Chewing and swallowing in obese individuals referred to bariatric surgery/gastroplasty - a pilot study

Abstract

Objective: to describe the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty before the procedure, using standardized clinical protocols. Methods: a cross-sectional descriptive case-control study that presents preliminary data for a larger investigation. Eight participants matched for age and sex were divided into two groups (four in the research group and four as controls) and submitted to clinical speech therapy assessment using the “Questionnaire on eating behavior and the anatomofunctional conditions of the stomatognathic system” from the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) and the maximum tongue pressure test. Results: when compared to controls, participants from the research group exhibited a predominantly unilateral chewing preference; reported that they just “swallowed food”; repeated swallowing of liquid and solid foods, with facial muscle tension; increased cheek volume and the presence of flaccidity; shorter meal and chewing times; increased tension of the lips, mentalis and facial muscles at rest and during swallowing; predominance of insufficient ability with associated movements and/or tremors during lip, tongue, jaw and cheek movements; and lack of knowledge regarding speech therapy. Conclusion: orofacial myofunctional dysfunctions were more frequent in patients from the research group when compared to controls. A need to increase the number of participants in this case series and conduct a post-surgery reassessment, in order to provide a longitudinal description of the chewing and swallowing pattern, was verified.

Evaluation of Stomatognathic System Parameters After Bariatric Surgery

“…We found that patients with clinically severe obesity exhibited abnormalities in the functioning of the stomatognathic system, with less muscle activity of the masseter and temporal muscles than women without obesity. These results corroborate with Rocha et al in which orofacial myofunctional dysfunctions were more frequent in patients with obesity [7]. In a similar study, Veyrune et al compared the chewing parameters and found a lower masticatory performance in patients without and with obesity [3].…”

“…Some reports pointed to the impact of obesity, particularly clinically severe obesity, in the stomatognathic system, which seems less efficient than individuals with a normal weight [3][4][5][6]. Consequently, chewing efficacy in people with obesity can affect not only the mechanical process of nourishment but also the relationship between nutrition and eating behavior [7], since this condition contributes to the consumption of ultra-processed food with higher energy density and pastier and easier to be consumed [8][9][10].…”

Association between Self-Perception of Chewing, Chewing Behavior, and the Presence of Gastrointestinal Symptoms in Candidates for Bariatric Surgery

“…Studies have suggested a relationship between chewing and weight gain [ 25 , 26 ], characterized by rapid chewing in individuals with severe obesity and/or those who have undergone bariatric surgery [ 27 , 28 , 29 ]. Some studies have shown that chewing quickly and less frequently is associated with obesity [ 30 , 31 ].…”