Impact of a 6-month treatment with intragastric balloon on body composition and psychopathological profile in obese individuals with metabolic syndrome

Abstract

BackgroundThe aim of this study was to investigate the effects of a 6-month treatment with intragastric balloon (IGB) on body composition and depressive/anxiety symptoms in obese individuals with metabolic syndrome (MS).MethodsFifty patients (aged 18–50 years) with obesity and MS were selected for treatment with IGB for 6 months. Body composition was verified with dual-energy X-ray absorptiometry (DXA) at baseline and right after IGB removal. Anxiety/depressive symptoms were assessed with the Beck Depression Inventory (BDI) and the hospital anxiety and depression scale (HADS) at baseline and after 6 months of treatment.ResultsIn total, 39 patients completed the study. After 6 months, there were significant decreases in weight (11.7 ± 9.6 kg, p < 0.0001) and waist circumference (9.3 ± 8.2 cm, p < 0.0001). Weight loss was also demonstrated by DXA and corresponded to decreases of 3.0 ± 3.4% in body fat percentage, 7.53 ± 7.62 kg in total body fat, and 3.70 ± 4.89 kg in lean body mass (p < 0.001 for all comparisons). Depressive symptoms scores decreased by a mean of 4.57 ± 10.6 points when assessed with the BDI (p = 0.002) and 1.82 ± 5.16 points when assessed with the HADS-Depression (p = 0.0345). Anxiety symptoms scores decreased by a mean of 1.84 ± 4.04 points when determined with the HADS-anxiety (p = 0.0066). The decrease in body fat percentage was the parameter that best correlated with improvements in depressive (p = 0.008) and anxiety symptoms (p = 0.014).ConclusionsIn obese individuals with MS, fat mass reduction was associated with short-term improvements in depressive and anxiety symptoms. Trial Registration Registered at ClinicalTrials.gov, NCT01598233

Psychological outcomes following surgical and endoscopic bariatric procedures: A systematic review

“…This was the only study to use a clinical diagnosis and structured clinical assessment (a more reliable assessment of depression) instead of questionnaires. Furthermore, the only two studies on endoscopic bariatric procedures found a significant reduction in depression symptoms at three and 6‐month follow‐up …”

“…Some studies reported on all three outcomes. Only two studies reported on endoscopic bariatric procedures, highlighting an urgent area of research and an important aim of this review . Therefore, results were discussed with reference to bariatric surgery and were not reflective of endoscopic bariatric procedures.…”

“…Ten studies reported on depression symptoms or changes in clinical diagnosis at 6 months post‐surgery, and two after endoscopic bariatric procedures. Eleven out of these 12 studies reported a reduction in depression symptoms from pre‐treatment . One study compared laparoscopic sleeve gastrectomy (LSG) with laparoscopic greater curvature plication (LGCP) and found a reduction only with LSG .…”

“…Seven studies conducted RYGB or GBY, four used LSG or sleeve gastrectomy (SG), and two used laparoscopic adjustable gastric banding (LAGB) . Other studies used LGCP, duodenal switch (DS), biliopancreatic diversion with duodenal switch (BDP/DS), or intragastric balloon . Apart from the documented differences above, there were no other differences in depression outcomes.…”

“…There were six studies that measured anxiety outcomes at or prior to 6 months post‐treatment. Five out of these six studies reported a reduction in anxiety symptoms from pre‐surgery, but one study found that pre‐surgery generalised anxiety disorder stayed the same at 6 months follow‐up . This was the only study to use a clinical diagnosis and structured clinical assessment instead of questionnaires .…”