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1.
Bocchieri-Ricciardi LE Chen EY Munoz D Fischer S Dymek-Valentine M Alverdy JC le Grange D 《Obesity surgery》2006,16(9):1198-1204
Background: The impact of pre-surgical binge eating on postoperative outcomes is poorly understood. Previous studies have
found marked preoperative differences between binge eaters (BE) and non-binge eaters (NBE) in hunger and disinhibition using
the Three-Factor Eating Questionnaire (TFEQ). Short-term prospective data are mixed regarding whether these differences persist
after surgery and if preoperative binge eating impacts postoperative weight outcomes. The purpose of the present study was
to compare self-reported eating behavior and weight outcomes between BE and NBE after the first postoperative year. Methods:
Prior to surgery, 72 Roux-en-Y gastric bypass (RYGBP) patients completed the Questionnaire of Eating and Weight Patterns (QEWP)
or QEWP-Revised (QEWP-R), to assess binge eating status which was defined as one objective binge episode per week over the
past 6 months. Subjects also completed the TFEQ prior to surgery and again ≥12 months after surgery. Results: For BE, higher
scores were found for both hunger and disinhibition prior to surgery. At a mean of 18 months after surgery, BE and NBE were
indistinguishable on these subscales and there were no differences in weight lost. Conclusions: RYGBP surgery has an equally
positive impact on eating behavior and weight loss for both BE and NBE. Within a multidisciplinary clinic, preoperative BE
status does not appear to be a negative prognostic indicator for RYGBP surgery in the domains of weight loss and disinhibition.
Further replication is needed with longer follow-up times and larger samples. 相似文献
2.
Background: The effectiveness of topiramate was evaluated in the treatment of recurrent binge eating and weight gain in patients
with binge eating disorder (BED) and obesity who had undergone initially successful bariatric surgery. Methods: The records
of 3 consecutive patients with BED and obesity who presented to our clinic with recurrent binge eating and weight gain after
undergoing initially successful bariatric surgery were reviewed. They were treated with topiramate for an average of 10 months.
Results: All three patients reported complete amelioration of their binge eating symptoms and displayed weight loss (31.7
kg in 17 months, 14.5 kg in 9 months, 2 kg in 4 months, respectively) in response to topiramate (mean dose 541 mg). Conclusion:
Although anecdotal, these observations suggest that topiramate may be an effective treatment for patients with BED and obesity
who experience recurrent binge eating and weight gain after initially successful bariatric surgery. 相似文献
3.
Busetto L Segato G De Luca M De Marchi F Foletto M Vianello M Valeri M Favretti F Enzi G 《Obesity surgery》2005,15(2):195-201
Background: The authors investigated the outcome of morbidly obese patients with binge eating disorder (BED) treated surgically
with laparoscopic adjustable gastric banding. Methods: The 5-year outcomes of 130 patients with BED and 249 patients without
BED are described. The diagnosis of BED was made preoperatively and all patients with BED were supported with psychological
therapy. Results: Patients with and without BED had similar BMI levels before surgery. More patients with than without BED had depressive symptoms and associated minor
disturbances of eating behavior (night eating and grazing). Percent excess weight loss (%EWL) in the first 5 years after surgery
was similar in patients with and without BED. The percentage of BED patients showing %EWL >50% at the 5-year evaluation was
23.1, and 25.7% in non-BED patients. The percentage of patients showing weight regain in the last 4 years of follow-up was
similar in binge eaters (20.8%) and in non-binge eaters (22.5%). The 5-year frequency of gastric pouch and esophageal dilatation
was significantly higher in binge eaters than in non-binge eaters (25.4 vs 17.7 %, P<0.05 and 10.0 vs 4.8%, P<0.05, respectively). Binge eaters underwent a higher number of postoperative band adjustments than
non-binge eaters (3.0±2.1 vs 2.6±1.9, P<0.05) and the maximum band fill after surgery was higher in the BED patients than in non-BED patients (3.2±1.2 vs 2.8±1.3
ml, P<0.01). Conclusion: Morbidly obese patients with BED supported by adequate psychological treatment can have good outcomes
after gastric banding. 相似文献
4.
