Long-term effects of gastric bypass surgery on psychosocial well-being and eating behavior: not all that glitters is gold

Vangoitsenhoven, Roman; Frederiks, Pascal; Gijbels, Brecht; Lannoo, Matthias; Borght, Wout Van der; Eynde, Amber Van den; Mertens, Ann; Mathieu, Chantal; Schueren, Bart Van der

doi:10.1080/17843286.2016.1174393

Cited by 10 publications

(6 citation statements)

References 42 publications

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“…Qualitative analysis indicated an improvement in emotional eating in the first 12 months after bariatric surgery 25–28,31,34,37,39–43 , and mixed findings thereafter. The observation in longitudinal studies that early postoperative changes in emotional eating may not be sustained in the longer term are consistent with findings from cross‐sectional studies comparing patients at 24–68 months after LAGB with presurgical controls 48 and patients at 7 years post‐RYGB with control groups with obesity 49 , as well as with a 2016 systematic review by Opozda and colleagues 50 which examined preoperative and postoperative emotional eating patterns, mostly after RYGB.…”

Section: Discussionsupporting

confidence: 80%

Change in emotional eating after bariatric surgery: systematic review and meta-analysis

et al. 2020

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Background: The effect of bariatric surgery on 'emotional eating' (EE) in people with obesity is unclear. This systematic review and meta-analysis aimed to examine changes in self-reported emotional eating behaviour after bariatric surgery. Methods: Fifteen electronic databases were searched from inception to August 2019. Included studies encompassed patients undergoing primary bariatric surgery, quantitatively assessed EE, and reported EE scores before and after surgery in the same participants. Studies were excluded if they were not in English or available in full text. The systematic review and meta-analysis were conducted according to the PRISMA guidelines. Random-effects models were used for quantitative analysis. Study quality was assessed using the National Heart, Lung, and Blood Institute quality assessment tool for before-after (pre-post) studies with no control group. Results: Some 23 studies containing 6749 participants were included in the qualitative synthesis, with follow-up of from 2 weeks to 48 months. EE scores decreased to 12 months after surgery. Results were mixed beyond 12 months. Quantitative synthesis of 17 studies (2811 participants) found that EE scores decreased by a standardized mean difference of 1⋅09 (95 per cent c.i. 0⋅76 to 1⋅42) 4-18 months after surgery, indicating a large effect size. Conclusion: Bariatric surgery may mitigate the tendency to eat in response to emotions in the short to medium term.

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Section: Discussionsupporting

confidence: 80%

Change in emotional eating after bariatric surgery: systematic review and meta-analysis

et al. 2020

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“…Thirdly, the 1-year follow-up might have been too short. Several studies reported long-term recidivism in eating pathologies, notably in those patients who experience weight regain [32,43]. Fourthly, the majority of patients in our cohort were female and underwent RYGB, therefore the overall outcomes (EDE-Q scores, comorbidity resolution, surgical complications) are less generalizable to males and to patients who undergo SG.…”

Section: Discussionmentioning

confidence: 86%

Predictors of a Healthy Eating Disorder Examination-Questionnaire (EDE-Q) Score 1 Year After Bariatric Surgery

