 1.87), which was positively related to anxiety (r = .37) and depression (r = .20) symptoms; eating in response to anger/frustration (r = .26), anxiety (r = .28), and depression (r = .31); and addictive eating behaviors (r = .26); and was significantly associated with the presence of loss-of-control (odds ratio [OR] = 1.39), binge (OR = 1.39), and graze (OR = 1.24) eating. WSO also was related to more frequent grazing (r = .23) but not loss-of-control or binge eating frequency for participants who endorsed behavior presence. CONCLUSIONS Findings underscore that links between WSO, psychiatric distress, and maladaptive eating behaviors persist up to 4 years after bariatric surgery. These domains should be assessed at bariatric follow-ups, and assessment of WSO may help providers identify patients at risk for poorer outcomes. Findings should be used to inform temporal modeling of how WSO may predispose patients to poorer bariatric outcomes.
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Affiliation(s)
- Elise S Pearl
- Behavioral Health, Henry Ford Health, Detroit, Michigan.
| | | | - Erin N Haley
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | - Maunda Snodgrass
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Department of Surgery, Henry Ford Health, Detroit, Michigan
| | - Jordan M Braciszewski
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
| | | | - Lisa R Miller-Matero
- Behavioral Health, Henry Ford Health, Detroit, Michigan; Center for Health Policy and Health Services Research, Henry Ford Health, Detroit, Michigan
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Micanti F, Caiazza C, Franzese L, D'Ambrosio M, Solini N, Iasevoli F, Fornaro M, de Bartolomeis A, Rago V. Exploring clinical phenotypes of food addiction and its distress correlates: A cross-sectional evaluation in treatment-seeking individuals with obesity. Eat Behav 2025; 57:101961. [PMID: 40048882 DOI: 10.1016/j.eatbeh.2025.101961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2025] [Revised: 02/06/2025] [Accepted: 02/26/2025] [Indexed: 06/01/2025]
Affiliation(s)
- Fausta Micanti
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Claudio Caiazza
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy; ASL NA3sud, U.O.S.M., 55-57 Torre del Greco, Ercolano, Italy.
| | - Luigi Franzese
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Michele D'Ambrosio
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Niccolò Solini
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Felice Iasevoli
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Michele Fornaro
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Andrea de Bartolomeis
- Department of Time-dependent Unit, Unit of Psychiatry and Psychology: Eating Disorders, Obesity and Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Vito Rago
- ASL NA3sud, U.O.S.M., 55-57 Torre del Greco, Ercolano, Italy
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Kuipers EAM, Timmerman JG, van Det MJ, Vollenbroek-Hutten MMR. Feasibility and Links Between Emotions, Physical States, and Eating Behavior in Patients After Metabolic Bariatric Surgery: Experience Sampling Study. JMIR Form Res 2025; 9:e60486. [PMID: 40053719 PMCID: PMC11923469 DOI: 10.2196/60486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 09/11/2024] [Accepted: 01/07/2025] [Indexed: 03/09/2025] Open
Abstract
BACKGROUND Lifestyle modification is essential to achieve and maintain successful outcomes after metabolic bariatric surgery (MBS). Emotions, physical states, and contextual factors are considered important determinants of maladaptive eating behavior, emphasizing their significance in understanding and addressing weight management. In this context, experience sampling methodology (ESM) offers promise for measuring lifestyle and behavior in the patient's natural environment. Nevertheless, there is limited research on its feasibility and association among emotions and problematic eating behavior within the population after MBS. OBJECTIVE This study aimed to examine the feasibility of ESM in the population after MBS regarding emotions, physical states, contextual factors, and problematic eating behavior, and to explore the temporal association among these variables. METHODS An experience sampling study was conducted in which participants rated their current affect (positive and negative), physical states (disgust, boredom, fatigue, and hunger), contextual factors (where, with whom, and doing what), and problematic eating behavior (ie, grazing, dietary relapse, craving, and binge eating) via smartphone-based ESM questionnaires at 6 semirandom times daily for 14 consecutive days. Feasibility was operationalized as the study's participation rate and completion rate, compliance in answering ESM questionnaires, and response rates per day. At the end of the study period, patients reflected on the feasibility of ESM in semistructured interviews. Generalized estimation equations were conducted to examine the temporal association between emotions, physical states, contextual factors, and problematic eating behavior. RESULTS In total, 25 out of 242 participants consented to participate, resulting in a study participation rate of 10.3%. The completion rate was 83%. Overall compliance was 57.4% (1072/1868), varying from 13% (11/84) to 89% (75/84) per participant. Total response rates per day decreased from 65% (90/138) to 52% (67/130) over the 14-day study period. According to the interviews, ESM was considered feasible and of added value. Temporal associations were found for hunger and craving (odds ratio 1.04, 95% CI 1.00-1.07; P=.03), and for positive affect and grazing (odds ratio 1.61, 95% CI 1.03-2.51; P=.04). CONCLUSIONS In this exploratory study, patients after MBS were not amenable to participate. Only a small number of patients were willing to participate. However, those who participated found it feasible and expressed satisfaction with it. Temporal associations were identified between hunger and craving, as well as between positive affect and grazing. However, no clear patterns were observed among emotions, physical states, context, and problematic eating behaviors.
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Affiliation(s)
- Ellen A M Kuipers
- Department of Surgery, Hospital Group Twente, Almelo, The Netherlands
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | | | - Marc J van Det
- Department of Surgery, Hospital Group Twente, Almelo, The Netherlands
| | - Miriam M R Vollenbroek-Hutten
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
- Board of Directors, Medisch Spectrum Twente, Enschede, The Netherlands
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Kellett J, Soliman SS, Podwojniak A, Minkanic M, Kumar G, Goodwin B, Yang HJ, Elsawwah JK, Nemeth ZH. The Efficacy of Glucagon-like Peptide-1 (GLP-1) Receptor Agonists for Insufficient Weight Loss or Regain After Metabolic/Bariatric Surgery: A Systematic Review and Meta-analysis. Obes Surg 2025; 35:1127-1134. [PMID: 39910018 DOI: 10.1007/s11695-025-07723-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 12/24/2024] [Accepted: 01/26/2025] [Indexed: 02/07/2025]
Abstract
Metabolic and bariatric surgery (MBS) is a successful surgical option for obesity. However, many patients can experience insufficient weight loss and weight regain post-operatively. Glucagon-like peptide-1 (GLP-1) receptor agonists have become available for effective weight loss treatment due to their effects of suppressing appetite, slowing gastric emptying, and promoting fat loss. This systematic review aims to evaluate the efficacy of using GLP-1 agonists to treat insufficient weight loss or regain after metabolic/bariatric surgery. Pooled analysis demonstrated that GLP-1 agonists have a moderate effect on weight loss after failed weight loss or weight regain following MBS, with a Cohen's d-score of 0.470 (p ≤ 0.001). GLP-1 agonists show promise and deserve additional research as part of the standard of care following MBS with insufficient weight loss.
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Affiliation(s)
- Joseph Kellett
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Sara S Soliman
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | | | | | - Gaurav Kumar
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Brandon Goodwin
- Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, USA
| | - Hyo J Yang
- Department of Surgery, Morristown Medical Center, Morristown, NJ, USA
| | - Jana K Elsawwah
- Department of Surgery, Morristown Medical Center, Morristown, NJ, USA
| | - Zoltan H Nemeth
- Department of Surgery, Morristown Medical Center, Morristown, NJ, USA.
- Department of Anesthesiology, Columbia University, New York, NY, USA.
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Nie Y, Zhang Y, Liu B, Meng H. Glucagon-Like Peptide-1 Receptor Agonists for the Treatment of Suboptimal Initial Clinical Response and Weight Gain Recurrence After Bariatric Surgery: a Systematic Review and Meta-analysis. Obes Surg 2025; 35:808-822. [PMID: 39948306 DOI: 10.1007/s11695-025-07733-8] [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: 08/27/2024] [Revised: 01/28/2025] [Accepted: 02/04/2025] [Indexed: 03/14/2025]
Abstract
BACKGROUND Suboptimal initial clinical response (SICR) and weight gain recurrence (WGR) are challenging issues following bariatric surgery. Recently, the promising weight loss effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been applied to bariatric patients. We aimed to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of GLP-1 RAs in the treatment of SICR and WGR after bariatric surgery. METHODS A literature search was performed across online databases. The primary outcomes were percentage of total weight loss (%TWL) and absolute weight loss. Secondary outcomes included changes in biochemical markers and adverse effects (AEs). RESULTS Nineteen studies including 1290 patients were included. After at least 3 months of treatment, the pooled %TWL was 9.24% for liraglutide, 11.38% for semaglutide, and 15.50% for tirzepatide, with corresponding weight reductions of 8.56 kg, 11.62 kg, and 12.60 kg, respectively. Additionally, %TWL and weight loss with liraglutide use were 7.65% and 7.47 kg for ≤ 6 months, 10.22% and 9.30 kg for 6-12 months, and 10.80% and 9.72 kg for ≥ 12 months. For semaglutide, the %TWL and weight reduction were 10.18% and 9.43 kg at 6 months, and 13.15% and 14.68 kg at 12 months. Biochemical markers including triglycerides, total cholesterol, low-density lipoprotein cholesterol, glycated hemoglobin, and alanine aminotransferase levels showed significant reductions after GLP-1 RA treatment. Common AEs were nausea (23%), vomiting (6%), diarrhea (6%), constipation (10%), headache (6%), fatigue (8%), abdominal pain (2%), and abdominal bloating (2%). The proportion of patients who discontinued the treatment due to AEs was 3%. CONCLUSIONS GLP-1 RAs are effective and safe for treating SICR and WGR after bariatric surgery.
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Affiliation(s)
- Yuntao Nie
- Department of General Surgery & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China
| | - Yiran Zhang
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Baoyin Liu
- Department of General Surgery & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China
| | - Hua Meng
- Department of General Surgery & Obesity and Metabolic Disease Center, China-Japan Friendship Hospital, Beijing, China.
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Biete C, Biete A, Patriota ESO, Gonçalves VSS, Buccini G, Pizato N. Household food insecurity and symptoms of anxiety and depression during pregnancy: Systematic review and meta-analysis. MATERNAL & CHILD NUTRITION 2025; 21:e13714. [PMID: 39263941 PMCID: PMC11650026 DOI: 10.1111/mcn.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 08/01/2024] [Accepted: 08/12/2024] [Indexed: 09/13/2024]
Abstract
Household food insecurity (HFI) has been related to adverse maternal-child health outcomes and mental health worsening during pregnancy. Few studies evaluated the temporal association between HFI and anxiety and depressive symptoms in pregnant women, and this association remains not completely understood. This study aimed to systematically review the association between HFI and symptoms of depression and anxiety in pregnant individuals. The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (CRD42022373615). Systematic searches were conducted on 10 electronic databases and grey literature. Two researchers independently conducted the study selection, data extraction process, and the risk of bias assessment. Random-effects meta-analysis models were used, and I2 > 40% indicated high heterogeneity across studies. Eighteen articles were included for the systematic review, comprising n = 27,882, and a total of 18,987 pregnant individuals aged between 14 and 45 years were included in the meta-analysis. The prevalence of HFI reported in studies ranged from 12.6% to 62.1% (n = 17). The prevalence of depressive and anxiety symptoms ranged from 18% to 49% (n = 11) and 23% to 34% (n = 2), respectively. HFI during pregnancy was associated with increased odds of experiencing symptoms of depression [(OR: 2.52; 95% CI: 2.11-3.02), I2 = 73.23%]. The quality of evidence was very low due to high heterogeneity. Our findings highlighted the association between HFI and depression symptoms during pregnancy. Findings from this study suggest the importance of assessing HFI and mental health during pregnancy.