Background: There is limited data on the prevalence of eating disorder pathology in morbidly obese patients undergoing Roux-en-Y
gastric bypass (RYGBP) and the degree to which this may affect surgical outcome. The present study examined surgical outcome
between 2 groups of patients undergoing RYGBP: those with pre-surgical binge eating (BE) and those without pre-surgical binge eating (NBE). Methods: This study tested the hypothesis that the BE group would demonstrate greater pathology
on measures of eating pathology, psychological wellbeing, and quality of life than the NBE group both pre- and post-surgery.
Results: Compared with the NBE group, the BE group had significantly higher levels of disinhibited eating, and hunger, and
significantly lower levels of social functioning at pre-surgery and 6 months post-surgery. The BE group had a significantly
lower percentage of excess weight lost than the NBE group at 6 months post-surgery. Conclusions: These findings indicate a
less successful outcome for the BE patients compared with the NBE patients. While there were more distinct differences between
the BE and NBE groups before surgery, they were largely impossible to differentiate on psychosocial measures at post-surgery. 相似文献
5.
Gian Franco Adami MD Giuseppe M Marinari MD Annalisa Bressani MD Sara Testa MD Nicola Scopinaro MD 《Obesity surgery》1998,8(5):517-519
Background: The purpose of this study was to evaluate the impairment of body image in patients with binge eating disorder
(BED). Materials and Methods: A 3-year longitudinal study was undertaken in 25 BED obese patients and 26 non-BED obese patients
who had undergone biliopancreatic diversion (BPD) for obesity. The body image was evaluated by the Eating Disorder Inventory
body dissatisfaction scale. Results: Within the third postoperative year, 95% of patients had stopped binge eating. After
the first postoperative year, the BED patients showed body dissatisfaction scores higher than those of the non-BED group,
whereas the longer-term results were closely similar. Conclusions: Over the long term following BPD, binge eating disappears,
which suggests that the loss of control over food intake is mainly dependent on dieting and on the preoccupation with food
and body shape. The derangement of body image in obese patients with BED is only partly dependent on inner feelings. In fact,
the stable weight normalization after BPD is accompanied by a sharp improvement in body image in all cases. It appears that
the complete normalization requires more time in BED patients than in their non-BED counterparts. 相似文献
6.
《Surgery for obesity and related diseases》2020,16(5):690-697
BackgroundDepression and binge eating disorder (BED) are prevalent among bariatric surgery candidates. Depression subtypes may be differentially related to obesity, such that the atypical subtype predicts poorer outcomes. However, no research has examined depression subtypes, BED, and weight loss in bariatric candidates.ObjectiveTo examine whether presurgical atypical depressive symptoms, compared with no depressive and melancholic depressive symptoms, were associated with higher rates of presurgical BED, binge eating severity, and poorer postsurgical weight loss trajectories among bariatric candidates.SettingAn outpatient Midwest bariatric clinic.MethodsParticipants were 345 adults (aged 46.27 ± 12.78 yr, 76% female; body mass index = 49.84 ± 8.51 kg/m2) who received a presurgical evaluation. Depression subtypes (melancholic, atypical, and no depressive symptoms) were categorized using the Beck Depression Inventory-II. BED diagnosis and severity were evaluated using the Eating Disorder Diagnostic Scale and Binge Eating Scale, respectively. Weight loss trajectories were calculated as percent total weight loss postsurgery.ResultsUsing no depression as the referent, participants reporting melancholic symptoms (odds ratio = 7.60, P < .001 confidence interval95 [2.59–22.28]) and atypical symptoms (odds ratio = 10.11, P < .01 confidence interval95 [2.69–37.94]) were more likely to meet criteria for BED. Patients with atypical depressive symptoms exhibited the highest binge eating severity scores (mean = 23.03). Depression subtypes did not predict percent total weight loss trajectories within 18-months postbariatric surgery.ConclusionsPatients reporting preoperative atypical depressive symptoms were more likely to meet criteria for co-morbid BED diagnosis and have greater binge eating severity but did not have poorer weight loss within 18 months postsurgery. Future studies with longer-term follow-up and corresponding measures of postsurgical depression and binge eating pathology are warranted. 相似文献
7.
