Stability of problematic eating behaviors and weight loss trajectories after bariatric surgery: a longitudinal observational study

Conceição, Eva; Mitchell, James E.; Pinto-Bastos, Ana; Arrojado, Filipa; Brandão, Isabel; Machado, Paulo P. P.

doi:10.1016/j.soard.2016.12.006

Cited by 94 publications

(91 citation statements)

References 35 publications

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“…Therefore, despite the participants in T4 presenting more eating‐related psychopathology, we were not able to find a greater representation of ED cases in the T4 trajectory. These findings are discrepant with previous studies suggesting that the pre‐surgical presence of BED impairs weight loss following BS (Niego, Kofman, Weiss, & Geliebter, ), but they seem to be in line with other studies suggesting that pre‐surgical BED does not attenuate weight loss (Conceição et al, ; Wadden et al, ). However, the low sample size of participants with ED does not allow meaningful comparisons.…”

Section: Discussioncontrasting

confidence: 99%

“…Several studies have identified weight loss trajectories after BS and have assessed specific techniques of BS examining some eating behaviours or metabolic consequences (Conceição et al, ; Gómez‐Ambrosi et al, ), but no study to date, to our knowledge, has sought to compare these weight loss (or BMI) trajectories and identify their main psychopathological and personality predictors after BS. Identifying the risk factors in the trajectories of weight loss could be useful in developing more efficient interventions for these patients.…”

Section: Introductionmentioning

confidence: 99%

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Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

García-Ruiz-de-Gordejuela

Agüera

Granero

et al. 2017

Euro Eating Disorders Rev

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This study aimed to explore the empirical trajectories of body mass index (BMI) 1 year following bariatric surgery (BS) and to identify the risk factors for each trajectory. The study included 115 patients with severe obesity who underwent BS. Assessment included metabolic variables, psychopathological and personality measures. Growth mixture modelling identified four separated trajectories for the percentage of total weight loss course shape (namely, T1 'good-fast', T2 'good', T3 'low' and T4 'low-slow'). After adjusting for BS subtype and metabolic baseline state, T1 and T2 registered less eating and general psychopathology. T1 was characterized by the lowest scores in novelty seeking and self-transcendence, whereas T4 was defined by the highest scores in novelty seeking and the lowest scores in persistence. Our findings suggest that psychological state prior to BS is predictive of BMI trajectories during the 12 months following BS. These results could be useful in developing more efficient interventions for these patients. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

García-Ruiz-de-Gordejuela

Agüera

Granero

et al. 2017

Euro Eating Disorders Rev

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“…Therefore, strategies to optimize early postoperative weight loss and mitigate weight regain are needed to enhance the durability of T2D remission. Previous groups have suggested the control of problematic eating behavior as one intervention for increasing early postoperative weight loss, 33 and others have acknowledged poor compliance with physical activity recommendations both before and after bariatric operations as an additional contributing factor to suboptimal weight loss outcomes. 34,35 Still, weight recidivism after RYGB is multifactorial and can also be influenced by operation-specific factors, including gastric pouch size, stoma size, alimentary limb length, gastro-gastric fistulas, and other.…”

Section: Discussionmentioning

confidence: 99%

Factors Mediating Type 2 Diabetes Remission and Relapse after Gastric Bypass Surgery