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Affiliation(s)
- Camila Biete
- Graduate Program in Human Nutrition, Faculty of Health SciencesUniversity of BrasiliaBrasiliaBrazil
| | - Amanda Biete
- Graduate Program in Human Nutrition, Faculty of Health SciencesUniversity of BrasiliaBrasiliaBrazil
| | - Erika S. O. Patriota
- Graduate Program in Public Health, Faculty of Health SciencesUniversity of BrasiliaBrasiliaBrazil
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Faculty of Health SciencesUniversity of BrasiliaBrasiliaBrazil
| | - Gabriela Buccini
- Department of Social and Behavioural Health, School of Public HealthUniversity of Nevada Las VegasLas VegasNevadaUSA
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Faculty of Health SciencesUniversity of BrasiliaBrasiliaBrazil
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Kerver GA, Wonderlich JA, Laam LA, Amponsah T, Nameth K, Steffen KJ, Heinberg LJ, Safer DL, Wonderlich SA, Engel SG. A naturalistic assessment of the relationship between negative affect and loss of control eating over time following metabolic and bariatric surgery. Appetite 2025; 204:107748. [PMID: 39486592 DOI: 10.1016/j.appet.2024.107748] [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: 05/15/2024] [Revised: 10/22/2024] [Accepted: 10/30/2024] [Indexed: 11/04/2024]
Abstract
Disordered eating behavior has been linked to suboptimal weight outcomes following metabolic and bariatric surgery (MBS), thereby threatening the most efficacious treatment for severe obesity. While up to 40% of patients may experience loss of control (LOC) eating following MBS, mechanisms driving this behavior are not fully understood. Preliminary evidence suggests that high levels of negative affect (NA) in the moment prompt LOC eating post-MBS; however, it remains unclear whether this momentary relationship is stable or changes over the first several years following surgery. Consequently, this study examined differences in the prospective relationship between NA and LOC eating severity over time post-MBS using three waves of ecological momentary assessment data collection. Participants (n = 143, 87% female), were asked to rate momentary levels of NA and LOC eating severity on their smartphone ≥5 times/day for 7 days at 1-, 2-, and 3-years post-MBS. Both NA and LOC eating were rated on a 1-5 Likert scale, with higher scores indicating more severe symptoms. NA was within- and between-person centered and used as a prospective predictor of LOC eating severity. Analyses evaluated if time post-MBS moderated the relationship. A generalized linear mixed model demonstrated that higher NA predicted more severe LOC eating at the next signal when centered within- and between-subjects. Time post-MBS moderated the within-NA to LOC eating severity effect, such that the relationship remained unchanged between years 1 and 2, but strengthened between years 2 and 3. Findings suggest that momentary NA becomes a more powerful predictor of LOC eating severity as time passes post-MBS, which has important implications for interventions aimed at reducing LOC eating and promoting optimal weight outcomes in the post-surgical period.
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Affiliation(s)
- Gail A Kerver
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, 1919 Elm St. N, Fargo, ND, 58102-2416, USA.
| | - Joseph A Wonderlich
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA
| | - Leslie A Laam
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA
| | - Theresa Amponsah
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA; Department of Pharmaceutical Sciences, North Dakota State University, 1401 Albrecht Boulevard, Fargo, ND, 58102, USA
| | - Katherine Nameth
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5722, USA
| | - Kristine J Steffen
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA; Department of Pharmaceutical Sciences, North Dakota State University, 1401 Albrecht Boulevard, Fargo, ND, 58102, USA
| | - Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, 9500 Euclid Ave., Cleveland, OH, 44195, USA
| | - Debra L Safer
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5722, USA
| | - Stephen A Wonderlich
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, 1919 Elm St. N, Fargo, ND, 58102-2416, USA
| | - Scott G Engel
- Sanford Research, Center for Biobehavioral Research, 120 8th St. South, P.O. Box 2010, Fargo, ND, 58122, USA; Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, 1919 Elm St. N, Fargo, ND, 58102-2416, USA
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9
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Budny A, Janczy A, Szymanski M, Mika A. Long-Term Follow-Up After Bariatric Surgery: Key to Successful Outcomes in Obesity Management. Nutrients 2024; 16:4399. [PMID: 39771020 PMCID: PMC11679841 DOI: 10.3390/nu16244399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Revised: 12/14/2024] [Accepted: 12/18/2024] [Indexed: 01/11/2025] Open
Abstract
Background/Objectives: Bariatric surgery (BS) is considered one of the most effective interventions for the treatment of obesity. To achieve optimal long-term results, continuous follow-up (FU) within a multidisciplinary treatment team is essential to ensure patient compliance and maximize the benefits of BS. However, many patients find it difficult to maintain regular FU, which can affect the quality of care and lead to postoperative complications. This review aims to highlight factors that may hinder compliance with FU after BS, examine potential causes and consequences of inadequate FU, and identify strategies to improve patient participation in long-term FU. Methods: The literature search was conducted between October 2023 and June 2024 in Medline (PubMed) and the Cochrane Library datasets. Studies were selected for their relevance to adherence to FU, multidisciplinary approaches, and long-term bariatric outcomes. Results: The pre- and postoperative period is critical for educating patients and healthcare team members about the importance of FU, addressing potential barriers (e.g., logistical, psychological, and social challenges), and highlighting the risk of relapse to obesity after surgery. The lack of a standardized FU protocol leads to differences between medical centers, further impacting patient adherence. Conclusions: Tailored and regularly updated strategies are essential to address individual patient needs and improve adherence to FU. Further research is needed to identify the specific factors that influence variability in long-term BS outcomes, highlighting the need for a patient-centered approach to obesity treatment.
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Affiliation(s)
- Aleksandra Budny
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Agata Janczy
- Division of Food Commodity Science, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, 80-211 Gdansk, Poland;
| | - Michal Szymanski
- Division of Oncological, Transplant and General Surgery, Faculty of Medicine, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Adriana Mika
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, 80-211 Gdansk, Poland;
- Department of Environmental Analytics, Faculty of Chemistry, University of Gdansk, 80-308 Gdansk, Poland
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Walø-Syversen G, Kristinsson J, Eribe IL, Rø Ø, Dahlgren CL. Exploring the prevalence and symptom presentation of food addiction among Norwegian bariatric surgery patients: associations with depression, dysregulated eating, and postoperative weight loss. J Eat Disord 2024; 12:206. [PMID: 39696704 DOI: 10.1186/s40337-024-01170-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 12/03/2024] [Indexed: 12/20/2024] Open
Abstract
BACKGROUND Pathological eating and addictive processes are linked to obesity. Food addiction (FA) involves hedonic eating of highly palatable foods, accompanied by addictive symptoms like craving, loss-of-control (LOC) eating, and withdrawal. The main objectives of this study were to assess FA prevalence and symptoms in bariatric surgery candidates, and its relationship with depression, dysregulated eating, and 1- year postoperative weight loss (WL). METHODS Data from 69 bariatric surgery patients (74% female, 26% male, ) were analysed. Self-report measures including Yale Food Addiction Scale (YFAS) 2.0, Eating Disorder Examination-Questionnaire (EDE-Q), Repetitive Eating Questionnaire [Rep(eat)-Q] and Hospital Anxiety and Depression Scale (HADS) were administered pre-surgery and at 1-year follow-up. RESULTS The mean preoperative YFAS symptom score was 2.2. (SD = 2.59). 16% of the sample met YFAS diagnostic criteria for FA. Top reported FA criteria were "substance taken in larger amount than intended" (33%), "persisted desire or repeated unsuccessful attempts to quit" (29%), and "use in physically hazardous situations" (23%). The YFAS symptom scores correlated significantly with the frequency of LOC binge eating, depression and repetitive eating scores, but showed no correlation with age or BMI. Preoperative YFAS symptom scores did not significantly predict % WL at 1-year follow-up. CONCLUSIONS Our findings align with previous research, indicating that preoperative FA symptoms is unrelated to preoperative BMI and total %WL, but linked to eating pathology, such as LOC binge eating and grazing, as well as depression in bariatric surgery candidates.
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Affiliation(s)
- Gro Walø-Syversen
- Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway.
- Journal of the Norwegian Psychological Association, Oslo, Norway.
| | - Jon Kristinsson
- Centre for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Inger L Eribe
- Centre for Morbid Obesity and Bariatric Surgery, Oslo University Hospital, Oslo, Norway
| | - Øyvind Rø
- Regional Department for Eating Disorders, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
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11
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Fausta M, Claudio C, Mario M, Emanuela P, Giuseppe N. Psychological and psychiatric standardized procedures for metabolic bariatric surgery: a clinical practice model for mental health providers. Updates Surg 2024:10.1007/s13304-024-02053-5. [PMID: 39644446 DOI: 10.1007/s13304-024-02053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 11/27/2024] [Indexed: 12/09/2024]
Abstract
INTRODUCTION Obesity is a multifactorial and chronic disease, constantly growing in prevalence. Metabolic and Bariatric Surgery (MBS) is among the most effective therapies for obesity, determining consistent long-term weight loss and maintenance. Increasing evidence suggests a relevant mental health contribution to obesity pathogenesis. European and International Guidelines for MBS emphasize the importance of a pre-surgical psychological/psychiatric assessment and a post-surgical follow-up to improve MBS outcomes. Yet, no standard psychological/psychiatric procedures currently exist. METHODS This paper overviews the psychological/psychiatric procedures which Italian mental health providers currently perform on MBS candidates to provide psychological support through every step of the MBS, from the assessment to the postsurgical follow-up, to evaluate eligibility, prevent mental health flare-ups and weight regain, as endorsed by the Board of the Italian Society of Surgery for Obesity and Metabolic Diseases (SICOB). RESULTS The psychological/psychiatric procedures should encompass two phases: pre-surgical assessment and post-surgical follow-up. Pre-surgical assessment should investigate every condition that might reduce the MBS effectiveness or contraindicate the surgical process. It must include a mental state evaluation, weight history, eating behavior, body image, psychosocial conditions, and motivation. The post-surgical follow-up should offer psychological support to patients in achieving weight loss and maintenance. It should also prevent the onset or recurrence of psychiatric disorders that may affect clinical outcomes. DISCUSSION This paper is the first to introduce a standardized protocol for psychological/psychiatric procedures for each phase of the surgical process, to allow MBS candidates to receive similar care despite geographical differences. It also serves as a potential clinical model for assessing mental eligibility or contraindications prior to MBS, and subsequently support the individual behavioral and lifestyle changes to achieve and maintain weight loss.
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Affiliation(s)
- Micanti Fausta
- Department of Time-Dependent Network, Psychiatry, and Psychology: Eating Disorders, Obesity, and Bariatric Surgery Unit, University Hospital "Federico II", Via Sergio Pansini N.5, University Hospital, Edificio 18, Psichiatria, ZIP 80131, Naples, Italy.
| | - Caiazza Claudio
- Department of Time-Dependent Network, Psychiatry, and Psychology: Eating Disorders, Obesity, and Bariatric Surgery Unit, University Hospital "Federico II", Via Sergio Pansini N.5, University Hospital, Edificio 18, Psichiatria, ZIP 80131, Naples, Italy
| | - Musella Mario
- Bariatric Surgery Department of General Surgery. Bariatric Surgery, University Hospital "Federico II", Naples, Italy
| | - Paone Emanuela
- Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Polo Pontino, Bariatric Center of Excellence IFSO-EU, Sapienza University, Rome, Italy
| | - Navarra Giuseppe
- Department of Human Pathology of Adult and Evolutive Age, Surgical Oncology Division, University Hospital "G. Martino", Messina, Italy
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12
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Bhattacharya K, Bhattacharya N, Yagnik VD, Garg P. Suicide and Depression After Bariatric Surgery: A Critical Analysis. Indian J Surg 2024; 86:647-650. [DOI: 10.1007/s12262-024-04020-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 01/03/2024] [Indexed: 07/26/2024] Open
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Porto EBS, Montero-Marin J, Quadros LG, Kristeller J, Sarubbi Junior V, Mattar LA, Garcia-Campayo J, Demarzo M. Mindfulness and compassion-based programs on eating behavior of post-bariatric surgery patients: A two phased clinical trial protocol. MethodsX 2024; 13:102885. [PMID: 39253004 PMCID: PMC11382006 DOI: 10.1016/j.mex.2024.102885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 07/30/2024] [Indexed: 09/11/2024] Open
Abstract
INTRODUCTION Weight regain after bariatric surgery remains a relevant and worrisome topic, requiring greater understanding and involvement in research into new adjuvant treatments. This study aims to compare the preliminary effectiveness and feasibility of the Mindfulness-Based Health Promotion and Attachment-Based Compassion Therapy programs as opposed to usual treatments (workshops) on the eating behavior of patients with progressive weight gain after bariatric surgery in Brazilian patients at a private clinic. It was hypothesized that both interventions are feasible and that the self-compassion program may be more effective than the mindfulness program. METHODS The study will be divided into two phases: a cross-analytical study of those who underwent bariatric surgery and a randomized controlled trial only with the ones who had weight regain. Interventions will be conducted for eight weeks synchronously with three assessment points (baseline, post intervention, and 6-month follow-up), both online. The primary outcome will be a change in eating behavior. Secondary outcomes will include improved quality of life, enhanced body image satisfaction and reduced distortion (Brazilian Silhouette Scales for adults), better weight management (maintenance or weight reduction), increased frequency of activity and monitoring with the surgery team. Qualitative data will also be collected by online identification of a sub-sample of participants. RESULTS Improvements are expected in eating behavior, weight, reverse progressive weight gain, classification of self-image, quality of life, and levels of mindfulness, self-compassion, and anxiety. CONCLUSION This study seeks to gather preliminary evidence on the effectiveness of mindfulness and compassion training for the adjunctive treatment of progressive weight gain in post-bariatric patients. Clinical Trials.gov Registration ID: NCT04171713.