Jones-Corneille LR Wadden TA Sarwer DB Faulconbridge LF Fabricatore AN Stack RM Cottrell FA Pulcini ME Webb VL Williams NN 《Obesity surgery》2012,22(3):389-397
Background
Prior studies have reached contradictory conclusions concerning whether binge eating disorder (BED) is associated with greater psychopathology in extremely obese patients who seek bariatric surgery. This study used the Structured Clinical Interview for DSM-IV Diagnoses (SCID) to compare rates of axis I psychopathology in surgery candidates who were determined to have BED or to be currently free of eating disorders. The relationship of BED to other psychosocial functioning and weight loss goals also was examined. 相似文献8.
Revision of Failed Laparoscopic Adjustable Gastric Banding to Roux-en-Y Gastric Bypass 总被引:3,自引:3,他引:0
Background: The most common bariatric surgical operation in Europe, laparoscopic adjustable gastric banding (LAGB), is reported
to have a high incidence of long-term complications. Also, insufficient weight loss is reported. We investigated whether revision
to Roux-en-Y gastric bypass (RYGBP) is a safe and effective therapy for failed LAGB and for further weight loss. Methods:
From Jan 1999 to May 2004, 613 patients underwent LAGB. Of these, 47 underwent later revisional Roux-en-Y gastric bypass (RYGBP).
Using a prospectively collected database, we analyzed these revisions. All procedures were done by two surgeons with extensive
experience in bariatric surgery. Results: All patients were treated with laparoscopic (n=26) or open (n=21) RYGBP after failed
LAGB. Total follow-up after LAGB was 5.5±2.0 years. For the RYGBP, mean operating time was 161±53 minutes, estimated blood
loss was 219±329 ml, and hospital stay was 6.7±4.5 days. There has been no mortality. Early complications occurred in 17%.
There was only one late complication (2%) – a ventral hernia. The mean BMI prior to any form of bariatric surgery was 49.2±9.3
kg/m2, and decreased to 45.8±8.9 kg/m2 after LAGB and was again reduced to 37.7±8.7 kg/m2 after RYGBP within our follow-up period. Conclusion: Conversion of LAGB to RYGBP is effective to treat complications of LAGB
and to further reduce the weight to healthier levels in morbidly obese patients. 相似文献
9.
Background: A psychological assessment is critical for morbidly obese patients seeking Roux-en-Y gastric bypass (RYGBP) surgery.
The Minnesota Multiphasic Personality Inventory (MMPI) has been widely used in past psychological studies of bariatric surgery
patients, but, to date, there is no published research on the more recent version of the MMPI, the Minnesota Multiphasic Personality
Inventory-2 (MMPI2), and its relation to RYGBP outcome.This investigation was designed to evaluate the predictive validity
of the MMPI-2 with respect to outcome of RYGBP for morbid obesity. Methods: The research involved a retrospective analysis
of MMPI-2 scores of 2 groups of patients 1 year following RYGBP: 1) those who lost ≥ 50% of their excess weight and 2) those
who lost <50% of their excess weight. Subjects were 52 morbidly obese patients (mean age 44 years, mean BMI 56 kg/m2).The
measurement of psychological variables consisted of the MMPI-2 scores of 3 validity scales, 10 clinical scales, and 3 Content
Scales, and BMI. Results: Those who lost <50% excess weight scored significantly higher than those who lost >50% excess weight
on the F,Hysteria, Paranoia, and Health Concerns scales of the MMPI-2, and significantly lower on the Masculinity-femininity
scale. Stepwise regression analysis found that a combination of the Health Concerns and Masculinity-femininity scales was
the most accurate predictor model for 1-year post-surgery weight loss. Conclusion: A standard personality measure, the MMPI-2,
appears to be associated with weight loss outcome 1 year after RYGBP. Psychological traits such as anxiety and excessive health
concerns are likely to influence bariatric surgical outcome. 相似文献
10.
