Isabelle Mack1, Sabrina Ölschläger2, Helene Sauer2, Maximilian von Feilitzsch3, Katja Weimer2, Florian Junne2, Riyad Peeraully4, Paul Enck2, Stephan Zipfel2, Martin Teufel2. 1. Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany. isabelle.mack@medizin.uni-tuebingen.de. 2. Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany. 3. Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany. 4. Department of Paediatric Surgery, Queen's Medical Centre, Nottingham, UK.
Abstract
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a restrictive bariatric surgery procedure and currently the second most performed technique worldwide. Follow-up data on depression, stress and eating behaviour are scarce. The aim of this longitudinal study was to investigate the medium-term effects of LSG on mental health and eating behaviour and their influence on weight loss by using a comprehensive interview-based assessment. METHODS: Seventy-five individuals, who had undergone LSG at a university hospital, were included in the study. Symptoms of disordered eating were assessed using a structured clinical interview (eating disorder examination) and the Three-Factor Eating Questionnaire with depressive symptoms and stress assessed via the Patient Health Questionnaire. RESULTS: Mean interval from LSG to follow-up (FU) examination was 48 ± 13.3 months. The total body weight loss was 24.2 ± 12.0 %. Depressive symptom scores improved from pre-operative to FU (9 [IQR 5-14] vs. 6 [IQR 2-10], p = 0.002) as did stress scores (8.7 ± 4.6 vs. 6.3 ± 4.7, p = 0.001). At FU, 11 % of patients reported loss-of-control eating and 39 % grazing, paralleled by increased body mass index, stress and depressive symptoms. Prior to LSG, nine patients fulfilled the diagnostic criteria of binge eating disorder but only one at FU. CONCLUSIONS: Post-surgical mental health appears to be highly relevant in terms of weight loss maintenance. It is likely that the surgical outcome could be positively influenced if patients at risk of developing mental health issues or eating disorders were identified and monitored in order to offer targeted interventions.
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is a restrictive bariatric surgery procedure and currently the second most performed technique worldwide. Follow-up data on depression, stress and eating behaviour are scarce. The aim of this longitudinal study was to investigate the medium-term effects of LSG on mental health and eating behaviour and their influence on weight loss by using a comprehensive interview-based assessment. METHODS: Seventy-five individuals, who had undergone LSG at a university hospital, were included in the study. Symptoms of disordered eating were assessed using a structured clinical interview (eating disorder examination) and the Three-Factor Eating Questionnaire with depressive symptoms and stress assessed via the Patient Health Questionnaire. RESULTS: Mean interval from LSG to follow-up (FU) examination was 48 ± 13.3 months. The total body weight loss was 24.2 ± 12.0 %. Depressive symptom scores improved from pre-operative to FU (9 [IQR 5-14] vs. 6 [IQR 2-10], p = 0.002) as did stress scores (8.7 ± 4.6 vs. 6.3 ± 4.7, p = 0.001). At FU, 11 % of patients reported loss-of-control eating and 39 % grazing, paralleled by increased body mass index, stress and depressive symptoms. Prior to LSG, nine patients fulfilled the diagnostic criteria of binge eating disorder but only one at FU. CONCLUSIONS: Post-surgical mental health appears to be highly relevant in terms of weight loss maintenance. It is likely that the surgical outcome could be positively influenced if patients at risk of developing mental health issues or eating disorders were identified and monitored in order to offer targeted interventions.
Authors: Marney A White; Melissa A Kalarchian; Michele D Levine; Robin M Masheb; Marsha D Marcus; Carlos M Grilo Journal: Obes Surg Date: 2015-10 Impact factor: 4.129
Authors: Lindsey E Bocchieri-Ricciardi; Eunice Y Chen; Daniel Munoz; Sarah Fischer; Maureen Dymek-Valentine; John C Alverdy; Daniel le Grange Journal: Obes Surg Date: 2006-09 Impact factor: 4.129
Authors: Martina de Zwaan; Anja Hilbert; Lorraine Swan-Kremeier; Heather Simonich; Kathy Lancaster; L Michael Howell; Tim Monson; Ross D Crosby; James E Mitchell Journal: Surg Obes Relat Dis Date: 2009-09-03 Impact factor: 4.734
Authors: Kerstin Bauer; Sandra Schild; Helene Sauer; Martin Teufel; Andreas Stengel; Katrin Elisabeth Giel; Philipp Schellhorn; Florian Junne; Andreas Nieß; Stephan Zipfel; Isabelle Mack Journal: Obes Facts Date: 2021-09-14 Impact factor: 3.942
Authors: Kathrin Schag; Isabelle Mack; Katrin E Giel; Sabrina Ölschläger; Eva-Maria Skoda; Maximilian von Feilitzsch; Stephan Zipfel; Martin Teufel Journal: Nutrients Date: 2016-11-14 Impact factor: 5.717
Authors: Nathalia Pizato; Patrícia B Botelho; Vivian S S Gonçalves; Eliane S Dutra; Kênia M B de Carvalho Journal: Nutrients Date: 2017-12-05 Impact factor: 5.717