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Affiliation(s)
- Erika Blamires S Porto
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion. Department of Preventive Medicine at Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 740, Zip code: 04023-062. São Paulo, SP, Brazil
| | - Jesus Montero-Marin
- Department of Psychiatry, University of Oxford, Oxford, OX37JX, UK
- Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiology and Public Health - CIBERESP), 28029 Madrid, Spain
| | - Luiz Gustavo Quadros
- Kaiser Day Hospital, Rua Quinze de Novembro, 3975, Zip code: 15015-110, Sao Jose do Rio Preto, SP, Brazil
| | - Jean Kristeller
- Department of Psychology, Indiana State University, 200 N 7th St, Terre Haute, IN, 47809, USA
| | - Vicente Sarubbi Junior
- Department of Medicine, Universidade Estadual de Mato Grosso do Sul, Av. Dom Antonio Barbosa (MS-080), 4.155, Zip Code: 79115-898, Campo Grande, MS, Brazil
| | - Luis Augusto Mattar
- LEV Clinic, Avenida Vasconcelos Costa, Bairro, 967 - 10° andar - Osvaldo Rezende, Zip code: 38400-450, Uberlândia, MG, Brazil
| | - Javier Garcia-Campayo
- Department of Psychiatry, Miguel Servet Hospital, Aragon Institute of Health Sciences, Calle Gonzalo Calamita, 50009, Zaragoza, Zamora, Spain
| | - Marcelo Demarzo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion. Department of Preventive Medicine at Escola Paulista de Medicina, Universidade Federal de São Paulo, Rua Botucatu, 740, Zip code: 04023-062. São Paulo, SP, Brazil
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14
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Vinciguerra F, Romeo LM, Frittitta L, Baratta R. Pharmacological treatment of non-responders following bariatric surgery. Minerva Endocrinol (Torino) 2024; 49:196-204. [PMID: 33792233 DOI: 10.23736/s2724-6507.21.03311-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity is a complex chronic disease and requires a long-term multidisciplinary management. Even patients undergoing bariatric surgery, one the most effective treatments for obesity, can have insufficient weight loss (IWL) than expected (primary non responder) or weight regain (WR) after a successful primary procedure (secondary non responder). A poor response represents a challenge of bariatric surgery that can induce persistence or recurrence of obesity-related comorbidities, prejudicing benefits of surgery. Increasing evidence suggests that weight loss medications represent a useful strategy in obesity care also after bariatric surgery procedures. This narrative review summarizes the evidence concerning anti-obesity therapy in the management of no-responders to primary bariatric surgery. Available data on liraglutide (one randomized double-blind placebo-controlled trial, three prospective and three retrospective studies), naltrexone/bupropion (three retrospective studies), orlistat (one case control prospective and one retrospective studies) and topiramate and phentermine (five retrospective studies) have been considered. Available data suggest that weight loss medications could offer a significant adjunctive benefit to lifestyle and behavioral modifications in the life-long management of obesity. Newer treatment modalities including the use of anti-obesity drugs provide patients and healthcare providers with more options in the management of poor response after bariatric surgery.
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Affiliation(s)
- Federica Vinciguerra
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -
| | - Luana M Romeo
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Lucia Frittitta
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Section of Diabetes, Obesity and Dietetic Center, Garibaldi Hospital, Catania, Italy
| | - Roberto Baratta
- Section of Diabetes, Obesity and Dietetic Center, Garibaldi Hospital, Catania, Italy
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Salazar J, Duran P, Garrido B, Parra H, Hernández M, Cano C, Añez R, García-Pacheco H, Cubillos G, Vasquez N, Chacin M, Bermúdez V. Weight Regain after Metabolic Surgery: Beyond the Surgical Failure. J Clin Med 2024; 13:1143. [PMID: 38398456 PMCID: PMC10888585 DOI: 10.3390/jcm13041143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/20/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
Patients undergoing metabolic surgery have factors ranging from anatomo-surgical, endocrine metabolic, eating patterns and physical activity, mental health and psychological factors. Some of the latter can explain the possible pathophysiological neuroendocrine, metabolic, and adaptive mechanisms that cause the high prevalence of weight regain in postbariatric patients. Even metabolic surgery has proven to be effective in reducing excess weight in patients with obesity; some of them regain weight after this intervention. In this vein, several studies have been conducted to search factors and mechanisms involved in weight regain, to stablish strategies to manage this complication by combining metabolic surgery with either lifestyle changes, behavioral therapies, pharmacotherapy, endoscopic interventions, or finally, surgical revision. The aim of this revision is to describe certain aspects and mechanisms behind weight regain after metabolic surgery, along with preventive and therapeutic strategies for this complication.
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Affiliation(s)
- Juan Salazar
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Pablo Duran
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Bermary Garrido
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Heliana Parra
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Marlon Hernández
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Clímaco Cano
- Endocrine and Metabolic Diseases Research Center, School of Medicine, University of Zulia, Maracaibo 4004, Venezuela
| | - Roberto Añez
- Departamento de Endocrinología y Nutrición, Hospital Quirónsalud, 28009 Madrid, Spain
| | - Henry García-Pacheco
- Facultad de Medicina, Departamento de Cirugía, Universidad del Zulia, Hospital General del Sur, Dr. Pedro Iturbe, Maracaibo 4004, Venezuela
- Unidad de Cirugía para Obesidad y Metabolismo (UCOM), Maracaibo 4004, Venezuela
| | | | | | - Maricarmen Chacin
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080001, Colombia
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla 080001, Colombia
| | - Valmore Bermúdez
- Facultad de Ciencias de la Salud, Universidad Simón Bolívar, Barranquilla 080001, Colombia
- Centro de Investigaciones en Ciencias de la Vida, Universidad Simón Bolívar, Barranquilla 080001, Colombia
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Mantzios M, McAtamney K, Regan H, Kokocinska K, Kauser S, Kalika E, Hussain M, Keyte R, Wood J, Wallis D, Egan H. Does controlling for epicurean eating or the tendency to supersize food portions change the relationship between mindful eating and grazing? Heliyon 2024; 10:e24823. [PMID: 38352731 PMCID: PMC10861966 DOI: 10.1016/j.heliyon.2024.e24823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/03/2024] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
The study examines the potential for Epicurean eating to offer fresh perspectives on the predictive value of mindful eating. This research seeks to ascertain whether accounting for Epicurean eating (or its antithesis, supersizing), could influence the previously identified negative relationship between mindful eating and grazing habits. In a cross-sectional study, 419 participants completed questionnaires on epicurean eating, grazing, and mindful eating. The findings suggested mindful eating and epicurean eating were significantly associated with grazing, with both variables accounting for a significant amount of variance in grazing. Further analysis of the mindful eating subscales showed that eating without distraction, eating with awareness, and hunger and satiety cues accounted for this association with grazing when epicurean eating was included. Finally, whilst eating without distraction, eating with awareness, and hunger and satiety cues were associated with grazing, preference for supersizing did not account for a significant amount of variance in the relationship with grazing. The complex interplay between grazing and mindful eating becomes more apparent when considering the influence of epicurean eating. Exploring cross-cultural factors through additional research could provide valuable insights into the dynamics of epicurean eating and grazing. Simultaneously, incorporating alternative mindful eating scales may yield a more nuanced interpretation of mindful eating. Collectively, these avenues of inquiry warrant further investigation. Limitations and future directions are discussed.
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Affiliation(s)
- Michail Mantzios
- College of Psychology, Birmingham City University, United Kingdom
| | | | - Harvey Regan
- College of Psychology, Birmingham City University, United Kingdom
| | | | - Sophia Kauser
- College of Psychology, Birmingham City University, United Kingdom
| | - Eliza Kalika
- College of Psychology, Birmingham City University, United Kingdom
| | - Misba Hussain
- College of Psychology, Birmingham City University, United Kingdom
| | - Rebecca Keyte
- College of Psychology, Birmingham City University, United Kingdom
| | - Jeffrey Wood
- College of Psychology, Birmingham City University, United Kingdom
| | - Deborah Wallis
- College of Psychology, Birmingham City University, United Kingdom
| | - Helen Egan
- College of Psychology, Birmingham City University, United Kingdom
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Zefreh H, Amani-Beni R, Sheikhbahaei E, Farsi F, Ahmadkaraji S, Barzin M, Darouei B, Khalaj A, Shahabi S. What About My Weight? Insufficient Weight Loss or Weight Regain After Bariatric Metabolic Surgery. Int J Endocrinol Metab 2023; 21:e136329. [PMID: 38666043 PMCID: PMC11041817 DOI: 10.5812/ijem-136329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/13/2023] [Accepted: 10/15/2023] [Indexed: 04/28/2024] Open
Abstract
Context This review study aimed to investigate the definition, etiology, risk factors (RFs), management strategy, and prevention of insufficient weight loss (IWL) and weight regain (WR) following bariatric metabolic surgery (BMS). Evidence Acquisition Electronic databases were searched to retrieve relevant articles. The inclusion criteria were English articles with adult participants assessing the definition, prevalence, etiology, RFs, management strategy, and prevention of IWL/WR. Results Definition: The preferred definition for post-BMS IWL/WR are the terms "Lack of maintenance of total weight loss (TWL)>20%" and "weight change in percentage compared to nadir weight or weight loss". Prevalence: The exact prevalence of IWL/WR is still being determined due to the type of BMS and various definitions. Etiology: Several mechanisms, including hormonal/metabolic, dietary non-adherence, physical inactivity, mental health, and anatomic surgical failure, are possible etiologies of post-BMS IWL/WR. Risk factors: Preoperative body mass index (BMI), male gender, psychiatric conditions, comorbidities, age, poor diet, eating disorders, poor follow-ups, insufficient physical activity, micronutrients, and genetic-epigenetic factors are the most important RFs. Management Strategy: The basis of treatment is lifestyle interventions, including dietary, physical activity, psychological, and behavioral therapy. Pharmacotherapy can be added. In the last treatment line, different techniques of endoscopic surgery and revisional surgery can be used. Prevention: Behavioral and psychotherapeutic interventions, dietary therapy, and physical activity therapy are the essential components of prevention. Conclusions Many definitions exist for WR, less so for IWL. Etiologies and RFs are complex and multifactorial; therefore, the management and prevention strategy is multidisciplinary. Some knowledge gaps, especially for IWL, exist, and these gaps must be filled to strengthen the evidence used to guide patient counseling, selection, and improved outcomes.
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Affiliation(s)
- Hamidreza Zefreh
- Minimally Invasive Surgery and Obesity Research Center, School of Medicine, Alzahra University Hospital, Isfahan University of Medical Sciences, Esfahan, Iran
| | - Reza Amani-Beni
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Erfan Sheikhbahaei
- Minimally Invasive Surgery and Obesity Research Center, School of Medicine, Alzahra University Hospital, Isfahan University of Medical Sciences, Esfahan, Iran
| | - Farnaz Farsi
- Minimally Invasive Surgery Research Center, Hazrat-E Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Ahmadkaraji
- Minimally Invasive Surgery Research Center, Hazrat-E Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Barzin
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bahar Darouei
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khalaj
- Department of Surgery, School of Medicine, Tehran Obesity Treatment Center, Shahed University, Tehran, Iran
| | - Shahab Shahabi
- Minimally Invasive Surgery Research Center, Hazrat-E Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran
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Heriseanu AI, Spirou D, Moraes CEF, Hay P, Sichieri R, Appolinario JC. Grazing Is Associated with ADHD Symptoms, Substance Use, and Impulsivity in a Representative Sample of a Large Metropolitan Area in Brazil. Nutrients 2023; 15:2987. [PMID: 37447311 DOI: 10.3390/nu15132987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Grazing is a clinically relevant eating behaviour, especially when it presents with a sense of loss of control (compulsive grazing). There is evidence that other disordered eating patterns are associated with problematic substance use and impulsivity-related conditions, such as attention-deficit/hyperactivity disorder (ADHD). This overlap contributes to higher psychopathology and treatment complications. Less is known about grazing, and most information originates in high-income countries. Hence, we sought to investigate relationships between grazing, tobacco and alcohol use, ADHD, and impulsivity in a large representative sample from Brazil. Data were collected by trained interviewers from adults (N = 2297) through an in-person household survey based on a stratified and clustered probability sample. We found significant associations between compulsive grazing and problematic alcohol use (OR = 3.02, 95% CI: 1.65, 5.53), ADHD (OR = 8.94, 95% CI: 5.11, 15.63), and smoking (OR = 1.67, 95% CI: 1.12, 2.47), with impulsivity contributing to the first two relationships. The substantial association with ADHD suggests that other executive functions may promote disordered eating, possibly expressed through difficulties in adhering to regular meals. Clinically, these findings highlight the importance of assessing problematic eating patterns, such as compulsive grazing, in those presenting with difficulties with substance use or impulsivity, and vice versa.