A Prospective Comparison of Vertical Banded Gastroplasty and Roux-en-Y Gastric Bypass in a Non-Superobese Population 总被引:4,自引:4,他引:0
Background: In the non-superobese population, consensus is currently unavailable in bariatric surgery. We report the results
of a prospective comparison of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) in a non-superobese
population. Methods: From 1994 to 2000, 179 patients with clinically severe obesity underwent various surgical procedures
in our department. During this time a prospective study was undertaken in order to compare VBG with RYGBP in morbidly obese
patients with a BMI <50 kg/m2. Based on specific criteria including eating behavior, 68 patients were selected to undergo RYGBP and 35 VBG. All patients
have undergone complete follow-up evaluation at 1, 3, 6, and 12 months postoperatively and every year thereafter. Results:
All patients have now completed their 5th postoperative year. Mean follow-up period to date is 96.5±12.2 months for VBG and
67.6±11.3 months for RYGBP. 3 patients (8.6%) in the VBG group and 9 patients (13.2%) in the RYGBP group are lost to follow-up.
Mean excess weight loss (EWL) was always better in the RYGBP group (P=0.0013). The percentage of failure, defined as EWL <25%, was not significantly different between the two procedures. No statistically
significant differences were observed between the 2 groups in the total number of non-metabolic complications, and the only
statistically significant difference observed in metabolic complications was vitamin B12 deficiency after RYGBP. Frequency of vomiting was significantly less and quality of eating significantly better in RYGBP
than in VBG patients. Conclusion: This prospective long-term study, with nearly complete follow-up, suggests that in the non-superobese
population, preoperative eating habits may play a role in choosing the most appropriate bariatric operation for each patient.
Although RYGBP is associated with better mean weight loss outcomes, the percentage of patients who achieved and maintained
≥50% EWL after VBG in this pre-selected patient population was not significantly different. Each type of operation has advantages
and disadvantages, and, if properly chosen, a purely restrictive procedure can be successful for some patients. Therefore,
it can be said that the decision regarding which bariatric procedure to perform in non-superobese patients must be based on
in-depth preoperative evaluation as well as the patients' own preferences and outcome expectations. 相似文献
11.
Does Gastric Dilatation Limit the Success of Sleeve Gastrectomy as a Sole Operation for Morbid Obesity? 总被引:6,自引:10,他引:6
Langer FB Bohdjalian A Felberbauer FX Fleischmann E Reza Hoda MA Ludvik B Zacherl J Jakesz R Prager G 《Obesity surgery》2006,16(2):166-171
Background: Sleeve gastrectomy as the sole bariatric operation has been reported for high-risk super-obese patients or as
first-step followed by Roux-en-Y gastric bypass (RYGBP) or duodenal switch (DS) in super-super obese patients. The efficacy
of laparoscopic sleeve gastrectomy (LSG) for morbidly obese patients with a BMI of <50 kg/m2 and the incidence of gastric dilatation following LSG have not yet been investigated. Methods: 23 patients (15 morbidly obese,
8 super-obese) were studied prospectively for weight loss following LSG. The incidence of sleeve dilatation was assessed by
upper GI contrast studies in patients with a follow-up of >12 months. Results: Patients who underwent LSG achieved a mean
excess weight loss (EWL) at 6 and 12 months postoperatively of 46% and 56%, respectively. No significant differences were
observed in %EWL comparing obese and super-obese patients. At a mean follow-up of 20 months, dilatation of the gastric sleeve
was found in 1 patient and weight regain after initial successful weight loss in 3 of the 23 patients. Conclusion: LSG has
been highly effective for weight reduction for morbid obesity even as the sole bariatric operation. Gastric dilatation was
found in only 1 patient in this short-term follow-up. Weight regain following LSG may require conversion to RYGBP or DS. Follow-up
will be necessary to evaluate long-term results. 相似文献
12.
