Eating disorders and emotional dysregulation are associated with insufficient weight loss after bariatric surgery: a 1-year observational follow-up study

Abstract

Purpose Subjects with obesity, especially those seeking bariatric surgery, exhibit high rates of mental disorders and marked psychopathological traits. The primary objective of this prospective, non-interventional study was to investigate whether the presence of different psychiatric disorders, attention deficit/hyperactivity disorder (ADHD) symptomatology and emotional dysregulation influenced weight loss at 1-year follow-up after surgery. Methods Subjects consecutively referred for pre-surgical evaluation at the Obesity Center of Pisa University Hospital were recruited. Psychiatric diagnoses were made through the Mini-International Neuropsychiatric Interview (MINI) and ADHD symptomatology was assessed with the Wender–Reimherr Adult Attention Deficit Disorder Scale (WRAADDS). Emotional dysregulation was investigated through the WRAADDS and self-report questionnaires. After surgery, weight and obesity-related comorbidities were monitored during follow-up. Results Of the 99 participants recruited, 76 underwent surgery and 65 could be reevaluated 1 year after surgery. Subjects with insufficient weight loss (excess body mass index loss ≤ 53%, n = 15) had more frequent lifetime binge eating disorder (BED) and BED-mood disorders comorbidity than subjects with favorable post-surgical outcome. Additionally, they scored higher on both physician-administered and self-report scales assessing emotional dysregulation, which represents a nuclear symptom of ADHD in adults. At the logistic regression analysis, older age, higher preoperative excess body mass index and greater affective instability were predictors of reduced weight loss at 1-year follow-up. Conclusion Emotional dysregulation seems to be associated with a worse outcome after bariatric surgery. Further studies with larger samples and longer follow-up are needed to confirm the influence of different psychiatric disorders and psychopathological traits on post-surgical outcome. Level of evidence V, prospective descriptive study.

Using latent class analysis to identify different clinical profiles according to food addiction symptoms in obesity with and without binge eating disorder

“…This represents a cohort of individuals with obesity actively engaged in a weight loss intervention. The fortuitous alignment in group sizes is in line with the prevalent occurrence of BED among individuals with obesity undergoing weight loss interventions such as weight loss programs and bariatric surgery ( Barbuti et al., 2023 ; de Zwaan, 2001 ). Notably, participants in the obesity without BED group did not meet the criteria for any eating disorder.…”

Anthropometric and Body Composition Changes over Five Years after Bariatric Surgery in Patients with Obesity, Diagnosed or Not Diagnosed with Binge Eating Disorder (BED) in the Preoperative Period

“…In addition, the clinical management of patients diagnosed with BED in the preoperative period of bariatric surgery must be more precise and must occur throughout the postoperative period, as it can be a determining factor in weight regain [36,39]. Sessions of psychotherapy, structured self-help treatment, neuropsychological assessment, and pharmacotherapy for patients with BED have been suggested throughout the postoperative period [40,41].…”

A avaliação do transtorno da compulsão alimentar periódica pré e pós bariátrica

“…Os rastreadores de saúde mental mostraram taxas mínimas de psicopatologia adversa, com 63% não relevando sintomas de depressão e 52,69% relevando sintomas leves ou nenhum sintoma de ansiedade na triagem (Butt et al, 2023). Barbuti et al (2023) realizaram um estudo com o objetivo principal investigar se os transtornos de TDAH e a desregulação emocional influenciaram a perda de peso no acompanhamento em um acompanhamento de um ano após a cirurgia. Foram recrutadas pessoas que estavam em processo de avaliação pré-cirúrgica em um hospital de Pisa.…”