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Affiliation(s)
- Andreea I Heriseanu
- eCentreClinic, School of Psychological Sciences, Macquarie University, Wallumattagal Campus, Macquarie Park, NSW 2109, Australia
| | - Dean Spirou
- School of Medicine, Western Sydney University, Sydney, NSW 2214, Australia
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Carlos E F Moraes
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Phillipa Hay
- School of Medicine, Western Sydney University, Sydney, NSW 2214, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Mental Health Service, South West Sydney Local Health District, Campbelltown, NSW 2560, Australia
| | - Rosely Sichieri
- Social Medicine Institute, State University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
| | - Jose C Appolinario
- Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro 22290-140, Brazil
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Wong G, Garner EM, Takkouche S, Spann MD, English WJ, Albaugh VL, Srivastava G. Combination anti-obesity medications to effectively treat bariatric surgery weight regain at an academic obesity center. Obes Sci Pract 2023; 9:203-209. [PMID: 37287513 PMCID: PMC10242249 DOI: 10.1002/osp4.635] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/21/2023] Open
Abstract
Background Combination anti-obesity medications (AOMs) to treat postoperative bariatric surgery weight regain have limited data on their use in the clinical setting. Understanding the optimal treatment protocol in this cohort will maximize weight loss outcomes. Methods A retrospective review of bariatric surgery patients (N = 44) presenting with weight regain at a single academic multidisciplinary obesity center who were prescribed AOM(s) plus intensive lifestyle modification for 12 months. Results Age: 28-76 years old, 93% female, mean weight 110.2 ± 20.3 kg, BMI 39.7 ± 7.4 kg/m2, presenting 5.2 ± 1.6 years post-bariatric surgery [27 (61.4%), 14 (31.8%), and 3 (6.8%) laparoscopic Roux-en-Y gastric bypass (RYGB), laparoscopic vertical sleeve gastrectomy (VSG), and open RYGB, respectively], with 15.1 ± 11.1 kg mean weight gain from nadir. Mean weight loss after medical intervention at 3-, 6-, and 12-month time points was 4.4 ± 4.6 kg, 7.3 ± 7.0 kg, and 10.7 ± 9.2 kg, respectively. At 12 months, individuals prescribed 3 or more AOMs lost more weight than those prescribed one (-14.5 ± 9.0 kg vs. -4.9 ± 5.7 kg, p < 0.05) irrespective of age, gender, number of comorbidities, initial weight or BMI, type of surgery, or GLP1 use. RYGB patients lost less weight overall (7.4% vs. 14.8% VSG respectively; p < 0.05). Conclusions Combination AOMs may be needed to achieve optimal weight loss results to treat post-operative weight regain.
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Affiliation(s)
- Gunther Wong
- Department of MedicineDivision of Diabetes, Endocrinology & MetabolismVanderbilt University School of MedicineNashvilleTennesseeUSA
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Erica M. Garner
- Department of MedicineDivision of Diabetes, Endocrinology & MetabolismVanderbilt University School of MedicineNashvilleTennesseeUSA
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Sahar Takkouche
- Department of MedicineDivision of Diabetes, Endocrinology & MetabolismVanderbilt University School of MedicineNashvilleTennesseeUSA
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Matthew D. Spann
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of SurgeryVanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Wayne J. English
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of SurgeryVanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Vance L. Albaugh
- Metamor InstitutePennington Biomedical Research CenterBaton RougeLouisianaUSA
| | - Gitanjali Srivastava
- Department of MedicineDivision of Diabetes, Endocrinology & MetabolismVanderbilt University School of MedicineNashvilleTennesseeUSA
- Vanderbilt Weight Loss CenterVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of SurgeryVanderbilt University School of MedicineNashvilleTennesseeUSA
- Department of PediatricsVanderbilt University School of MedicineNashvilleTennesseeUSA
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Anbara T. The impacts of eating disorders on sleeve gastrectomy outcomes. SURGERY IN PRACTICE AND SCIENCE 2023; 13:100165. [PMID: 39845395 PMCID: PMC11749972 DOI: 10.1016/j.sipas.2023.100165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
Introduction Eating disorders have been found to be associated with poorer weight loss outcomes following sleeve gastrectomy. However, limited research has been conducted on the specific impact of eating disorders on patients after sleeve gastrectomy. This study aimed to investigate the role of eating disorders, particularly binge eating disorder and loss of control, on weight loss outcomes and eating-disorder psychopathology following sleeve gastrectomy. Methods A prospective study was conducted on 104 individuals who underwent sleeve gastrectomy and reported experiencing eating disorders at least once weekly. Eating disorders were assessed using the Eating Disorder Examination (EDE) Bariatric Surgery Version. Chi-square and ANOVA tests were used for categorical and dimensional variables, respectively. Results Of the participants, 55 cases (52.88%) were diagnosed with binge eating disorder and 49 cases (47.11%) were categorized as having loss of control. The group with binge eating disorder had significantly greater EDE scores and lower weight loss outcomes compared to the loss of control group at six months post-surgery. Conclusion Our findings suggest that binge eating disorder is associated with poorer outcomes following sleeve gastrectomy, including greater severity of eating-disorder psychopathology and poorer weight loss outcomes. The results of this study highlight the need for additional research on the specific impacts of eating disorders on patients undergoing sleeve gastrectomy. The possible limitations of this study are self-reported eating disorders, lack of a control group, and short-term follow-up.
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Affiliation(s)
- Taha Anbara
- Department of Surgery, Arman International Hospital, Tehran, Iran
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21
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Ghafouri-Taleghani F, Abiri B, Zamanian A, Saidpour A. Effects of probiotic supplementation with weight reducing intervention on anthropometric measures, body composition, eating behavior, and related hormone levels in patients with food addiction and weight regain after bariatric surgery: a study protocol for a randomized clinical trial. BMC Nutr 2023; 9:63. [PMID: 37072872 PMCID: PMC10114428 DOI: 10.1186/s40795-023-00717-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/11/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND One of the unfortunate events after bariatric surgery is the weight regain, which occurs in some patients. Food addiction is an eating disorder related to the brain-intestinal axis and can be effective in weight regain after bariatric surgery. In addition, the gut microbiome plays a vital role in eating behaviors, including food addiction. So, this study will aim to evaluate the effects of probiotic supplementation with a weight-reducing diet and cognitive behavioral therapy on anthropometric measures, body composition, eating behavior, and related hormone levels, leptin, oxytocin, and serotonin, in patients with food addiction and weight regain after bariatric surgery. METHODS We will carry out a triple-blinded randomized clinical trial for 12 weeks to evaluate the effect of probiotic supplementation with a weight-reducing diet and cognitive behavioral therapy on anthropometric measures, body composition, eating behavior, and related hormone levels including leptin, oxytocin, and serotonin, in patients with food addiction and weight regain after bariatric surgery. DISCUSSION Based on the available evidence, probiotic supplementation by modifying the intestinal microbiome can improve food addiction and subsequent weight loss. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20220406054437N1 Registered on 2022-06-01.
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Affiliation(s)
- Fateme Ghafouri-Taleghani
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Zamanian
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atoosa Saidpour
- Department of Clinical Nutrition & Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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22
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Teodoro MC, Conceição EM, Sinval J, de Lourdes M, Neufeld CB. Adaptation, confirmatory factor analysis, and psychometric properties of the Brazilian version of the Repetitive Eating Questionnaire. Int J Eat Disord 2023; 56:747-757. [PMID: 36965138 DOI: 10.1002/eat.23943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 03/14/2023] [Accepted: 03/15/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE The Repetitive Eating Questionnaire (Rep(eat)-Q) is a brief self-report measure developed to assess grazing behavior-an understudied problematic eating behavior associated with eating disorder psychopathology and poor weight management. This study aimed to adapt and test the psychometric properties and factor structure of the Rep(eat)-Q in a Brazilian community sample. METHOD We used the International Test Commission guidelines for the adaptation of psychological measures between cultures. Participants were recruited from the community and on a university campus and completed a set of questionnaires including the Rep(eat)-Q, psychological measures, and sociodemographic data. RESULTS A total of 718 (86.4% female) completed the Rep(eat)-Q and were eligible for the confirmatory factor analysis (CFA). Only 542 completed the entire survey (Rep(eat)-Q and other psychological measures) and were eligible for the analysis of the validity evidence based on the relations to other variables. CFA revealed support for a two first-order model as originally proposed, however, a hierarchical (i.e., second-order) model is proposed. We found support for second-order scalar invariance across sex. Both first- and second-order internal consistency estimates presented very good evidence. Analysis (n = 542) revealed moderate to strong correlations (≥.58 to .77) between grazing (total score and subscales) and binge eating and other psychological measures, presenting good convergent evidence. DISCUSSION This study reports good psychometric properties of the Rep(eat)-Q for the Brazilian community sample. PUBLIC SIGNIFICANCE Grazing is a problematic eating behavior and the Rep(eat)-Q is one of the measures to assess grazing. The article aimed to adapt and test the psychometric properties of the Rep(eat)-Q in a Brazilian community sample. The results support a two-factor structure and suggest that the Rep(eat)-Q possesses good psychometric properties to be used with the Brazilian populations.
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Affiliation(s)
- Marília C Teodoro
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eva M Conceição
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Jorge Sinval
- Business Research Unit (BRU-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- Department of Evidence-Based Health, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
| | - Marta de Lourdes
- Psychology Department, Universidade do Minho-Braga, Braga, Portugal
| | - Carmem B Neufeld
- Psychology Department, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
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23
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Sherf-Dagan S, Biton R, Ribeiro R, Kessler Y, Raziel A, Rossoni C, Kais H, Bragança R, Santos Z, Goitein D, Viveiros O, Graham Y, Mahawar K, Sakran N, Ben-Porat T. Nutritional and Lifestyle Behaviors Reported Following One Anastomosis Gastric Bypass Based on a Multicenter Study. Nutrients 2023; 15:nu15061515. [PMID: 36986245 PMCID: PMC10053792 DOI: 10.3390/nu15061515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
This study aimed to describe nutritional and lifestyle parameters following one-anastomosis gastric bypass (OAGB). A multicenter study among OAGB patients across Israel (n = 277) and Portugal (n = 111) was performed. Patients were approached according to the time elapsed since surgery. An online survey with information regarding demographics, anthropometrics, and nutritional and lifestyle aspects was administered in both countries simultaneously. Respondents from Israel (pre-surgery age of 41.6 ± 11.0 years, 75.8% females) and Portugal (pre-surgery age of 45.6 ± 12.3 years, 79.3% females) reported changes in their appetite (≤94.0% and ≤94.6%), changes in their taste (≤51.0 and ≤51.4%), and intolerance to specific foods (i.e., red meat, pasta, bread, and rice). Bariatric surgery-related eating recommendations were generally followed well, but a trend toward lower adherence was evident in groups with longer time elapsed since surgery in both countries. Most respondents from Israel and Portugal reported participation in follow-up meetings with a surgeon (≤94.0% and 100%) and a dietitian (≤92.6% and ≤100%), while far fewer reported participation in any follow-up meeting with a psychologist/social worker (≤37.9% and ≤56.1%). Patients following OAGB might experience changes in appetite, taste, and intolerance to specific foods. Adherence to bariatric surgery-related eating recommendations is not always satisfying, especially in the longer term post-surgery.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Reut Biton
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
| | - Rui Ribeiro
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- General Surgery Department Coordinator, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yafit Kessler
- Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel 40700, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
| | - Carina Rossoni
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- Institute of Environmental Health, Faculty Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Hasan Kais
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Division of Surgery, Shamir Medical Center, Zerifin 70300, Israel
| | - Rossela Bragança
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Zélia Santos
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
- H&TRC-Health & Technology Research Center, (ESTeSL) Escola Superior de Tecnologia da Saúde de Lisboa, 1990-096 Lisbon, Portugal
| | - David Goitein
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery C, Sheba Medical Center, Tel Hashomer, Ramat Gan 5266202, Israel
| | - Octávio Viveiros
- Multidisciplinary Center for Obesity Treatment, Hospital Lusíadas Amadora, 2724-002 Amadora, Portugal
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland SR1 3SD, UK
- Bariatric Surgical Unit, Sunderland Royal Hospital, Sunderland SR4 7TP, UK
| | - Nasser Sakran
- Assia Medical Group, Assuta Medical Center, Tel Aviv 6971028, Israel
- Department of Surgery, Holy Family Hospital, Nazareth 1600100, Israel
- The Azrieli Faculty of Medicine Safed, Bar-Ilan University, Ramat Gan 5290002, Israel
| | - Tair Ben-Porat
- Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montréal, QC H4B 1R6, Canada
- Montreal Behavioural Medicine Centre (MBMC), Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS-NIM), Montréal, QC H4J 1C5, Canada
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24
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Noria SF, Shelby RD, Atkins KD, Nguyen NT, Gadde KM. Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment. Curr Diab Rep 2023; 23:31-42. [PMID: 36752995 PMCID: PMC9906605 DOI: 10.1007/s11892-023-01498-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 02/09/2023]
Abstract
PURPOSE OF REVIEW Although bariatric surgery is the most effective treatment of severe obesity, a proportion of patients experience clinically significant weight regain (WR) with further out from surgery. The purpose of this review is to summarize the prevalence, predictors, and causes of weight regain. RECENT FINDINGS Estimating the prevalence of WR is limited by a lack of consensus on its definition. While anatomic failures such as dilated gastric fundus after sleeve gastrectomy and gastro-gastric fistula after Roux-en-Y gastric bypass can lead to WR, the most common causes appear to be dysregulated/maladaptive eating behaviors, lifestyle factors, and physiological compensatory mechanisms. To date, dietary, supportive, behavioral, and exercise interventions have not demonstrated a clinically meaningful impact on WR, and there is limited evidence for pharmacotherapy. Future studies should be aimed at better defining WR to begin to understand the etiologies. Additionally, there is a need for non-surgical interventions with demonstrated efficacy in rigorous randomized controlled trials for the prevention and reversal of WR after bariatric surgery.