Background
Cholecystolithiasis (CL) is a common occurrence after bariatric surgery. Few studies have prospectively analyzed not only gallstone formation after Roux-en-Y gastric bypass (RYGBP), but also its complications and symptoms. This study aimed to identify the incidence of CL itself and symptomatic CL after RYGBP as well as the presence of predictive factors for CL.Methods
A prospective observational study was performed on 40 morbidly obese patients free of gallbladder disease undergoing RYGBP at a public hospital in Brazil between February and October 2007. They were followed up clinically, biochemically (lipid profile), and ultrasonographically at 6?months and 1, 2, and 3?years after surgery. Postoperative prophylactic bile salt therapy (ursodiol) was not prescribed. Of the 40 patients, 38 completed the 3-year follow-up. They were divided into two groups: those who formed gallstones and those who did not. These groups were compared with respect to gender, age, preoperative body mass index (BMI) and lipid profile results, and postoperative percentage of excess BMI lost (%EBL) and lipid profile results.Results
The overall postoperative incidence of CL was 28.9?% (11 out of 38), with a 15.7?% incidence of symptomatic CL (6 out of 38). Gender, age, preoperative BMI, postoperative %EBL, and preoperative and postoperative lipid profile results were not identified as predictive factors for CL after RYGBP.Conclusions
There was a high incidence of CL after RYGBP, occurring primarily in the first 2?years postoperatively. There was no identified predictive factor for gallstone formation after RYGBP. Most patients who formed gallstones were symptomatic, some with potentially severe complications. 相似文献13.
Background: Postoperative follow-up after bariatric surgery is important. Because of the need for adjustments, follow-up after
gastric banding may have a greater impact on weight loss than after Roux-en-Y gastric bypass.We reviewed all patients at 1
year after these two operations. Methods: During the first year after surgery, laparoscopic adjustable gastric banding (LAGB)
patients were followed every 4 weeks and Roux-en-Y gastric bypass (RYGBP) patients were followed at 3 weeks postoperatively
and then every 3 months.The number of follow-up visits for each patient was calculated, and 50% compliance for follow-up and
weight loss was compared. Results: Between October 2000 and September 2002, 216 LAGB and 139 RYGBP operations were performed.
Of these patients, 186 LAGB patients and 115 RYGBP patients were available for 1-year follow-up. Age and BMI were similar
for each group. Overall excess weight loss (EWL) after LAGB was 44.5%. 130 (70%) returned 6 or less times in the first year
and achieved 42% EWL. 56 patients (30%) returned more than 6 times and had 50% EWL (P=0.005). Overall %EWL after RYGBP was
66.1%. 53 patients (46%) returned 3 or less times in the first year, achieving 66.1% EWL. 62 patients (54%) returned more
than 3 times after surgery and achieved 67.6% EWL (P=NS). Conclusion: Patient follow-up plays a significant role in the amount
of weight lost after LAGB, but not after RYGBP. Patient motivation and surgeon commitment for long-term follow-up is critical
for successful weight loss after LAGB surgery. 相似文献
14.
Puglisi F Antonucci N Capuano P Zavoianni L Lobascio P Martines G Lograno G Memeo V 《Obesity surgery》2007,17(4):504-509
Background In recent years, particular attention has been paid to the effect that eating disturbances and especially binge eating can
have on the outcome of surgical treatments for obesity. Endoscopic positioning of the Bioenterics intragastric balloon (BIB)
is mainly used in the work-up for surgical treatment of morbid obesity. Available data show that the BIB is a valid tool for
reducing weight and co-morbidity, even if only a temporary treatment in morbidly obese patients. We evaluated the results
of treatment with the BIB with the patient’s tendency to indulge in binge eating.
Methods Between April 2003 and March 2006, 89 patients with morbid obesity (BMI 39–55) were enrolled in the study. Before introducing
the BIB and within 3 months after removal, patients underwent a psychiatric evaluation and the following psychodiagnostic
tests: SCID (Structured Clinical Interview for DSM IV), ED-SCID (Eating Disorder Module, Structured Clinical Interview) and
BSQ (Binge Scale Questionnaire). All those positive for the BED criteria according to the DSM IV, and who had at least one
binge eating episode per week, were considered Binge Eaters (BE).
