Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis

Mauro, Maria Francisca F. P.; Papelbaum, Marcelo; Brasil, Marco Antônio Alves; Carneiro, João Régis Ivar; Coutinho, Eridan M.; Coutinho, Walmir; Appolinário, José Carlos

doi:10.1111/obr.12907

Cited by 56 publications

(51 citation statements)

References 69 publications

(231 reference statements)

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“…Moreover, not only do altered eating patterns seem to have an immediate impact on weight outcomes, but also sustaining problematic eating behaviors will probably result in further weight gain in the long-term [38]. It is therefore imperative that patients are continuously on psychological and weight outcomes after bariatric surgery [31].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19

Conceição

Lourdes

Ramalho

et al. 2021

Surgery for Obesity and Related Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19

Conceição

Lourdes

Ramalho

et al. 2021

Surgery for Obesity and Related Diseases

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“…A substantial evidence-base supports the prevalence of disordered eating behaviors (DEB) and eating disorders (ED) in bariatric surgery outcomes [e.g., ( 28 – 31 )] with two recent studies finding a higher prevalence of ED in post-surgical bariatric patients with weight regain ( 32 , 33 ). In addition, Binge Eating Disorder (BED) is highly prevalent among bariatric patients ( 34 ).…”

Section: Disordered Eating Behaviors and Eating Disordersmentioning

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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“…Factors leading to weight regain following surgery remain poorly understood, yet cross-sectional studies point towards a possible role of the brain in regulating the treatment response. Impulsivity and disinhibition are traits often associated with poorer weight loss after surgery, but both psychosocial issues and psychiatric comorbidities may also have a major impact on weight loss outcomes (Odom et al, 2010; Mauro et al, 2019; Muller et al, 2019; Sarwer et al, 2019). However, only few neuroimaging studies have examined neural predictors of weight loss after surgery.…”

Section: Introductionmentioning

confidence: 99%

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

Karlsson

Tuominen

Helin

et al. 2021

Preprint

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BackgroundBariatric surgery is the most effective method for weight loss in morbid obesity. There is significant individual variability in the weight loss outcomes, yet factors leading to postoperative weight loss or weight regain remain elusive. Alterations in the µ-opioid receptor (MOR) and dopamine D2 receptor (D2R) systems are associated with obesity, appetite control, and reward processing. The magnitude of initial brain receptor system perturbation is a plausible predictor of long-term surgical weight loss outcomes. The aim was to test this hypothesis by measuring obese subjects’ MOR and D2R availability with positron emission tomography (PET) preoperatively before bariatric surgery and then assessing their weight development association with regional MOR and D2R availabilities at 2-year follow-up.MethodsWe studied 19 morbidly obese women (mean BMI 40, mean age 43) scheduled to undergo bariatric surgery, i.e. Roux-en-Y gastric bypass or sleeve gastrectomy, according to their standard clinical treatment. Preoperative MOR and D2R availabilities were measured using PET with [11C]carfentanil and [11C]raclopride, respectively. Subject weight was recorded at 3, 6, 12, and 24 months after surgery. Radiotracer binding potentials (BPND) were extracted and correlated with patient weight at different time points. ROIs were delineated in the striatum and in limbic and paralimbic components of the emotion and reward networks.ResultsMOR availabilities were not correlated with preoperative weight. MOR availabilities in the amygdala (r = −0.54), insula (r = −0.46), ventral striatum (r = −0.48) and putamen (r = −0.49) were associated with subject weight at 3 months. Significant association was found in the amygdala at 6 months (r = −0.53), 12 (r = −0.49), and 24 months (r = −0.50). D2R availabilities were associated with neither preoperative weight nor weight loss at any follow-up time point.ConclusionsTo our knowledge, this is the first study to demonstrate that neuroreceptor markers prior to bariatric surgery in patients with morbid obesity are associated with the postoperative weight loss. Preoperative MOR availability in the amygdala was associated with long-term postoperative weight development after surgery suggesting that postoperative weight regain may derive from dysfunction in the opioid system. Postoperative weight loss outcomes after bariatric surgery may be partially predicted based on preoperative receptor availability opening up new potential for treatment possibilities.Clinical Trials RegistrationSleevePET2, NCT01373892, http://www.clinicaltrials.gov

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Is weight regain after bariatric surgery associated with psychiatric comorbidity? A systematic review and meta‐analysis

Cited by 56 publications

References 69 publications

Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19

Eating behaviors and weight outcomes in bariatric surgery patients amidst COVID-19

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

Preoperative μ-opioid receptor availability predicts weight loss following bariatric surgery

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