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Affiliation(s)
- Sabrena F Noria
- Department of Surgery, Division of General and Gastrointestinal Surgery, The Ohio State University, N718 Doan Hall, 410 W 10th Ave, Columbus, OH, 43210, USA.
| | - Rita D Shelby
- Department of Plastic and Reconstructive Surgery, University of Miami, Miller School of Medicine, 1600 NW 10th Ave #1140, Miami, FL, 33136, USA
| | - Katelyn D Atkins
- Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA, 70808, USA
| | - Ninh T Nguyen
- Department of Surgery, University of California Irvine, 3800 W Chapman Ave, Orange, CA, 92868, USA
| | - Kishore M Gadde
- Department of Surgery, University of California Irvine, 3800 W Chapman Ave, Orange, CA, 92868, USA
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25
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Cardia L, de Cleva R, Ferreira L, Gadducci AV, Estabile P, Santos Silva PR, Greve J, Santo MA. Postoperative Resting Metabolic Rate and Successful Weight Loss After Roux-en-Y Gastric Bypass. Obes Surg 2023; 33:1178-1183. [PMID: 36808386 DOI: 10.1007/s11695-023-06498-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To analyze whether changes in RMR 6 months after RYGB could be a predictor of weight loss on late follow-up. METHODS Prospective study of 45 individuals submitted to RYGB in a university tertiary care hospital. Body composition was evaluated by bioelectrical impedance analysis and RMR by indirect calorimetry before (T0), 6 (T1), and 36 months (T2) after surgery. RESULTS RMR/day was lower in T1 (1.552 ± 275 kcal/day) than in T0 (1734 ± 372 kcal/day; p < 0.001) with a return to similar values at T2 (1.795 ± 396 kcal/day; p < 0.001). In T0, there was no correlation between RMR/kg and body composition. In T1, there was a negative correlation between RMR and BW, BMI, and % FM, and a positive correlation with % FFM. The results in T2 were similar to T1. There was a significant increase in RMR/kg between T0, T1, and T2 (13.6 ± 2.2 kcal/kg, 16.9 ± 2.7 kcal/kg, and 19.9 ± 3.4 kcal/kg) in the total group and according to gender. Eighty percent of the patients who had increased RMR/kg ≥ 2 kcal at T1 achieved > 50% EWL in T2, particularly in women (odds ratio: 27.09, p < 0.037). CONCLUSIONS The increase in RMR/kg after RYGB is a major factor related to a satisfactory % excess weight loss on late follow-up.
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Affiliation(s)
- Lilian Cardia
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil.
| | - Roberto de Cleva
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil
| | - Leandro Ferreira
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil
| | - Alexandre Vieira Gadducci
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil
| | - Priscila Estabile
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil
| | | | - Julia Greve
- Orthopedics and Traumatology Department, University of São Paulo Medical School, São Paulo, Brazil
| | - Marco Aurelio Santo
- Gastroenterology Department, University of São Paulo Medical School, Av Dr Eneas de Carvalho Aguiar, 255, 9 Andar- ICHC, São Paulo, CEP: 05403-000, Brazil
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26
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Biete A, Gonçalves VSS, Franceschini SCC, Nilson EAF, Pizato N. The Prevalence of Nutritional Anaemia in Brazilian Pregnant Women: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1519. [PMID: 36674275 PMCID: PMC9859559 DOI: 10.3390/ijerph20021519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Despite the global tendency of maternal anaemia to decline, the persistence of anaemia in Brazil is an important health problem given its vulnerability to deficiencies and the significant increase in nutritional requirements during pregnancy. The aim of this study was to estimate the prevalence of anaemia in Brazilian pregnant women through a systematic literature review and meta-analysis. The systematic review was carried out according to Systematic Reviews and Meta-Analyses PRISMA checklist recommendations and using the following electronic databases: Medline, Scopus, Embase, Web of Science, Lilacs, Scielo, Google Scholar, and CAPES Catalog of Theses and Dissertations. Studies that presented a prevalence of anaemia data in Brazilian pregnant women, considering all gestational trimesters, were included. The total sample included 12,792 pregnant women covering all gestational trimesters. The pooled prevalence of anaemia in Brazilian pregnant women was 23% (95% CI: 20-27), with the highest prevalence in the Northeast Region at 26% (95% CI 23-29), while the lowest prevalence was observed in the North Region with 17% (95% CI 14-20). Among the subgroups, no statistical difference was observed. The prevalence of anaemia status in Brazil is still classified as a moderate public health problem according to the World Health Organization maternal anaemia classification.
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Affiliation(s)
- Amanda Biete
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Vivian S. S. Gonçalves
- Graduate Program in Public Health, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
| | - Sylvia C. C. Franceschini
- Graduate Program in Nutrition Sciences, Department of Nutrition and Health, Federal University of Viçosa, Viçosa 36570-900, Brazil
| | - Eduardo A. F. Nilson
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo 05508-060, Brazil
- Oswaldo Cruz Foundation (Fiocruz) Brasilia, Brasilia 70904-130, Brazil
| | - Nathalia Pizato
- Graduate Program in Human Nutrition, Department of Nutrition, University of Brasilia, Brasilia 70910-900, Brazil
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27
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Billing-Bullen G, Nielsen D, Wham C, Kruger R. Enablers and barriers to prevent weight-regain post bariatric surgery - A qualitative enquiry. Eat Behav 2022; 47:101677. [PMID: 36252389 DOI: 10.1016/j.eatbeh.2022.101677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Weight-regain is commonly experienced after bariatric surgery. This qualitative enquiry aimed to explore participants' self-reported enablers and barriers to prevent future weight-regain post-surgery. METHODS Eligible adults were recruited at 12-months post-bariatric-surgery at Counties Manukau, Auckland. Participants were invited to attend data collection at their 18-month group nutrition-education session, and to participate in a focus group at 21-months post-surgery. Thematic analysis was used to evaluate patient experiences. RESULTS Participants (n = 28) were mostly female (73.2 %), New Zealand European (41.5 %), and had gastric sleeve surgery (92.3 %). Five key themes emerged from the analysis: A Life Changing Health Journey - participants experienced a decrease in obesity-related comorbidities and a subsequent decrease in medications. Weight change and food intolerances impacted quality of life. Challenge of managing a New Healthy Lifestyle - financial stress, buying healthier foods and social events were new challenges, often centred on food. Changing Eating Behavior - all participants struggled managing eating behaviors. Mindset Changes - post-surgery most participants had a positive mindset, increased confidence, and feelings of happiness. However, many struggled with mindset around weight and food. A need for On-going Support - most felt under-supported and expressed a need for longer, specific follow-up care. CONCLUSION Post-surgery group education sessions provided participants with increased support from both health professionals and peers on the same journey, to overcome struggles such as binge eating or identifying new coping strategies. Findings provide important insights into the challenges patients with bariatric surgery face and key learnings to develop specific supports for future care practices.
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Affiliation(s)
- Gypsy Billing-Bullen
- School of Sport, Exercise and Nutrition, Massey University, Private Bag 102 904, Auckland 0745, New Zealand
| | - Deirdre Nielsen
- Counties Manukau Health, Middlemore Hospital, Hospital Road, Auckland, Auckland, 0745, New Zealand
| | - Carol Wham
- School of Sport, Exercise and Nutrition, Massey University, Private Bag 102 904, Auckland 0745, New Zealand.
| | - Rozanne Kruger
- School of Sport, Exercise and Nutrition, Massey University, Private Bag 102 904, Auckland 0745, New Zealand.
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28
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Santos AC, Passos AFF, Holzbach LC, Cardoso BR, Santos MA, Coelho ASG, Cominetti C, Almeida GM. Lack of sufficient evidence to support a positive role of selenium status in depression: a systematic review. Nutr Rev 2022:nuac095. [PMID: 36314383 DOI: 10.1093/nutrit/nuac095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
CONTEXT Globally, depression affects more than 322 million people. Studies exploring the relationship between diet and depression have revealed the benefits of certain dietary patterns and micronutrients in attenuating the symptoms of this disorder. Among these micronutrients, selenium stands out because of its multifaceted role in the brain. OBJECTIVE To assess the impact of selenium intake and status on symptoms of depression. DATA SOURCES A systematic search was performed in databases, including PubMed, Web of Science, EMBASE, PsycINFO, Scopus, and gray literature (on April 6, 2021, updated on January 28, 2022), without restrictions of date, language, or study type. DATA EXTRACTION Studies of adults (18-60 y of age) with depression or depressive symptoms were included. Data on selenium biomarkers and/or intake were included. The risk of bias was assessed using the Joanna Briggs Institute checklists. DATA ANALYSIS Of the 10 studies included, 2 were cohorts (n = 13 983 and 3735), 3 were cross-sectional (n = 736, 7725, and 200), 1 was case-control (n = 495), and 4 were randomized controlled trials (n = 30, 11, 38, and 63). Several studies have indicated that low selenium intake or concentration may be associated with symptoms of depression. However, this association was inconsistent across the studies included in this systematic review; due to the high heterogeneity, it was not possible to perform meta-analyses. The main contributing factors to the high heterogeneity include the different methodological designs, methods for diagnosing depression, selenium assessment, and clinical conditions. CONCLUSION Overall, there is insufficient evidence to support a positive role of selenium status in depression. Studies with more accurate methods and adequate assessment of selenium status are needed to better understand the role of this nutrient in depression. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021220683.
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Affiliation(s)
- Acsa C Santos
- Nutritional Genomics Research Group, Graduate Program in Nutrition and Health, School of Nutrition, Federal University of Goiás, Goiania, GO, Brazil
| | - Anna F F Passos
- Nutritional Genomics Research Group, Graduate Program in Nutrition and Health, School of Nutrition, Federal University of Goiás, Goiania, GO, Brazil
| | - Luciana C Holzbach
- Nutritional Genomics Research Group, Graduate Program in Nutrition and Health, School of Nutrition, Federal University of Goiás, Goiania, GO, Brazil
- Nutrition Undergraduate Course, Federal University of Tocantins, Palmas, TO, Brazil
| | - Barbara R Cardoso
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC, Australia
| | - Marta A Santos
- Nutrition Undergraduate Course, Federal University of Tocantins, Palmas, TO, Brazil
| | | | - Cristiane Cominetti
- Nutritional Genomics Research Group, Graduate Program in Nutrition and Health, School of Nutrition, Federal University of Goiás, Goiania, GO, Brazil
| | - Gessica M Almeida
- School of Nutrition, Federal University of Goiás, Goiania, GO, Brazil
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Bäuerle A, Schräpler L, Marsall M, Engelmann G, Knoll-Pientka N, Schüren LC, Niedergethmann M, Robitzsch A, Skoda EM, Hasenberg T, Teufel M. Development and Validation of Dietary Behavior Inventory-Surgery (DBI-S) in the Scope of International Post-Bariatric Surgery Guidelines and Recommendations. Nutrients 2022; 14:3692. [PMID: 36145070 PMCID: PMC9504912 DOI: 10.3390/nu14183692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 12/02/2022] Open
Abstract
(1) Dietary behavior is highly relevant for patients after bariatric surgery. No instrument exists assessing adherence to medical guidelines concerning the dietary behavior of patients after bariatric surgery. The aim of this study was to develop and validate such an instrument. (2) Data from patients after bariatric surgery (n = 543) were collected from March to May 2022. The development of the DBI-S was theory-based and interdisciplinary. Items’ and content validity of the DBI-S were examined. (3) The final version of the DBI-S consists of 13 items. Convergent validation was confirmed by significant correlations between DBI-S score and attitude towards healthy food (r = 0.26, p = <0.001) and impulsivity (r = −0.26, p = <0.001). Criterion validity was confirmed by significant correlations between DBI-S score and pre-/post-surgery BMI difference (r = −0.14, p = 0.002), pre-/post-surgery weight difference (r = 0.13, p = 0.003), and quality of life (r = 0.19, p = <0.001). Cluster analysis confirmed the ability to distinguish between two dietary behavior clusters (rather healthy and rather unhealthy). (4) The DBI-S is an economic and valid instrument to assess the adherence of post-bariatric surgery patients to the relevant dietary behavior recommendations and guidelines and can distinguish between rather unhealthy and healthy dietary behavior.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Laura Schräpler
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Matthias Marsall
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Institute for Patient Safety (IfPS), University Hospital Bonn, 53127 Bonn, Germany
| | - Gerrit Engelmann
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
| | - Nadja Knoll-Pientka
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Lynik Chantal Schüren
- Department of Surgery, Obesity and Metabolic Surgery Center, Alfried-Krupp Hospital Essen, 45131 Essen, Germany
| | - Marco Niedergethmann
- Department of Surgery, Obesity and Metabolic Surgery Center, Alfried-Krupp Hospital Essen, 45131 Essen, Germany
| | - Anita Robitzsch
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
| | - Till Hasenberg
- Helios Obesity Center West, Helios St. Elisabeth Hospital Oberhausen, Witten/Herdecke University, Helios University Hospital Wuppertal, 42283 Wuppertal, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, LVR-University Hospital Essen, 45147 Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, 45147 Essen, Germany
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Drakos P, Volteas P, Seeras K, Humayon S, Flink B, Yang J, Zhu C, Spaniolas K, Talamini M, Pryor A. S157-a structured early intervention program in patients with predicted poor long-term outcome following bariatric surgery: a prospective randomized study. Surg Endosc 2022; 36:6903-6914. [PMID: 35075525 DOI: 10.1007/s00464-022-09029-9] [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: 09/15/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Early postoperative weight loss can be predictive of one-year outcomes. It is unclear if poor performers identified in the first post-operative month can have improvement in outcomes with additional support and education. PURPOSE To evaluate the impact of a structured targeted support program for patients with lower-than-average early post-operative weight loss on 1-year outcomes. METHODS This was a prospective randomized study of bariatric surgery patients who experienced less than 50th percentile excess body weight loss (%EWL) at 3 weeks. Subjects with EWL < 18% were randomized into two groups: an intervention (IV) arm or a control (NI, no intervention) arm. The IV arm was offered a program with 7-weekly behavioral support sessions, while the NI patients received routine post-operative care. RESULTS A total of 128 patients were randomized: 65 NI and 63 IV. In the IV group, 20 attended all sessions, 7 attended < 4, and 36 did not participate. There was no difference in baseline demographics, procedure type, or BMI. At 1 year, there was no difference in %EWL (ratio 0.993, 95% CI 0.873, 1.131), %EBMIL (ratio 0.997, 95% CI 0.875, 1.137), and %TWL (ratio 1.016, 95% CI 0.901, 1.146) between groups. A subgroup analysis including only the subjects who participated in all seven sessions showed similar results. CONCLUSION Patients who present with suboptimal weight loss early after bariatric surgery do not experience a significant weight loss improvement with a structured behavioral support program. Importantly, despite being alerted to their poor early weight loss, patients demonstrated poor adherence to the proposed interventions.