Results Of the 89 patients enrolled, 75 were eligible for evaluations (M:F = 12:63), and 27 were positive for binge eating (BE). There
were no significant differences in age and preoperative BMI between the BE group and the 48 patients without BE (NBE group).
The complication and failure rates with the BIB treatment were significantly higher in the BE group (P < 0.01). After treatment with the BIB, both groups showed a significant reduction in BMI (P < 0.01), but the NBE-group showed a significantly higher weight (BMI 5.7 ± 2.5 kg/m2) than the BE-group (BMI 3.3 ± 2.2 kg/m2) (P = 0.03).
Conclusion The results of treatment with the intragastric balloon appear to be affected by binge eating pattern in morbidly obese patients,
even if the presence of this behavior does not prevent a successful reduction in the BMI. Binge eating does not seem to be
a contraindication for the adjuvant use of the BIB before a bariatric operation. A limitation of our study is the short period
of observation, related to the period of the BIB in the gastric lumen (not more than 6 months). Further studies may show whether
the association of psychiatric treatment with the BIB in patients affected by binge eating may enhance the results of the
treatment. 相似文献
15.
Prevalence of Subclinical Hypothyroidism in a Morbidly Obese Population and Improvement after Weight Loss Induced by Roux-en-Y Gastric Bypass 总被引:1,自引:1,他引:0
Moulin de Moraes CM Mancini MC de Melo ME Figueiredo DA Villares SM Rascovski A Zilberstein B Halpern A 《Obesity surgery》2005,15(9):1287-1291
Background:There are many studies concerning thyroid function in obesity, and some of them describe higher TSH levels in obese
subjects. Few studies evaluated long-term changes in thyroid function caused by weight loss after bariatric surgery. Our aims
were to evaluate the prevalence of subclinical hypothyroidism (SH) in a morbidly obese population and to analyze the effect of weight loss induced by Roux-en-Y gastric bypass (RYGBP)
on TSH and thyroid hormone (TH) levels. Methods: TSH, free thyroxine (fT4) and total triiodothyronine (T3) levels were analyzed
before and 12 months after RYGBP in patients with grade III or grade II obesity with co-morbidities. Subjects taking TH and/or
with positive antithyroid antibodies and/or with overt hypothyroidism were excluded. Results: 72 subjects (62F/10M), with
mean age 39.6±9.8 years and mean BMI 53.0±10.4 kg/m2 were studied. The prevalence of SH before RYGBP was 25% (n=18). There was a significant post-surgical decrease in BMI in
the whole population, as well as in SH patients. In the SH group and normal TSH group, there was a decrease in TSH and T3,
but not in fT4. TSH was not correlated with initial BMI or percent change in BMI. TSH concentrations reached normal values
in all SH patients after RYGBP. Conclusion: Our data confirm that severe obesity is associated with increased TSH. The decrease
in TSH was independent of BMI, but occurred in all SH patients. A putative effect of weight reduction on the improvement of
SH in all patients may be an additional benefit of bariatric surgery. 相似文献
16.
Background: This study examined the current practice of bariatric surgeons and their colleagues regarding patients with binge
eating disorder (BED) and night eating syndrome (NES) who present for Roux-en-Y gastric bypass (RYGBP) for obesity. Method:
We conducted a 9-item internet survey of American Society for Bariatric Surgery (ASBS) members. For each item, the numbers
of respondents endorsing each possible response, including "Other" and "Unknown or not applicable," were tabulated, and percentages
of the total sample of respondents were calculated. Results: Most respondents' screening process included mental health (82.0%)
and nutritional (78.0%) evaluations. Most inquired about binge eating (88.0%) and other eating disturbances (83.3%), while
fewer respondents (52.7%) screened for night eating. Management of patients with eating disorders varied widely. For patients
with binge eating, 20.0% of respondents proceeded with surgery, 2.7% recommended against surgery, and 27.3% postponed surgery,
with the remainder (50.0%) reporting that their management varied. For night eating and other eating disturbances, responses
were similarly diverse. Respondents who postponed surgery reported a wide range of estimates of how often patients with eating
disorders follow through with treatment for their eating problem and return for surgery: 16% (always/almost always), 36% (usually),
24% (sometimes), 12% (occasionally), and 12% (never/almost never). Conclusion: Although bariatric surgeons commonly screen
for eating disorders such as BED, there are limited empirical data and no consensus regarding the optimal management of these
patients. 相似文献
17.
