Insomnia and depressive symptoms in relation to unhealthy eating behaviors in bariatric surgery candidates

Abstract

BackgroundAlongside obesity, insomnia and depression are common public health problems. Sleep problems are currently believed to be associated with excessive food intake and metabolic disturbances. Therefore, we aimed to explore a relationship between insomnia, depressive symptoms and eating habits as well as metabolic parameters in bariatric surgery candidates.MethodsA total of 361 unrelated obese subjects were included in this study. Severity of sleep problems was measured with Athens Insomnia Scale (AIS) and the severity of depressive symptoms was assessed with the Beck Depression Inventory (BDI-II). Obstructive sleep apnea (OSA) was assessed by the Apnea Hypopnoea Index (AHI). Information was obtained about demographics, eating habits and lifestyle. Blood samples were collected to measure concentration of lipids (cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol), and glucose.ResultsThe median (interquartile range) score for AIS in the study participants was 5 (3–8) with a range of 0–24 and 47% (171) participants scored ≥6 (met criteria for diagnosis of insomnia). Statistically significant correlations were found between the AIS scores and serum triglycerides and glucose concentrations, and BDI-II total scores. The highest scores on AIS and BDI-II were found in participants with high frequency of snack food consumption, in physically inactive individuals as well as in those who self-reported eating at night or who declared more than 3 intense emotions associated with a desire-to-eat. Adjusted multivariate logistic regression analysis revealed that clinical insomnia was most strongly associated with daily consumption of snack foods, with the odds ratio of 3.26 (95% CI: 1.74–6.11), while depressive symptoms were strongly associated with both eating in response to ≥3 specific emotions with OR = 2.93 (95% CI: 1.26–6.78) as well as with daily consumption of snack foods with OR = 2.87 (95% CI: 1.16–5.14).ConclusionsThe results indicate that insomnia and depression in obese individuals are associated with eating habits, and suggest that in some patients these associations appears as major factors affecting obesity development.

Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating

“…Increasing evidence suggests a bidirectional relationship between disordered sleep and obesity [1, 2, 3]. Poor sleep quality and short sleep duration are known co-morbidities of obesity and specifically associated with the development and progression of obesity, which can undermine weight loss efforts [2].…”

“…Psychological factors have also been found to impact the relationship between poor sleep and disordered eating among individuals with obesity [8]. In a sample of bariatric surgery candidates with obesity, clinical insomnia (e.g., difficulty initiating and/or maintaining sleep accompanied by distress or impairment; [13]) and depressive symptoms were associated with increased daily consumption of snack foods, eating in response to emotion, and night eating thereby supporting a relationship between disordered sleep and problematic eating habits prior to surgery [3]. Collectively, such findings suggest a link between mood symptoms, sleep quality, obesity, and eating patterns.…”

“…The relationship between sleep and LOC eating has not yet been examined post-operatively, but previous research with bariatric candidates provides support for the aims of the present study. Bariatric candidates with LOC eating endorsed significantly higher levels of depression, eating-disorder psychopathology, and night eating compared to individuals without LOC eating [3, 18]. Similarly, poor sleep is associated with obesity, depression, lower quality of life, and disordered eating patterns such as increased night eating [5, 6, 8].…”

Self-Persuasion Increases Healthy Eating Intention Depending on Cultural Background

“…Unhealthy eating behavior has become one of the most recognized global health risks, and has been identified as a major cause of a number of severe physical and mental health problems, such as cancer, insomnia, and depression [1,2]. According to a report from the Dutch National Institute for Public Health and the Environment [3], the Dutch population ranks quite high in consumption of high-calorie food, such as snacks and fats, and ranks relatively low in consumption of vegetables, fish, and fruit in comparison to 12 other European countries.…”

Should we use BMI as a selection criterion for bariatric surgery?

“…In addition to cardiometabolic risk, selection for bariatric surgery should of course also consider psychological and emotional factors that may have a negative impact on the outcome of bariatric surgery. In one study, there were associations between insomnia and depression with appetite scores and daily consumption of snack foods [17]. Whilst our own group did not demonstrate pre-operative psychological (and quality of life) factors as significant predictors of weight-loss following gastric band insertion [18], future studies on preoperative predictors of outcome following bariatric surgery should further explore this area, and include measures of sleep quality and sufficiency, given the known effects of sleep duration on appetite control [19].…”