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Affiliation(s)
- Panagiotis Drakos
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA.
| | - Panagiotis Volteas
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
| | - Kevin Seeras
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Shabana Humayon
- Department of Biostatistics, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Benjamin Flink
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Jie Yang
- Division of Preventive Medicine, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Chencan Zhu
- Department of Biostatistics, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Konstantinos Spaniolas
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
| | - Mark Talamini
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
| | - Aurora Pryor
- Department of Surgery, Stony Brook Medicine, Renaissance School of Medicine, Health Sciences Center, Stony Brook, NY, T19-05311794 8191, USA
- Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Renaissance School of Medicine, Stony Brook, NY, USA
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Voglino C, Badalucco S, Tirone A, Ciuoli C, Cantara S, Benenati N, Bufano A, Formichi C, Croce F, Gaggelli I, Vuolo ML, Vuolo G. Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients. Updates Surg 2022; 74:1389-1398. [PMID: 35780262 PMCID: PMC9338161 DOI: 10.1007/s13304-022-01314-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 06/14/2022] [Indexed: 12/03/2022]
Abstract
Bariatric surgery (BS) is the most effective treatment strategy for obesity. Nevertheless, a subset of patients does not reach a successful weight loss or experience long-term weight regain. Conflicting evidence exists regarding predictors of BS outcomes. We aimed to define the early factors linked to 3 year unsuccessful weight loss in order to promote a tailored close follow-up. We enrolled 443 patients who underwent BS from January 2014 to December 2018 with a 3 year follow-up. An unsuccessful BS outcome was defined as a percentage of total weight loss (%TWL) < 20. We compared the characteristics between successful and unsuccessful patients in order to identify predictor factors of unsuccess after surgery. We found that the proportion of patients with unsuccessful weight loss progressively increased from one to three years after BS. In a multiple regression model, only 1 month %TWL and sleeve gastrectomy (SG) were significantly associated with 3 year unsuccessful weight loss. We stratified our cohort in four groups according to the risk of BS unsuccess, in terms of 1 month %TWL and type of surgery (SG vs gastric bypass). Interestingly, groups showed a significant difference in terms of %TWL at each follow-up point. Patients submitted to SG with lower 1 month %TWL must be considered at higher risk of future weight regain; consequently, they require a tailored and closer follow-up.
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Affiliation(s)
- Costantino Voglino
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Simona Badalucco
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy.
| | - Andrea Tirone
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Cristina Ciuoli
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Silvia Cantara
- Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Nicoletta Benenati
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Annalisa Bufano
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Caterina Formichi
- Department of Medicine, Surgery and Neurosciences, Unit of Endocrinology, University of Siena, Viale Bracci, Policlinico "Le Scotte", 53100, Siena, Italy
| | - Federica Croce
- Department of Diagnostic Imaging, Hospital Campostaggia, Campostaggia, 53036, Poggibonsi, SI, Italy
| | - Ilaria Gaggelli
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Maria Laura Vuolo
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
| | - Giuseppe Vuolo
- Department of General and Specialized Surgery, Unit of Bariatric Surgery, University of Siena, Policlinico "Le Scotte", Viale Bracci 14, 53100, Siena, Italy
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Felske AN, Williamson TM, Rash JA, Telfer JA, Toivonen KI, Campbell T. Proof of Concept for a Mindfulness-Informed Intervention for Eating Disorder Symptoms, Self-Efficacy, and Emotion Regulation among Bariatric Surgery Candidates. Behav Med 2022; 48:216-229. [PMID: 33052762 DOI: 10.1080/08964289.2020.1828255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Up to 64% of patients seeking bariatric (weight-loss) surgery report eating disorder (ED) symptoms (addictive-like eating, binge eating, emotional eating, grazing) that can interfere with post-surgical weight loss. This prospective proof-of-concept study aimed to evaluate the impact of a pre-surgical mindfulness-informed intervention (MII) on ED symptoms and potential mechanisms-of-action to inform optimization of the intervention. Surgery-seeking adults attended four, 2-hour, MII sessions held weekly. Participants completed validated questionnaires assessing ED symptoms, eating self-efficacy, emotion regulation, and mindful eating pre-MII, post-MII, and at a 12-week follow-up. The MII consisted of mindfulness training, with cognitive, behavioral, and psychoeducational components. Fifty-six patients (M = 47.41 years old, 89.3% female) participated. Improvements in addictive-like eating, binge eating, emotional eating, and grazing were observed from pre- to post-MII. ED symptom treatment gains were either maintained or improved further at 12-week follow-up. Eating self-efficacy and emotion regulation improved from pre-MII to follow-up. Scores on the mindful eating questionnaire deteriorated from pre-MII to follow-up. In mediation analyses, there was a combined indirect effect of emotion regulation, eating self-efficacy, and mindful eating on grazing and binge eating, and an indirect effect of emotion regulation on emotional eating and addictive-like eating. Participation in the MII was associated with improvements in ED symptoms and some mechanisms-of-action, establishing proof-of-concept for the intervention. Future work to establish the MII's efficacy in a randomized controlled trial is warranted.
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Affiliation(s)
- Ashley N Felske
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | | | - Joshua A Rash
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jo Ann Telfer
- Calgary Adult Bariatric Surgery Clinic, Alberta Health Services, Richmond Road Diagnostic and Treatment Services, Calgary, AB, Canada
| | - Kirsti I Toivonen
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Tavis Campbell
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Martin-Fernandez KW, Martin-Fernandez J, Marek RJ, Ben-Porath YS, Heinberg LJ. Associations among psychopathology and eating disorder symptoms and behaviors in post-bariatric surgery patients. Eat Weight Disord 2021; 26:2545-2553. [PMID: 33548052 DOI: 10.1007/s40519-021-01111-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/13/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE A considerable number of post-bariatric surgery patients report problematic eating behaviors (PEBs) and/or eating disorders (EDs). Examining psychosocial variables associated with ED symptoms may identify targets for postoperative interventions to reduce these behaviors and improve surgical outcomes. METHODS A total of 161 participants completed the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and the Eating Disorder Examination-Questionnaire (EDE-Q). Participants were classified into ED risk or no ED risk groups and subjective binge eating (SBE) or no SBE groups. Independent-sample t tests were computed to examine mean differences in total weight loss (%TWL) and MMPI-2-RF scale scores between the ED groups. Relative Risk Ratios (RRRs) were computed to determine which MMPI-2-RF scales were associated with increased risk of ED group membership. RESULTS The ED risk group lost significantly less weight (19.36% TWL) than the no ED risk group (25.18% TWL). The SBE group lost significantly less weight (17.98% TWL) than the no SBE group (25.57% TWL). Participants in the ED groups scored significantly higher on internalizing and externalizing MMPI-2-RF scales than the no ED groups. These scales were associated with increased risk (1.55-2.55 times the risk) of being classified into the ED groups. CONCLUSIONS Patients who experienced postoperative ED symptoms lost significantly less weight than patients without ED symptoms. Postoperative ED symptoms are related to, and may be impacted by, higher levels of internalizing and externalizing dysfunction after surgery. Postoperative assessment of and interventions targeting psychosocial dysfunction could decrease ED symptoms. LEVEL OF EVIDENCE III: Evidence obtained from well-designed cohort or case-control analytic studies.
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Affiliation(s)
| | | | - Ryan J Marek
- Department of Primary Care, Sam Houston State University College of Osteopathic Medicine, Conroe, TX, 77304, USA
| | - Yossef S Ben-Porath
- Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA
| | - Leslie J Heinberg
- Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
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Sasaki A, Yokote K, Naitoh T, Fujikura J, Hayashi K, Hirota Y, Inagaki N, Ishigaki Y, Kasama K, Kikkawa E, Koyama H, Masuzaki H, Miyatsuka T, Nozaki T, Ogawa W, Ohta M, Okazumi S, Shimabukuro M, Shimomura I, Nishizawa H, Saiki A, Seki Y, Shojima N, Tsujino M, Ugi S, Watada H, Yamauchi T, Yamaguchi T, Ueki K, Kadowaki T, Tatsuno I. Metabolic surgery in treatment of obese Japanese patients with type 2 diabetes: a joint consensus statement from the Japanese Society for Treatment of Obesity, the Japan Diabetes Society, and the Japan Society for the Study of Obesity. Diabetol Int 2021; 13:1-30. [PMID: 34777929 PMCID: PMC8574153 DOI: 10.1007/s13340-021-00551-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Indexed: 12/20/2022]
Abstract
Bariatric surgery has been shown to have a variety of metabolically beneficial effects for patients with type 2 diabetes (T2D), and is now also called metabolic surgery. At the 2nd Diabetes Surgery Summit held in 2015 in London, the indication for bariatric and metabolic surgery was included in the “algorithm for patients with type T2D”. With this background, the Japanese Society for Treatment of Obesity (JSTO), the Japan Diabetes Society (JDS) and the Japan Society for the Study of Obesity (JASSO) have formed a joint committee to develop a consensus statement regarding bariatric and metabolic surgery for the treatment of Japanese patients with T2D. Eventually, the consensus statement was announced at the joint meeting of the 38th Annual Meeting of JSTO and the 41st Annual Meeting of JASSO convened in Toyama on March 21, 2021. In preparing the consensus statement, we used Japanese data as much as possible as scientific evidence to consider the indication criteria, and set two types of recommendation grades, “recommendation” and “consideration”, for items for which recommendations are possible. We hope that this statement will be helpful in providing evidence-based high-quality care through bariatric and metabolic surgery for the treatment of obese Japanese patients with T2D.