Fischer S Chen E Katterman S Roerhig M Bochierri-Ricciardi L Munoz D Dymek-Valentine M Alverdy J le Grange D 《Obesity surgery》2007,17(6):778-784
Background The impact of presurgical eating patterns on postoperative outcomes is poorly understood. The results of previous studies
are mixed regarding the impact of presurgical binge eating on weight loss after surgery. However, many patients describe other
maladaptive eating patterns prior to surgery, such as eating in response to emotions.The goals of this study were to describe
presurgical emotional eating patterns in morbidly obese individuals, determine whether these individuals were binge eaters,
and assess the effect of this eating behavior on weight loss after surgery.
Methods Prior to surgery, 144 Roux-en-Y gastric bypass (RYGBP) patients completed the Questionnaire of Eating and Weight Patterns
(QEWP) or QEWPRevised (QEWP-R) and the Emotional Eating Scale to assess eating patterns prior to surgery. Their eating behavior,
levels of depression, and weight were assessed after surgery.
Results High emotional eaters tended to have higher levels of depression, binge eating, and eating in response to external cues than
low emotional eaters prior to surgery.However, there appeared to be a distinct group of individuals who were high emotional
eaters but who did not engage in binge eating. At a mean of 8 months after surgery, High Emotional Eaters and Low Emotional
Eaters were indistinguishable on these subscales and there were no differences in weight lost.
Conclusions RYGBP has an equally positive impact on eating behavior and weight loss for both High Emotional Eaters and Low Emotional Eaters.
Further replication is needed with longer follow-up times and larger samples. 相似文献
18.
The Decrease in Plasma Ghrelin Concentrations following Bariatric Surgery Depends on the Functional Integrity of the Fundus 总被引:7,自引:3,他引:4
Frühbeck G Diez-Caballero A Gil MJ Montero I Gómez-Ambrosi J Salvador J Cienfuegos JA 《Obesity surgery》2004,14(5):606-612
Background: Gastric bypass surgery, which involves the production of a reduced stomach pouch,has been shown to markedly suppress
circulating ghrelin concentrations. Since bypassing the ghrelin-producing cell population may be relevant to the disruption
of fundic-derived factors participating in food intake signaling, the effect of weight loss induced by either adjustable gastric
banding (AGB), Roux-en-Y gastric bypass (RYGBP) or biliopancreatic diversion (BPD) was studied. Methods: 16 matched obese
patients [35.0 + 2.4 years; initial body weight 124.8 ± 5.7 kg; body mass index (BMI) 47.1 ± 2.2 kg/m2] in whom similar weight loss had been achieved by either AGB (n=7), RYGBP (n=6) or BPD (n=3) were studied. Blood was obtained
for biochemical and hormonal analyses. Body composition was assessed by air-displacement-plethysmography. Results: Comparable
weight loss (AGB: 26.1 ± 5.1 kg; RYGBP: 32.1 ± 5.0; BPD: 31.7 ± 6.1; P=NS) and decrease in percentage body fat (AGB: 10.0 ± 1.5%; RYGBP: 14.2 ± 2.8; BPD: 10.3 ± 1.0; P=NS) induced by bariatric surgery exerted significantly different (P=0.004) effects on plasma ghrelin concentrations, depending on the surgical procedure applied (AGB: 480 ± 78 pg/ml; RYGBP:
117 ± 34; BPD: 406 ± 86). Without significant differences in BMI, body fat, glucose, triglycerides, cholesterol, insulin and
leptin levels, patients who had undergone the RYGBP exhibited statistically significant diminished circulating fasting plasma
ghrelin concentrations compared with the other two bariatric techniques which conserve direct contact of the fundus with ingested
food (P=0.003 vs AGB and P=0.020 vs BPD). Conclusion: Fasting circulating ghrelin concentrations in patients undergoing diverse bariatric operations
depend on the degree of dysfunctionality of the fundus. 相似文献
19.
