The psychological impact of COVID-19 pandemic on patients included in a bariatric surgery program

Abstract

Purpose The COVID-19 pandemic has radically impacted the world lifestyle. Epidemics are well-known to cause mental distress, and patients with a current or past history of obesity are at increased risk for the common presence of psychological comorbidities. This study investigates the psychological impact of the current pandemic in patients participating in a bariatric surgery program. Methods Patients were consecutively enrolled during the Italian lockdown among those waiting for bariatric surgery or attending a post-bariatric follow-up, and were asked to complete through an online platform the Depression Anxiety Stress Scales-21 and a self-assessment questionnaire of 22 items evaluating the resilience, change in eating behavior and emotional responses referring to the ongoing pandemic. Results 59% of the 434 enrolled subjects reported of being worried about the pandemic, and 63% specifically reported of being worried about their or their relatives' health. 37% and 56% felt lonelier and more bored, respectively. 66% was hungrier with increased frequency of snacking (55%) and 39% reported more impulse to eat. Noteworthy, 49% felt unable to follow a recommended diet. No difference in terms of psychological profile was recorded among pre and post-bariatric subjects. Logistic regression analysis on post-bariatric patients showed a relationship between snacking, hunger, eating impulsivity, and anxiety, stress, and/or depression symptoms. Conclusion The pandemic led to increased psychological distress in patients with a current or past history of obesity, reducing quality of life and affecting dietary compliance. Targeted psychological support is warranted in times of increased stress for fragile subjects such as pre-and post-bariatric patients. Level of evidence Level V: cross-sectional descriptive study.

Effect of SARS-CoV-2 (COVID-19) Pandemic and Lockdown on Body Weight, Maladaptive Eating Habits, Anxiety, and Depression in a Bariatric Surgery Waiting List Cohort

“…Moreover, our results of a decrease in anxiety with no changes in depression scores during the lockdown are in contrast with other data reported in the limited literature available, reporting a significant increase of both anxiety and depression in patients included in a bariatric surgery program [ 9 , 20 , 21 ] and patients with obesity [ 22 , 23 ]). It is to be considered that in these studies, a mixed cohort of patients waiting for different types of procedures were analyzed and the largest sample was represented by post-surgical patients.…”

Bariatric Surgery Closure During COVID-19 Lockdown in Italy: The Perspective of Waiting List Candidates

“…A study investigating the impact of COVID-19 on patients included in a bariatric surgery program (i.e., waiting for bariatric surgery or attending a post-bariatric follow-up) showed that those individuals perceived an increased level of psychological distress along with a worsening of the eating behaviors (15). Accordingly, the majority of our sample reported eating more during the COVID-19 emergency.…”

Substance Use, Mental Health, and Weight-Related Behaviors During the COVID-19 Pandemic Among Metabolic and Bariatric Surgery Patients

“…In Brazil, one study showed that almost 90% of postbariatric patients were not consuming enough protein and that almost a quarter of their diet consisted of ultraprocessed foods, [38] while another study from Brazil reported that adherence to social distancing orders significantly increased sedentary behaviors and decreased time spent in moderate to vigorous physical activities [39]. Among 434 BS subjects in Italy, who were either waiting for BS or who had completed it, 37% and 56% felt lonelier and more bored, respectively, 66% were hungrier with increased frequency of snacking (55%), 39% reported more impulse to eat, and 49% reported they were unable to follow a recommended diet [40]. While survey studies in adults across the USA and Europe have shown that alcohol consumption has increased during the SARS-CoV-2 pandemic, little is known about the pandemic's effect on substance abuse in patients with prior BS [41][42][43][44][45].…”