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Affiliation(s)
- Akira Sasaki
- Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695 Japan
| | - Koutaro Yokote
- Department of Endocrinology Hematology, and Gerontology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takeshi Naitoh
- Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Junji Fujikura
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Karin Hayashi
- Department of Neuropsychiatry, Toho University Sakura Medical Center, Sakura, Chiba Japan
| | - Yushi Hirota
- Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasushi Ishigaki
- Division of Diabetes and Metabolism, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan
| | - Kazunori Kasama
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Eri Kikkawa
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Hidenori Koyama
- Department of Diabetes, Endocrinology and Clinical Immunology, Hyogo College of Medicine, Nishinomiya, Hyogo Japan
| | - Hiroaki Masuzaki
- Division of Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology, Department of Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Takeshi Miyatsuka
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takehiro Nozaki
- Clinical Trial Center, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masayuki Ohta
- Global Oita Medical Advanced Research Center for Health, Oita University, Oita, Japan
| | - Shinichi Okazumi
- Department of Surgery, Toho University Sakura Medical Center, Sakura, Chiba Japan
| | - Michio Shimabukuro
- Department of Diabetes, Endocrinology and Metabolism, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Hitoshi Nishizawa
- Department of Metabolic Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Atsuhito Saiki
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Yosuke Seki
- Weight loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Nobuhiro Shojima
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Motoyoshi Tsujino
- Department of Endocrinology and Metabolism, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Satoshi Ugi
- Division of Endocrinology and Metabolism, Department of Medicine, Shiga University of Medical Science, Otsu, Japan
| | - Hiroaki Watada
- Department of Metabolism and Endocrinology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Toshimasa Yamauchi
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takashi Yamaguchi
- Center of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Sakura, Japan
| | - Koujiro Ueki
- Department of Molecular Diabetic Medicine, Diabetes Research Center, National Center for Global Health and Medicine, Tokyo, Japan
| | | | - Ichiro Tatsuno
- Chiba Prefectural University of Health Sciences, Chiba, Japan
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Schaefer LM, Crosby RD, Machado PP. A systematic review of instruments for the assessment of eating disorders among adults. Curr Opin Psychiatry 2021; 34:543-562. [PMID: 34475351 PMCID: PMC8645259 DOI: 10.1097/yco.0000000000000746] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW The availability of psychometrically sound assessment instruments for assessing eating disorder symptomatology is crucial for both clinical practice and research. The purpose of the current review is to provide the reader with a list of psychometrically validated assessments for adults that are available within the field of eating disorders. Eating disorder interviews and self-report questionnaires were identified using online literature searches, reviewing previous review articles, and via research and/or clinical experience of the authors. The focus of the review was on (1) standard assessments that were frequently used in eating disorder research (such as the Eating Disorder Examination and Eating Attitudes Test), and (2) newer assessments that were developed over the past 5 years. Information compiled on each instrument included the purpose of the assessment, scores that can be derived, psychometric information, translations in other languages, and availability for use in research and clinical settings. RECENT FINDINGS Several recent trends in assessment instruments were identified including updates based upon Diagnostic and Statistical Manual criteria, briefer assessments, assessments for specific populations, and assessment of specific clinical features observed in people with eating disorders. SUMMARY The current review provides eating disorder clinicians and researchers a guide for making informed decisions about the selection of eating disorder assessments.
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Affiliation(s)
- Lauren M. Schaefer
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Ross D. Crosby
- Sanford Center for Bio-behavioral Research, Fargo, ND, USA
- University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Paulo P.P. Machado
- Psychotherapy and Psychopathology Research Unit – Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
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36
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Demerdash HM. Weight regain after bariatric surgery: Promoters and potential predictors. World J Meta-Anal 2021; 9:438-454. [DOI: 10.13105/wjma.v9.i5.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/07/2021] [Accepted: 09/17/2021] [Indexed: 02/06/2023] Open
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Teodoro MC, Conceição EM, de Lourdes M, Alves JR, Neufeld CB. Grazing's frequency and associations with obesity, psychopathology, and loss of control eating in clinical and community contexts: A systematic review. Appetite 2021; 167:105620. [PMID: 34352352 DOI: 10.1016/j.appet.2021.105620] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/01/2022]
Abstract
The term grazing is generally described as the repetitive and nonplanned consumption of small amounts of food, not in response to hunger/satiety sensations. The present study aims to identify and critically review studies examining the frequency of grazing in both clinical and community samples, as well as, to investigate its relationship with eating disorder psychopathology, Loss of Control eating (LOC), psychological impairment, and weight-related variables. This systematic review followed the PRISMA recommendations for reporting systematic reviews and meta-analysis. A total of 138 articles were initially retrieved from the database search. In the end, 18 articles were considered for this systematic review. The results were separated in Grazing and Grazing-like behavior (picking and nibbling). Results of studies of grazing-like behaviors displays that, in these studies, the results are sometimes inconsistent and controversial. On the other hand, studies of Grazing behavior showed more consistent results. These results show that the use of different definitions across the literature makes it difficult to establish comparisons across studies. In this literature review, the studies selected used five different definitions of grazing and five different instruments to assess this eating behavior which reinforces the requirement for standardized definition and evaluation. More, the studies hereby revised suggested that LOC eating was considered in association with grazing, being significantly associated with higher levels of psychopathology and psychological impairment. In accordance, a growing body of research argues that LOC eating was a stronger predictor of eating disorder psychopathology than the amounts of food consumed. Furthermore, the results found by studies show an advance to literature with an accordance about LOC, supported by evidences in studies of this review.
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Affiliation(s)
- Marília Consolini Teodoro
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil.
| | - Eva M Conceição
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Marta de Lourdes
- School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Jéssika Rodrigues Alves
- Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Carmem Beatriz Neufeld
- Cognitive-Behavioral Intervention and Research Laboratory - LaPICC-USP, Psychology Department, Faculty of Philosophy, Sciences and Letters at Ribeirāo Preto, University of São Paulo, Ribeirão Preto, Brazil
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Berber LCL, Melendez-Araújo MS, Nakano EY, de Carvalho KMB, Dutra ES. Grazing Behavior Hinders Weight Loss in Long-Term Post Bariatric Surgery: a Cross-Sectional Study. Obes Surg 2021; 31:4076-4082. [PMID: 34215973 DOI: 10.1007/s11695-021-05533-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 06/13/2021] [Accepted: 06/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Grazing behavior is common in patients undergoing bariatric surgery (BS); however, little is known about grazing behavior in operated patients in the long term. We aimed to estimate grazing frequency and its association with weight loss and surgery response in patients who had undergone BS. METHODS This cross-sectional study included 109 patients who had undergone Roux-en-Y gastric bypass at least 5 years previously. They answered questions about socioeconomic factors, surgical information, and adherence to treatment/follow-up. The Rep(eat) questionnaire was used for grazing assessment. Student's t-test and Pearson's chi-square test were used to evaluate differences between groups. Analysis of covariance and partial correlation were used to investigate grazing behavior, and weight loss outcomes were controlled for the elapsed time since BS, healthcare service type, current psychologist care status, and the presence of a constriction ring. RESULTS The mean elapsed time since BS was 9.97 ± 2.39 years. Patients with grazing behavior (67%) comprised fewer surgery responders (p = 0.019), had lower total (%TWL, p = 0.005) and excess weight loss (%EWL, p = 0.029), and received less psychological counseling (45.5% vs. 54.5%, p = 0.042). Correlations were found between the presence of grazing and its subtypes and %EWL and %TWL (T = - 0.382, T = - 0.361, p < 0.001; compulsive grazing: T = - 0.358, T = - 0.342, p < 0.001, p = 0.001; non-compulsive grazing: T = - 0.333, T = - 0.311, p = 0.001, p = 0.003). No significant difference between patients with and without grazing behavior was found for previous/current diagnoses of psychological diseases or dietitian counseling. CONCLUSION Grazing behavior is common in the long-term among patients who have undergone BS and is negatively related to weight loss parameters.
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Affiliation(s)
- Larissa Cristina Lins Berber
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Mariana Silva Melendez-Araújo
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil.
| | - Eduardo Yoshio Nakano
- Department of Statistics, Institute of Exact Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, DF, 70910-900, Brazil
| | - Kênia Mara Baiocchi de Carvalho
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
| | - Eliane Said Dutra
- Graduate Program of Human Nutrition, Department of Nutrition, Faculty of Health Sciences, University of Brasilia (UnB), Campus Universitário, Darcy Ribeiro. Asa Norte, Brasília, Federal District, 70910-900, Brazil
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Sherf-Dagan S, Sinai T, Goldenshluger A, Globus I, Kessler Y, Schweiger C, Ben-Porat T. Nutritional Assessment and Preparation for Adult Bariatric Surgery Candidates: Clinical Practice. Adv Nutr 2021; 12:1020-1031. [PMID: 33040143 PMCID: PMC8262552 DOI: 10.1093/advances/nmaa121] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/25/2020] [Accepted: 09/03/2020] [Indexed: 12/13/2022] Open
Abstract
Bariatric surgery (BS) has proven to be highly efficacious in the treatment of obesity and its comorbidities. However, careful patient selection is critical for its success. Thus, patients should undergo medical, behavioral, and nutritional assessment by a multidisciplinary team. From the nutritional point of view, BS candidates should undergo nutritional assessment, preparation, and education by a registered dietitian in the preoperative period. Currently, detailed specified and comprehensive information on these topics is lacking. The present narrative review aimed to summarize the available literature concerning both the preoperative nutritional assessment components and the preoperative nutritional preparation and education components of patients planning to undergo BS. Current literature indicates that proper management before BS should include a comprehensive nutritional assessment, in which it is advisable to perform a clinical interview to assess patients' medical background, weight management history, eating patterns and pathologies, oral health, physical activity habits, nutritional status, supplementation usage, BS knowledge, surgery expectations and anthropometric measurements. Nutritional preparation and educational strategies should include an individualized preoperative weight-loss nutrition program, improvement of glycemic control, micronutrients deficiencies correction, eating and lifestyle habits adaptation, physical activity initiation, and strengthening knowledge on obesity and BS. At this stage, more well-designed intervention and long-term cohort studies are needed in order to formulate uniform evidence-based nutritional guidelines for patients who plan to undergo BS, including populations at higher nutritional risk. Moreover, postoperative outcomes of presurgical nutritional intervention programs should be studied.
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Affiliation(s)
- Shiri Sherf-Dagan
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Nutrition, Assuta Medical Center, Tel Aviv, Israel
| | - Tali Sinai
- Israel Center for Disease Control, Ministry of Health, Ramat Gan, Israel
- School of Nutritional Sciences, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Ariela Goldenshluger
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel Aviv, Israel
| | | | - Yafit Kessler
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ariel, Israel
- Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel
| | - Chaya Schweiger
- Nutrition Service, Rabin Medical Center, Campus Beilinson, Petach Tiqva, Israel
| | - Tair Ben-Porat
- Department of Nutrition, Hadassah-Hebrew University Medical Center, Ein-Kerem Campus, Jerusalem, Israel
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel
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Oved I, Endevelt R, Mardy-Tilbor L, Raziel A, Sherf-Dagan S. Health Status, Eating, and Lifestyle Habits in the Long Term Following Sleeve Gastrectomy. Obes Surg 2021; 31:2979-2987. [PMID: 33829384 DOI: 10.1007/s11695-021-05336-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Sleeve gastrectomy (SG) is an established bariatric procedure. However, long-term data on eating and lifestyle behaviors and their effect on weight outcomes are scarce. Therefore, this study aimed to examine these long-term behaviors and their associations to weight outcomes following SG. METHODS A long-term follow-up study (>5 years post-surgery) of 266 adult patients admitted to a primary SG surgery during 2008-2012 and who participated in a pre-surgery study was conducted. Data on pre-surgery demographics, anthropometrics, and medical status were obtained from the patients' medical records. Data on long-term health status, anthropometrics, lifestyle and eating habits, eating pathologies, follow-up regime, and satisfaction from the surgery were collected by an interview phone calls according to a structured questionnaire. RESULTS Data of 169 patients were available before and 7.8±1.0 years post-SG. Their baseline mean age was 41.8±11.3 years, and 71.6% of them were females. The mean post-surgery excess weight loss (EWL) was 53.2±31.2%, and 54.2% had EWL of ≥50%. Eating 3-6 meals per day, not having the urge to eat after dinner, separating liquids from solids, avoiding carbonated beverages, and performing physical activity were related to better weight-loss outcomes (P≤0.026). However, frequent need for eating sweets, binge eating, and feeling guilty or sad after eating were related to worse weight-loss outcomes (P≤0.010). Furthermore, only a minority reported taking a multivitamin and participating in follow-up meetings after more than 1 year since the surgery (≤21.3%). CONCLUSIONS In the long term following SG, approximately half achieved EWL of ≥50%, and physical activity, certain eating patterns, and eating pathologies were related to weight outcomes.
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Affiliation(s)
- Irit Oved
- School of Public Health, University of Haifa, Haifa, Israel
| | - Ronit Endevelt
- School of Public Health, University of Haifa, Haifa, Israel.,Nutrition Division, Ministry of Health, Jerusalem, Israel
| | | | - Asnat Raziel
- Assia Medical Group, Assuta Medical Center, Tel-Aviv, Israel
| | - Shiri Sherf-Dagan
- Department of Nutritional Sciences, School of Health Sciences, Ariel University, Ramat HaGolan St 65, 40700, Ariel, Israel. .,Department of Nutrition, Assuta Medical Center, Tel-Aviv, Israel.
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El Ansari W, Elhag W. Weight Regain and Insufficient Weight Loss After Bariatric Surgery: Definitions, Prevalence, Mechanisms, Predictors, Prevention and Management Strategies, and Knowledge Gaps-a Scoping Review. Obes Surg 2021; 31:1755-1766. [PMID: 33555451 PMCID: PMC8012333 DOI: 10.1007/s11695-020-05160-5] [Citation(s) in RCA: 243] [Impact Index Per Article: 60.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/01/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022]
Abstract
Some patients experience weight regain (WR) or insufficient weight loss (IWL) after bariatric surgery (BS). We undertook a scoping review of WR and IWL after BS. We searched electronic databases for studies addressing the definitions, prevalence, mechanisms, clinical significance, preoperative predictors, and preventive and treatment approaches including behavioral, pharmacological, and surgical management strategies of WR and IWL. Many definitions exist for WR, less so for IWL, resulting in inconsistencies in the reported prevalence of these two conditions. Mechanisms and preoperative predictors contributing to WR are complex and multifactorial. A range of the current knowledge gaps are identified and questions that need to be addressed are outlined. Therefore, there is an urgent need to address these knowledge gaps for a better evidence base that would guide patient counseling, selection, and lead to improved outcomes.