Psychosocial Predictors of Weight Loss after Bariatric Surgery 总被引:1,自引:1,他引:0
Kinzl JF Schrattenecker M Traweger C Mattesich M Fiala M Biebl W 《Obesity surgery》2006,16(12):1609-1614
Background: The authors investigated the predictive value of various parameters such as age, preoperative weight, eating behavior,
psychiatric disorders, adverse childhood experiences and self-efficacy with regard to weight loss after gastric restrictive
surgery. Methods: After a minimum follow-up of 30 months (median follow-up 50 months; range 30-84 months), a questionnaire
concerning extent of, satisfaction with, and consequences of weight loss was mailed to 220 morbidly obese female patients
following laparoscopic Swedish adjustable gastric banding (SAGB). Results: Questionnaires were completed and returned by 140
patients (63%). Average BMI loss was 14.6 kg/m2. Most patients (85%) were happy with the extent of weight loss. Satisfaction with weight loss showed a significant correlation
with extent of weight loss. BMI loss was greatest in the obese with an atypical eating disorder (20.0 kg/m2), and BMI loss was least in the obese with no eating-disordered behavior before surgery (13.4 kg/m2). Obese patients with two or more psychiatric disorders showed significantly less weight loss than did obese patients with
one or no psychiatric disorder (BMI units 10.8 vs 14.0 vs 16.1; P=.047). Conclusions: The findings indicate a less successful outcome for obese patients with psychiatric disorders (particularly
adjustment disorders, depression and/or personality disorders), compared to patients not mentally ill. An eating disorder
preceding surgery, however, was not a negative predictor of success following bariatric surgery. To improve outcome of bariatric
surgery in obese patients with psychiatric disorders, more individual psychosocial intervention strategies are necessary. 相似文献
20.
Fasting Plasma Ghrelin Concentrations 6 Months after Gastric Bypass are not Determined by Weight Loss or Changes in Insulinemia 总被引:2,自引:2,他引:0
Frühbeck G Rotellar F Hernández-Lizoain JL Gil MJ Gómez-Ambrosi J Salvador J Cienfuegos JA 《Obesity surgery》2004,14(9):1208-1215
Background: Ghrelin is a gastric peptide with potent orexigenic effects. Circulating ghrelin concentrations are increased
in obese subjects, but increase after weight loss. However, in patients undergoing Roux-en-Y gastric bypass (RYGBP), a decrease
in ghrelin levels has been reported. The effect of comparable weight loss induced by either adjustable gastric banding (AGB),
RYGBP or conventional dietary treatment (Conv) on ghrelinemia was studied. Methods: 24 matched obese male patients in whom
similar weight loss had been achieved by either AGB (n=8), RYGBP (n=8) or Conv (n=8) were studied before and 6 months after
treatment start. The independence of ghrelin concentrations from body mass index (BMI) and weight loss was further analyzed
in a group of patients with total gastrectomy (TtGx, n=6). Results: Comparable weight loss after 6 months exerted significantly
different effects on plasma ghrelin concentrations, depending on the procedure applied (AGB: 424.6 ± 32.8 pg/ml; RYGBP: 131.4
± 13.5; Conv: 457.3 ± 18.7; P<0.001). Without significant differences in body weight and BMI, patients who had undergone the RYGBP exhibited a statistically
significant decrease in fasting ghrelin concentrations, while the other two procedures (AGB and Conv) showed a weight loss-induced
increase in ghrelin levels. Despite significant differences in BMI between RYGBP and TtGx patients after 6 months (31.9 ±
2.2 vs 22.0 ± 0.7 kg/m2, respectively; P<0.05), both groups showed similar ghrelin concentrations. Conclusion: The reduction in circulating ghrelin concentrations
in RYGBP patients after 6 months of surgery are not determined by an active weight loss or an improved insulin-sensitivity
but rather depend on the surgically-induced bypass of the ghrelin-producing cell population of the fundus. 相似文献