Exploring pre-surgery and post-surgery substance use disorder and alcohol use disorder in bariatric surgery: a qualitative scoping review

Kanji, Sarah; Wong, E; Akioyamen, Leo E.; Melamed, Osnat; Taylor, Valerie H.

doi:10.1038/s41366-019-0397-x

Cited by 38 publications

(21 citation statements)

References 68 publications

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“…Two international qualitative studies with sample sizes < 25 either were majority non-Hispanic White [6,61] or did not report ethnicity [7,62] and neither reported on substance use behaviors in BS patients. A history of BS is associated with increased substance, and this is thought to be due to a variety of psychosocial and physiological factors [8,9,[63][64][65][66]. In the current study, education, income, and ethnicity do not appear to be associated with or protective against these increases in mental health stresses and behaviors for post-BS patients.…”

Section: Discussioncontrasting

confidence: 51%

Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients

et al. 2021

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Purpose The impact of the COVID-19 pandemic on behavioral issues among those who have completed bariatric surgery (BS) is not well described in ethnically diverse populations. The aim of this study was to compare the impact of COVID-19 lockdown orders and after lockdown orders were lifted on substance use, mental health, and weight-related behaviors among a sample of post-BS adults. Materials and Methods A retrospective medical chart review identified BS patients from one university-based obesity medicine clinic and two BS practices. An online non-anonymous survey was implemented in two phases: during lockdown (April 1-May 31, 2020) and after lockdown orders were lifted (June 1, 2020-September 30, 2020) to obtain information about the COVID-19 pandemic's impact on BS patients. Results A total of 189 (during lockdown=39, post-lockdown=150) participants (90.4% female, mean age 52.4 years, SD 11.1, 49.8% non-Hispanic White, 30.6% non-Hispanic Black, 16.1% Hispanic) participated. Lockdown participants were more likely to have sleep problems (74.3% vs. 56.1%, P=.039) and feel anxious (82.0% vs. 63.0%, P=.024) versus post-lockdown participants. A majority (83.4%) reported depression in both lockdown/post-lockdown. Post-lockdown participants were more than 20 times more likely to report substance use compared those in lockdown (aOR 20.56, 95% CI 2.66-158.4).

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Section: Discussioncontrasting

confidence: 51%

Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients

et al. 2021

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“…In support of this view, a study found that bariatric candidates who reported pre-surgical grazing behaviors also reported more alcohol use, less physical activity, and more difficulties in post-surgery lifestyle modification ( 36 ). Similarly, longitudinal studies have indicated that pre-surgery problematic alcohol, substance, and tobacco use to be reliable correlates of post-surgery problematic alcohol and substance use in bariatric patients ( 87 – 89 ). Whether these maladaptive clusters are activated as coping and/or compensatory reward mechanisms in a caloric-restricted new lifestyle following bariatric surgery is yet to be explored ( 90 ).…”

Section: Behavioral Clustersmentioning

confidence: 99%

The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology

et al. 2020

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Ranked highly in its association with serious medical comorbidities, obesity, a rapidly growing epidemic worldwide, poses a significant socioeconomic 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 subgroups 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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“…Convergence from neuroscience findings with case reports from the field have made clear that dysregulation of DA function is important for reward-related processes driving substance-seeking behavior [ 84 ]. Many authors have speculated that the bidirectional association between food and alcohol/drug dysfunction represents an “addiction transfer” [ 85 ] which has been supported by many studies of bariatric patients [ 86 ]. In a large twin study from the Netherlands, genetic factors explained 48% of the variation in high sugar consumption (52% explained by unique environmental factors), suggesting that neuronal circuits underlying the development of addiction and obesity are related, possibly due to DA receptor dysfunction that lead to difficulties resisting rewarding stimuli [ 87 ].…”

Section: Substance Use Disordersmentioning

confidence: 99%

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

Wiss

Brewerton

2020

Nutrients

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Converging evidence from both animal and human studies have implicated hedonic eating as a driver of both binge eating and obesity. The construct of food addiction has been used to capture pathological eating across clinical and non-clinical populations. There is an ongoing debate regarding the value of a food addiction “diagnosis” among those with eating disorders such as anorexia nervosa binge/purge-type, bulimia nervosa, and binge eating disorder. Much of the food addiction research in eating disorder populations has failed to account for dietary restraint, which can increase addiction-like eating behaviors and may even lead to false positives. Some have argued that the concept of food addiction does more harm than good by encouraging restrictive approaches to eating. Others have shown that a better understanding of the food addiction model can reduce stigma associated with obesity. What is lacking in the literature is a description of a more comprehensive approach to the assessment of food addiction. This should include consideration of dietary restraint, and the presence of symptoms of other psychiatric disorders (substance use, posttraumatic stress, depressive, anxiety, attention deficit hyperactivity) to guide treatments including nutrition interventions. The purpose of this review is to help clinicians identify the symptoms of food addiction (true positives, or “the signal”) from the more classic eating pathology (true negatives, or “restraint”) that can potentially elevate food addiction scores (false positives, or “the noise”). Three clinical vignettes are presented, designed to aid with the assessment process, case conceptualization, and treatment strategies. The review summarizes logical steps that clinicians can take to contextualize elevated food addiction scores, even when the use of validated research instruments is not practical.

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Exploring pre-surgery and post-surgery substance use disorder and alcohol use disorder in bariatric surgery: a qualitative scoping review

Cited by 38 publications

References 68 publications

Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients

Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients

The Clinical Obesity Maintenance Model: A Theoretical Framework for Bariatric Psychology

Separating the Signal from the Noise: How Psychiatric Diagnoses Can Help Discern Food Addiction from Dietary Restraint

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