Effectiveness of Biliopancreatic Diversion in the Patients with Bulimia Nervosa |
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Authors: | Yury I Yashkov MD PhD Dmitry K Bekuzarov MD |
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Institution: | (1) The Center of Endosurgery and Lithotripsy (CELT), Moscow, Russia;(2) The Center of Endosurgery and Lithotripsy (CELT), Moscow, Russia |
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Abstract: | Background: Bulimia nervosa (BN) is an eating disorder, characterized by consumption of huge amounts of food during discrete
periods. Unlike patients with binge-eating disorder (BED), patients with BN demonstrate elements of compensatory "purging"
behavior to prevent weight gain and obesity: i.e. self-induced vomiting, use of laxatives and enemas. These habits may prevent
patients from attaining morbid obesity (MO), but may seriously affect life-style and become an excruciating, sometimes life-threatening
condition. Methods: 6 of 108 patients (5.6%) who underwent BPD in our clinic (laparoscopic Scopinaro BPD - 1, open BPD/DS
- 4, Lap. BPD/DS - 1) suffered from BN preoperatively. Their preoperative weight was 68-117 kg and BMI 27.6-41.9 kg/m2. 4 of 6 patients had BMI <40 kg/m2 before BPD but were MO in the past. The patient with the lowest weight had repeated gastroesophageal bleeding during self-induced
vomiting. 3 of the 6 patients had previously failed intragastric balloon or Lap-Band?. Results: All 6 patients were cured or significantly improved of bulimic symptoms soon after BPD. Weight loss was very good
and never reached an undesirably low level. Patient satisfaction was high. Conclusion: Severe BN may be considered as a latent
and potentially malignant MO. BPD (or BPD/DS) may be an effective solution for some patients with severe BN, as a final decision
after unsuccessful organized conservative attempts. All candidates for bariatric surgery should be screened for BN, because
it may influence choice of procedure in favor to BPD or BPD/DS. |
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Keywords: | EATING DISORDERS BULIMIA NERVOSA BILIOPANCREATIC DIVERSION DUODENAL SWITCH OBESITY MORBID OBESITY |
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