Pessoa

Browning

Mazzini

et al. 2020

Journal of the American College of Surgeons

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BACKGROUND: Defining factors associated with remission and relapse of type 2 diabetes (T2D) after Rouxen-Y gastric bypass (RYGB) can allow targeting modifiable factors. We investigated factors associated with T2D remission and relapse after RYGB. STUDY DESIGN: We conducted a retrospective review of consecutive patients with T2D who underwent RYGB between 1993 and 2017. T2D remission was defined as medication discontinuation and/or hemoglobin A1c <6.5%. Relapse was defined as recurrence medication use and/or hemoglobin A1c !6.5%. Independent correlates of T2D remission and relapse were identified using logistic regression. RESULTS: Six hundred and twenty-one patients (aged 46.7 AE 10.6 years; 30% on insulin; BMI 49.8 AE 8.3 kg/m 2) had at least 1-year follow-up. Median follow-up was 4.9 years (range 1 to 23.6 years). Prevalence of T2D remission was 74% at 1 year, 73% from 1 to 3 years, 63% between 3 and 10 years, and 47% beyond 10 years. Ninety-three percent of remissions occurred within 3 years of RYGB, 25% relapsed. Median time to relapse was 5.3 years (interquartile range 3 to 7.8 years) after remission. Higher 1-year percentage total body weight loss, lack of preoperative insulin use, and younger age at operation were independently associated with T2D remission. Preoperative insulin use, lower percentage total body weight loss at 1 year, and greater percentage total body weight regain after 1 year were independently associated with T2D relapse. CONCLUSIONS: This longitudinal retrospective analysis shows that preoperative insulin use and age, 1-year weight loss, and regain after that influence T2D remission and relapse after RYGB. Referring patients at a younger age, before insulin is needed, and optimizing weight loss and preventing weight regain after RYGB can improve the rates and durability of T2D remission.

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“…Uma maior percentagem de participantes do grupo com mais de 24 meses após a cirurgia referiram os diferentes CPAs, o que vai ao encontro da literatura existente que argumenta que CAPs tendem a (re)aparecer após os dois anos de cirurgia. 20 As percentagens encontradas no nosso estudo são superiores aos valores reportados na literatura, 21 o que poderá ser justificado pelo formato de avaliação usado neste estudo (autorrelato) e pela frequência considerada para identificar como presente um comportamento (uma vez na última semana). Não obstante, aceder à perceção do doente sobre o seu comportamento alimentar deverá ser uma estratégia central para a necessária deteção precoce destes comportamentos.…”

Section: Discussionunclassified

“…Os nosso dados apontam para a importância de uma avaliação cuidada e sistemática ao longo do tempo, não só da presencia de CAPs, mas também ficada na forma como o doente lida com situações de emocionalidade negativa. Tendo em conta a evidência estabelecida do impacto de CAPs na perda e aumento de peso, [20][21]24 a identificação precoce de CAPs, e o treino de competências de gestão emocional, em particular no longo prazo após a cirurgia, parecem estratégias relevantes para uma melhor adesão à alteração comportamental necessária para manter a perda de peso a longo-prazo.…”

Section: Conclusãounclassified

Comportamentos Alimentares Problemáticos após Cirurgia Bariátrica: Um Estudo com Amostra Nacional Portuguesa

et al. 2018

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Introduction: Bariatric surgery is the most effective method for the treatment of morbid obesity. However, the development of eating psychopathology and the emergence of problematic eating behaviours have been reported in the literature. The aim of this crosssectional study was to characterize the post-bariatric population in terms of the frequency of problematic eating behaviours over time and to understand the related psychological features.Material and Methods: This sample was composed of 155 bariatric patients that responded to several self-reported instruments assessing eating psychopathology, problematic eating behaviours, anxiety, depression and stress and impulsive behaviour.Results: Results showed that grazing, binge eating, concerns about body weight and shape, and negative urgency are significantly more frequent at 24 months after bariatric surgery (when compared to earlier postoperative assessments). Correlational analyses showed that eating psychopathology and problematic eating behaviours were significantly and positively associated with levels of anxiety, depression, stress and negative urgency. This study also reinforces the mediating role of negative urgency in the relationship between time elapsed since surgery and psychological distress, and problematic eating behaviours, accounting for a total of 32.3% and 27.2% of its variance, respectively.Discussion: The results suggest a growing trend of problematic eating behaviours and levels of impulsivity being reported by bariatric patients over time.Conclusion: Given the established evidence that supports its impact on weight variability, early identification of problematic eating behaviours and of patients with a tendency to act impulsively in situations of negative emotionality should be a central concern in the follow-up of the bariatric population.

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Stability of problematic eating behaviors and weight loss trajectories after bariatric surgery: a longitudinal observational study

Cited by 94 publications

References 35 publications

Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

Weight Loss Trajectories in Bariatric Surgery Patients and Psychopathological Correlates

Factors Mediating Type 2 Diabetes Remission and Relapse after Gastric Bypass Surgery

Comportamentos Alimentares Problemáticos após Cirurgia Bariátrica: Um Estudo com Amostra Nacional Portuguesa

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