Psychopathology, disordered eating, and impulsivity in patients seeking bariatric surgery

Sarwer, David B.; Wadden, Thomas A.; Ashare, Rebecca L.; Spitzer, Jacqueline C.; McCuen‐Wurst, Courtney; LaGrotte, Caitlin; Williams, Noel N.; Edwards, Michael A.; Tewksbury, Colleen; Wu, Jingwei; Tajeu, Gabriel S; Allison, Kelly C.

doi:10.1016/j.soard.2020.11.005

Cited by 24 publications

(22 citation statements)

References 35 publications

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“…In the study which included the present case, current mood disorders were diagnosed in 7% candidates for surgery and 44% reported a lifetime history of mood disorders. 24 Approximately 40% of candidates for bariatric surgery report current mental health treatment, [25][26] a percentage higher than typically reported in the general population. Most of this treatment is provided by psychiatrists, psychologists, and licensed clinical social workers.…”

Section: Psychosocial Status Of Candidates For Bariatric Surgerymentioning

confidence: 99%

“…17 At least eight studies have investigated rates of psychopathology in candidates for surgery using structured diagnostic interviews. 15,[18][19][20][21][22][23][24] Taken together, these studies are indicative of increased psychiatric vulnerability among persons who present for bariatric surgery. Lifetime rates of any psychiatric diagnoses ranged from 36.8%-72.6%; current diagnoses were less common, reported in 20.9%-55.5% of candidates.…”

Section: Psychosocial Status Of Candidates For Bariatric Surgerymentioning

confidence: 99%

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Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Sarwer¹

2021

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Section: Psychosocial Status Of Candidates For Bariatric Surgerymentioning

confidence: 99%

Section: Psychosocial Status Of Candidates For Bariatric Surgerymentioning

confidence: 99%

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Sarwer¹

2021

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“…Specifically, 40% of patients accessed mental health services for their first time after bariatric surgery 26 . The reported deterioration in mental health HRQoL post‐surgery and utilization of mental health services is unsurprising given the high prevalence of certain psychiatric disorders amongst individuals with obesity 27,28 . Literature on patients' experiences post‐bariatric surgery have consistently shown that a number of psychosocial factors inherent to obesity influence patients' satisfaction with surgery outcomes, acceptance of their body image, and internalization of suboptimal weight loss as a personal failure 5,8,29 …”

Section: Introductionmentioning

confidence: 99%

“…26 The reported deterioration in mental health HRQoL post-surgery and utilization of mental health services is unsurprising given the high prevalence of certain psychiatric disorders amongst individuals with obesity. 27,28 Literature on patients' experiences post-bariatric surgery have consistently shown that a number of psychosocial factors inherent to obesity influence patients' satisfaction with surgery outcomes, acceptance of their body image, and internalization of suboptimal weight loss as a personal failure. 5,8,29 As research into long-term predictors evolves, there is a need to understand the mechanism by which patient-related factors influence patients' capacity for self-management after bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Understanding bariatric patients' experiences of self‐management post‐surgery: A qualitative study

et al. 2021

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Summary Although most bariatric patients achieve significant weight loss and improvements in both physical and mental health‐related quality of life (HRQoL) in the short‐term, there is wide variability in weight and long‐term HRQoL outcomes. The role of bariatric patients' self‐management style in explaining variability in long‐term outcomes is unclear. This qualitative study examined bariatric patients' self‐management experiences after bariatric surgery in relation to long‐term outcomes. A qualitative study was conducted using semi‐structured individual interviews with post‐surgery patients (n = 23) at a Canadian bariatric surgery program. A constant comparative approach was used to systematically analyse the data and identify overarching themes. Variation in patients' experiences and follow‐up time were the two primary units of analysis. Patients were predominantly female (n = 19; 82.6%) and had a mean age of 50 ± 8.49 years. The median time post‐surgery was 2 years (range: 6 months–7 years). Three distinct phases described the process of self‐management post‐bariatric surgery: (1) rediscovering self‐esteem and confidence in one's ability to self‐manage (1‐month to 1.5‐years post‐surgery), (2) achieving weight maintenance and addressing emotion dysregulation (1.5–3‐years post‐surgery) and (3) embracing a flexible balanced lifestyle (beyond 3‐years). Bariatric surgery patients experience distinct challenges relative to their post‐surgery time course. Facilitating access to interprofessional bariatric care after surgery allowed patients to acquire the self‐management knowledge and skills necessary to address challenges to following the bariatric guidelines in the long‐term.