et al. 2019

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BACKGROUND: Bariatric surgery (BS) has been shown to ameliorate health-related quality of life and eating disorder symptoms. However, the correlation of these changes with weight loss is not uniform, suggesting that additional factors have an impact on postoperative outcomes. OBJECTIVE: To assess the impact of BS on eating disorder symptoms at 1 year postoperatively and to generate predictive models for the achievement of optimal eating behavior. METHODS: Retrospective cohort study on a prospectively collected database of all consecutive patients who underwent primary BS in our academic center between January 2015 and March 2017. Eating Disorder Examination-Questionnaire (EDE-Q) was used to measure eating psychopathology. Logistic regression was used to estimate the odds ratio of achieving "healthy" EDE-Q at 1 year. Missing data was handled by multiple imputations for the regression model. RESULTS: Two-hundred thirty-four patients were included. A complete-case analysis in 135 cases showed a "healthy" EDE-Q in 27.4% at baseline and in 83.7% at 1 year (difference = 56.3%, P = 0.018). Only the baseline EDE-Q "healthy" status influenced significantly the odds of achieving "healthy" EDE-Q at 1 year (OR 6.7, 95% CI 1.18-38.14, P = 0.04). CONCLUSION: BS seems to promote successful treatment of self-reported eating disorder symptoms during the first postoperative year. The achievement of optimal results is independent of age, sex, weight loss, obesity-related comorbidity status, surgical technique, or 30-day surgical complications. Future studies, using validated questionnaires specifically designed to investigate eating behavior after BS and/or direct measurements of the eating behavior are needed to clarify the underlying neuropsychologic mechanisms that drive the observed postoperative changes.

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“…For instance, there are some reports of some reduced anxiety after bariatric surgery [ 47 , 48 ]. Whereas RYGB and VSG in humans weight loss appears to improve quality of life [ 49 , 50 ] and reduce levels of depression [ 51 , 52 ], when anxiety is probed specifically, there are some short-term improvements [ 47 , 53 , 54 ] or no significant change [ 48 , 52 , 53 , 55 ] or even a decline of the anxiolytic improvements of surgery over time [ 54 ]. Therefore the timing of the tests and tissue measurements with we performed in these studies with respect to the timing of the surgery could further complicate our current interpretations.…”

Section: Discussionmentioning

confidence: 99%

Anxiety behavior and hypothalamic-pituitary-adrenal axis altered in a female rat model of vertical sleeve gastrectomy

et al. 2018

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Surgical weight loss results in a host of metabolic changes that culminate in net positive health benefit to the patients. However, the psychological impact of these surgeries has not been fully studied. On one hand, surgical weight loss has been reported to improve standard quality of life and resolution of symptoms of depression. But on the other hand, reports of self-harm and increased ER visits for self-harm suggest other psychological difficulties. Inability to handle anxiety following surgical weight loss has alarming potential ramifications for these gastric surgery patients. In the present study, we used models of diet-induced obesity and vertical sleeve gastrectomy (VSG) to ask whether anxiety behavior and hypothalamic-pituitary-adrenal (HPA) axis gene changes were affected by surgical weight loss under two diet regimens: i.e. low-fat diet (LFD) and high-fat diet (HFD). We show reduced exploratory behavior in the open field test but increased time in the open arms of the elevated plus maze. Furthermore, we show increased plasma levels of corticosterone in female VSG recipients in the estrus phase and increased levels of hypothalamic arginine-vasopressin (avp), pro-opiomelanocortin (pomc), and tyrosine hydroxylase (th). We report reduced dopamine receptor D1 (drd1) gene in prefrontal cortex (PFC) in VSG animals in comparison to Sham. Further we report diet-driven changes in stress-relevant gene targets in the hypothalamus (oxt, pomc, crhr1) and adrenal (nr3c1, nr3c2, mc2r). Taken together, these data suggest a significant impact of both surgical weight loss and diet on the HPA axis and further impact on behavior. Additional assessment is necessary to determine whether molecular and hormonal changes of surgical weight loss are the source of these findings.

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Long-term effects of gastric bypass surgery on psychosocial well-being and eating behavior: not all that glitters is gold

Abstract: Seven years post-RYGB, patients reported a significant improvement of physical health and higher satisfaction with daily life, but not with social relationships or sexual performance. Eating behavior post-RYGB was more influenced by external cues.

Cited by 10 publications

References 42 publications

Change in emotional eating after bariatric surgery: systematic review and meta-analysis

Change in emotional eating after bariatric surgery: systematic review and meta-analysis

Predictors of a Healthy Eating Disorder Examination-Questionnaire (EDE-Q) Score 1 Year After Bariatric Surgery

Anxiety behavior and hypothalamic-pituitary-adrenal axis altered in a female rat model of vertical sleeve gastrectomy

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