Daniel Gero1, Stefanos Tzafos1, Gabriella Milos2, Philipp A Gerber3, Diana Vetter1, Marco Bueter4. 1. Department of Surgery and Transplantation, University Hospital Zurich, Rämistrasse 100, 8091, Zürich, Switzerland. 2. Department of Psychiatry and Psychotherapy, University Hospital of Zurich, CH-8091, Zürich, Switzerland. 3. Division of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Zurich, Zürich, Switzerland. 4. Department of Surgery and Transplantation, University Hospital Zurich, Rämistrasse 100, 8091, Zürich, Switzerland. marco.bueter@usz.ch.
Abstract
BACKGROUND: Bariatric surgery (BS) has been shown to ameliorate health-related quality of life and eating disorder symptoms. However, the correlation of these changes with weight loss is not uniform, suggesting that additional factors have an impact on postoperative outcomes. OBJECTIVE: To assess the impact of BS on eating disorder symptoms at 1 year postoperatively and to generate predictive models for the achievement of optimal eating behavior. METHODS: Retrospective cohort study on a prospectively collected database of all consecutive patients who underwent primary BS in our academic center between January 2015 and March 2017. Eating Disorder Examination-Questionnaire (EDE-Q) was used to measure eating psychopathology. Logistic regression was used to estimate the odds ratio of achieving "healthy" EDE-Q at 1 year. Missing data was handled by multiple imputations for the regression model. RESULTS: Two-hundred thirty-four patients were included. A complete-case analysis in 135 cases showed a "healthy" EDE-Q in 27.4% at baseline and in 83.7% at 1 year (difference = 56.3%, P = 0.018). Only the baseline EDE-Q "healthy" status influenced significantly the odds of achieving "healthy" EDE-Q at 1 year (OR 6.7, 95% CI 1.18-38.14, P = 0.04). CONCLUSION: BS seems to promote successful treatment of self-reported eating disorder symptoms during the first postoperative year. The achievement of optimal results is independent of age, sex, weight loss, obesity-related comorbidity status, surgical technique, or 30-day surgical complications. Future studies, using validated questionnaires specifically designed to investigate eating behavior after BS and/or direct measurements of the eating behavior are needed to clarify the underlying neuropsychologic mechanisms that drive the observed postoperative changes.
BACKGROUND: Bariatric surgery (BS) has been shown to ameliorate health-related quality of life and eating disorder symptoms. However, the correlation of these changes with weight loss is not uniform, suggesting that additional factors have an impact on postoperative outcomes. OBJECTIVE: To assess the impact of BS on eating disorder symptoms at 1 year postoperatively and to generate predictive models for the achievement of optimal eating behavior. METHODS: Retrospective cohort study on a prospectively collected database of all consecutive patients who underwent primary BS in our academic center between January 2015 and March 2017. Eating Disorder Examination-Questionnaire (EDE-Q) was used to measure eating psychopathology. Logistic regression was used to estimate the odds ratio of achieving "healthy" EDE-Q at 1 year. Missing data was handled by multiple imputations for the regression model. RESULTS: Two-hundred thirty-four patients were included. A complete-case analysis in 135 cases showed a "healthy" EDE-Q in 27.4% at baseline and in 83.7% at 1 year (difference = 56.3%, P = 0.018). Only the baseline EDE-Q "healthy" status influenced significantly the odds of achieving "healthy" EDE-Q at 1 year (OR 6.7, 95% CI 1.18-38.14, P = 0.04). CONCLUSION: BS seems to promote successful treatment of self-reported eating disorder symptoms during the first postoperative year. The achievement of optimal results is independent of age, sex, weight loss, obesity-related comorbidity status, surgical technique, or 30-day surgical complications. Future studies, using validated questionnaires specifically designed to investigate eating behavior after BS and/or direct measurements of the eating behavior are needed to clarify the underlying neuropsychologic mechanisms that drive the observed postoperative changes.
Authors: Eva M Conceição; James E Mitchell; Ana Pinto-Bastos; Filipa Arrojado; Isabel Brandão; Paulo P P Machado Journal: Surg Obes Relat Dis Date: 2016-12-20 Impact factor: 4.734
Authors: Anita Robitzsch; Adam Schweda; Madeleine Hetkamp; Marco Niedergethmann; Nora Dörrie; Stephan Herpertz; Till Hasenberg; Sefik Tagay; Martin Teufel; Eva-Maria Skoda Journal: Front Psychiatry Date: 2020-07-10 Impact factor: 4.157