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“…Indeed, an average of 50% of excess weight may be lost in the first few years after bariatric surgery, which secondary improves comorbidities like diabetes mellitus and cardiovascular events [ 3 – 6 ]. However, bariatric surgery is not equally effective in all patients, and many factors influencing long-term postsurgical outcomes are still to be understood in this population in which high rates of psychopathology have been reported [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates

et al. 2021

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Background Even if bariatric surgery is considered the most effective therapeutic approach, it is not equally successful among individuals suffering from severe obesity and candidates for this weight loss surgery. Among the factors that influence postsurgical outcomes, eating behaviors styles are known to play a key role in relapses. The aim of our study was to assess eating behaviors styles and several modulating psychopathological factors in patients suffering from severe obesity. Methods Patients seeking bariatric surgery (N = 127) completed a set of standardized tools assessing eating behaviors (Dutch Eating Behavior Questionnaire), comorbid psychiatric conditions (Mini International Neuropsychiatric Interview), depression, and anxiety scores (Beck Depression Inventory, State-Trait Anxiety Inventory), and impulsivity scores (UPPS-P Impulsive Behavior Scale). Results We detected significant correlations between DEBQ Emotional Eating (EmoE) and depression, state and trait anxiety, and all dimensions of impulsivity. Significant correlations were also present between DEBQ External Eating (ExtE) and depression, state and trait anxiety and UPPS-P positive urgency, lack of perseverance and sensation seeking. Regression analyses identified sex (female), trait anxiety, and lack of perseverance as explanatory factors for EmoE, and depression severity score and positive urgency for ExtE. Conclusions EmoE might be a means of dealing with negative emotions and/or intrusive thoughts, while ExtE might result from a mechanism associated with depression. These results should help to improve patients’ outcomes by defining specific therapeutic targets in psychological interventions. Plain English summary After bariatric surgery, some patients regain weight. This is likely due to various factors, including a return of maladaptive eating styles, such as emotional eating (which occurs as a response to negative emotions, like depression, anxiety, anger, sadness, and discouragement), external eating (which refers to the tendency to eat in response to positive external cues, regardless of internal signals of hunger and satiety), and restraint eating (implying to make efforts to develop and maintain strategies to control calories intake, associated with weight loss after lifestyle intervention). Our goal in this research project was to explore associated factors (particularly depression, anxiety, and impulsivity) to these eating styles in patients suffering from obesity prior to bariatric surgery. Individuals seeking bariatric surgery were asked questions about their eating styles and their levels of depression, anxiety, and impulsivity using standardized questionnaires. We found that emotional eating might be a means of dealing with negative emotions and/or intrusive thoughts (e.g. about food or body dissatisfaction), while external eating might result from a mechanism associated with depression. We detected no association between restraint eating and any of the dimensions of impulsivity, nor depression and anxiety. Therapies aimed at improving patients’ abilities to regulate negative affects seem promising among subjects suffering from obesity and those seeking bariatric surgery. If well learned, these therapies might also help them to maintain weight loss after surgery by limiting maladaptive eating styles.

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Psychopathology, disordered eating, and impulsivity in patients seeking bariatric surgery

Cited by 24 publications

References 35 publications

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Multidisciplinary Assessment and Management of a Complex Patient Who Underwent Bariatric Surgery for Clinically Severe Obesity: A Case Report

Understanding bariatric patients' experiences of self‐management post‐surgery: A qualitative study

Contributing roles of depression, anxiety, and impulsivity dimensions in eating behaviors styles in surgery candidates

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