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Affiliation(s)
- Walid El Ansari
- Department of Surgery, Hamad General Hospital, Doha, 3050 Qatar
- College of Medicine, Qatar University, Doha, Qatar
- Schools of Health and Education, University of Skovde, Skövde, Sweden
| | - Wahiba Elhag
- Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Doha, 3050 Qatar
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Newman AKR, Herbozo S, Russell A, Eisele H, Zasadzinski L, Hassan C, Sanchez-Johnsen L. Psychosocial interventions to reduce eating pathology in bariatric surgery patients: a systematic review. J Behav Med 2021; 44:421-436. [PMID: 33580454 DOI: 10.1007/s10865-021-00201-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 01/06/2021] [Indexed: 02/07/2023]
Abstract
Bariatric surgery is the most effective treatment for severe obesity; however, a subset of patients experience suboptimal outcomes. Psychosocial interventions that address eating pathology may ameliorate negative consequences, although their efficacy has not been examined. Thus, a systematic review to evaluate the impact of psychosocial randomized controlled trials (RCTs) on eating pathology in adults pre and post-bariatric surgery was conducted. Six scientific databases were searched for psychosocial trials assessing eating pathology as an outcome. Ten RCTs representing seven distinct interventions were identified (i.e., four preoperative and six postoperative). Trials utilized cognitive-behavioral therapy, mindfulness-based approaches, acceptance-based treatment, motivational interviewing, and psychoeducational interventions. Findings provide initial support for reducing eating pathology pre and postoperatively in the short-term (i.e., 6 months); however, the small number of RCTs and heterogeneity among postoperative trials made it difficult to draw conclusions. Additional longitudinal studies are needed to determine the long-term impact of psychosocial interventions that address eating pathology in bariatric surgery patients endorsing significant eating pathology.
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Affiliation(s)
- Alison Kaylen-Reynard Newman
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA. .,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sylvia Herbozo
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Andrea Russell
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Heather Eisele
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.,Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lindsay Zasadzinski
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
| | - Chandra Hassan
- Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa Sanchez-Johnsen
- Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA.,Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
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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: 0.8] [Reference Citation Analysis] [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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Eik-Nes TT, Vrabel K, Raman J, Clark MR, Berg KH. A Group Intervention for Individuals With Obesity and Comorbid Binge Eating Disorder: Results From a Feasibility Study. Front Endocrinol (Lausanne) 2021; 12:738856. [PMID: 34803910 PMCID: PMC8597950 DOI: 10.3389/fendo.2021.738856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE A common challenge among a subgroup of individuals with obesity is binge eating, that exists on a continuum from mild binge eating episodes to severe binge eating disorder (BED). BED is common among bariatric patients and the prevalence of disordered eating and ED in bariatric surgery populations is well known. Conventional treatments and assessment of obesity seldom address the underlying psychological mechanisms of binge eating and subsequent obesity. This study, titled PnP (People need People) is a psychoeducational group pilot intervention for individuals with BED and obesity including patients with previous bariatric surgery. Design, feasibility, and a broad description of the study population is reported. MATERIAL AND METHODS A total of 42 patients were from an obesity clinic referred to assessment and treatment with PnP in a psychoeducational group setting (3-hour weekly meetings for 10 weeks). Of these, 6 (14.3%) patients had a previous history of bariatric surgery. Feasibility was assessed by tracking attendance, potentially adverse effects and outcome measures including body mass index (BMI), eating disorder pathology, overvaluation of shape and weight, impairment, self-reported childhood difficulties, alexithymia, internalized shame as well as health related quality of life (HRQoL). RESULTS All 42 patients completed the intervention, with no adverse effects and a high attendance rate with a median attendance of 10 sessions, 95% CI (8.9,9.6) and 0% attrition. Extent of psychosocial impairment due to eating disorder pathology, body dissatisfaction and severity of ED symptoms were high among the patients at baseline. Additionally, self-reported childhood difficulties, alexithymia, and internalized shame were high among the patients and indicate a need to address underlying psychological mechanisms in individuals with BED and comorbid obesity. Improvement of HRQoL and reduction of binge eating between baseline and the end of the intervention was observed with a medium effect. CONCLUSION This feasibility study supports PnP as a potential group psychoeducational intervention for patients living with BED and comorbid obesity. Assessments of BED and delivery of this intervention may optimize selection of candidates and bariatric outcomes. These preliminary results warrant further investigation via a randomized control trial (RCT) to examine the efficacy and effectiveness of PnP.
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Affiliation(s)
- Trine T. Eik-Nes
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
- *Correspondence: Trine T. Eik-Nes,
| | | | - Jayanthi Raman
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Melinda Rose Clark
- Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Kjersti Hognes Berg
- Stjørdal Community Mental Health Centre, Levanger Hospital, Levanger, Norway
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Faria SL, O’Kane M. The importance of a cookbook for patients who have bariatric surgery. NUTRITION AND BARIATRIC SURGERY 2021:257-282. [DOI: 10.1016/b978-0-12-822922-4.00010-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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Kops NL, Vivan MA, Fülber ER, Fleuri M, Fagundes J, Friedman R. Preoperative Binge Eating and Weight Loss After Bariatric Surgery: A Systematic Review and Meta-analysis. Obes Surg 2020; 31:1239-1248. [PMID: 33219919 DOI: 10.1007/s11695-020-05124-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND Several studies have investigated if bariatric surgery candidates with binge eating disorder (BED) are at risk for suboptimal postoperative weight loss. The aim of this systematic review with meta-analysis was to evaluate the association between binge eating diagnosed preoperatively and weight loss after bariatric surgery. METHODS MEDLINE, EMBASE, CENTRAL, LILACS, and other specialized databases were searched on August 2020. Clinical trials and observational studies including individuals who had undergone any type of bariatric surgical treatment with preoperative evaluation of BED and at least one postoperative measure of weight were initially selected. Four reviewers independently screened for eligibility. The mean difference was calculated using the random-effects model. RESULTS Nineteen studies, comprising 3223 participants (80.25% women; median age 41 years), met the inclusion criteria for meta-analysis. At 6 months postoperative, the percentage of total weight loss (%TWL) was not significantly different between BED and non-BED groups [6 studies, 914 participants: - 0.75% (95% CI, - 2.79 to 1.29; I2 = 0%)], even when analyzing only those three studies that included gold standard assessment tools. No significant differences were found at 12, 24, 36, or 60 months. CONCLUSIONS Pre-bariatric BED seems to have little or no influence on weight loss after surgery. However, many questions remain unanswered because of the use of different measures across studies. The heterogeneity among studies emphasizes the importance of investigators using the same assessment measures.
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Affiliation(s)
- Natália Luiza Kops
- Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, 90560-030, Brazil.
| | - Manoela Astolfi Vivan
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Elisa Ruiz Fülber
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Marco Fleuri
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Julia Fagundes
- Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rogério Friedman
- Graduate Program in Endocrinology, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, 90560-030, Brazil.,Endocrinology Division, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
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Gradaschi R, Molinari V, Sukkar SG, De Negri P, Adami GF, Camerini G. Disordered eating and weight loss after bariatric surgery. Eat Weight Disord 2020; 25:1191-1196. [PMID: 31302883 DOI: 10.1007/s40519-019-00749-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 07/04/2019] [Indexed: 12/23/2022] Open
Abstract
PURPOSES Aberrant eating patterns are frequently observed in bariatric patients. Since bariatric operations produce alterations in food transit and in appetite/satiety balance, postoperative eating behavior changes are not surprising. METHODS 88 consecutive obese patients undergoing Roux-en-Y gastric bypass (RYGBP, 50 cases) and Sleeve Gastrectomy (SG, 38 cases) were retrospectively evaluated. Beside anthropometric data measurement, eating behavior was assessed by direct interview prior to the operation and at the first and second postoperative years: patients were considered as eating disordered (ED) when referred habitual occurrence of binge eating and nibbling/grazing. Weight loss was assessed by percent of BMI loss (% Δ BMI). Together with standard follow-up, patients received additional behavioral/dietetic support upon request. RESULTS Postoperative ED patients showed lower % Δ BMI than the not ED ones at one (30.7% ± 8,5 vs. 26.8% ± 10, p < 0.02) and two (32% ± 10.3 vs. 27.4% ± 12.9, p < 0.05) years after operation, the follow-up rate being 82% and 76%, respectively, without differences between RYGBP and SG group. After RYGBP, an improvement of eating behavior was observed (ED patients from 75 to 28% at 1 year and to 27% at 2 years), while no changes were observed after SG. In SG patients, the number of additional behavioral/dietetic support sessions throughout the follow-up was positively associated with % Δ BMI. DISCUSSION The postoperative normalization of eating pattern has a role in weight loss after bariatric surgery. Behavioral/dietetic support is indicated in all SG patient, while after RYGBP is useful only when weight loss is unsatisfactory. LEVEL OF EVIDENCE III: retrospective cohort study.
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Affiliation(s)
- Raffaella Gradaschi
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Virginia Molinari
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Samir Giuseppe Sukkar
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Paola De Negri
- Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy
| | - Gian Franco Adami
- Department of Internal Medicine, University of Genova, Largo Benzi 8, Genova, 16132, Italy.
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Cassin S, Leung S, Hawa R, Wnuk S, Jackson T, Sockalingam S. Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy. Nutrients 2020; 12:nu12102905. [PMID: 32977459 PMCID: PMC7598202 DOI: 10.3390/nu12102905] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/16/2020] [Accepted: 09/21/2020] [Indexed: 12/11/2022] Open
Abstract
The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample.
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Affiliation(s)
- Stephanie Cassin
- Department of Psychology, Ryerson University, Toronto, ON M5B 2K3, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Correspondence: (S.C.); (S.S.); Tel.: +1-416-979-5000 (ext. 3007) (S.C.); +1-416-535-8501 (ext. 32178) (S.S.)
| | - Samantha Leung
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Raed Hawa
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Susan Wnuk
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
| | - Timothy Jackson
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
- Division of General Surgery, University Health Network, University of Toronto, Toronto, ON M5T 2S8, Canada
| | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada; (R.H.); (S.W.)
- Centre for Mental Health, University Health Network, Toronto, ON M5T 2S8, Canada;
- Bariatric Surgery Program, Toronto Western Hospital, Toronto, ON M5T 2S8, Canada;
- Centre for Addiction and Mental Health, Toronto, ON M5S 2S1, Canada
- Correspondence: (S.C.); (S.S.); Tel.: +1-416-979-5000 (ext. 3007) (S.C.); +1-416-535-8501 (ext. 32178) (S.S.)
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Konings G, Drukker M, Mulkens S, Severeijns R, van Os J, Ponds R. Postsurgical Compliance and Eating Behavior 5 Years After Surgery. Bariatr Surg Pract Patient Care 2020. [DOI: 10.1089/bari.2019.0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Gerdy Konings
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Marjan Drukker
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Sandra Mulkens
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Clinical Psychological Science, Section on Eating Disorders and Obesity, Maastricht University, Maastricht, The Netherlands
| | - Ruud Severeijns
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, London, United Kingdom
| | - Rudolf Ponds
- Department of Psychiatry and Psychology, School of Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands
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Raman J, Spirou D, Jahren L, Eik-Nes TT. The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology. Front Endocrinol (Lausanne) 2020; 11:563. [PMID: 32903696 PMCID: PMC7438835 DOI: 10.3389/fendo.2020.00563] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/10/2020] [Indexed: 11/13/2022] Open
Abstract
Ranked highly in its association with serious medical comorbidities, obesity, a rapidly growing epidemic worldwide, poses a significant socio-economic burden. While bariatric procedures offer the most efficacious treatment for weight loss, a subset of patients risk weight recidivism. Due to the heterogeneity of obesity, it is likely that there are phenotypes or sub-groups of patients that require evidence-based psychological support to produce more sustainable outcomes. So far, however, characteristics of patients have not led to a personalized treatment algorithm for bariatric surgery. Maintenance of weight loss following bariatric surgery requires long-term modification of eating behaviors and physical activity. A recent Clinical Obesity Maintenance Model (COMM) proposed a conceptual framework of salient constructs, including the role of habit, behavioral clusters, emotion dysregulation, mood, health literacy, and executive function as interconnected drivers of obesity maintaining behaviors relevant to the field of bariatric psychology. The primary aim of this concise review is to bring together emerging findings from experimental and epidemiological studies relating to the COMM constructs that may inform the assessment and follow up of bariatric surgery. We also aim to explain the phenotypes that need to be understood and screened prior to bariatric surgery to enable better pre-surgery intervention and optimum post-surgery response.
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Affiliation(s)
- Jayanthi Raman
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Dean Spirou
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Lisbeth Jahren
- Library Section for Medicine and Health Sciences, NTNU University Library, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine Tetlie Eik-Nes
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim, Norway
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