24 research outputs found
Comorbidades físicas e psicológicas antes e depois da cirurgia bariátrica : um estudo longitudinal
Introduction: Morbid obesity has multiple implications for
psychological and physical health. Bariatric surgery has been
selected as the treatment of choice for this chronic disease,
despite the controversial impact of the surgery on psychosocial
health. The objective of this study was to describe candidates
for bariatric surgery and analyze changes in weight, psychopathology,
personality, and health problems and complaints at
6- and 12- month follow-up assessments.
Methods: Thirty obese patients (20 women and 10 men) with a
mean age of 39.17±8.81 years were evaluated in different dimensions
before surgery and 6 and 12 months after the procedure.
Results: Six and 12 months after bariatric surgery, patients
reported significant weight loss and a significant reduction in
the number of health problems and complaints. The rates of
self-reported psychopathology were low before surgery, and
there were no statistically significant changes over time. The
conscientiousness, extraversion, and agreeableness dimensions
increased, but neuroticism and openness remained unchanged.
All changes had a medium effect size.
Conclusions: Our results suggest that patients experience
significant health improvements and some positive personality
changes after bariatric surgery. Even though these findings
underscore the role of bariatric surgery as a relevant treatment
for morbid obesity, more in-depth longitudinal studies
are needed to elucidate the evolution of patients after the
procedure.Introdução: A obesidade mórbida tem várias implicações para
a saúde psicológica e física. A cirurgia bariátrica tem sido o
tratamento de escolha para essa doença crônica, apesar da
controvérsia sobre o impacto da cirurgia na saúde psicossocial.
O objetivo deste estudo foi descrever candidatos a cirurgia bariátrica e analisar mudanças no peso, psicopatologia personalidade,
problemas e queixas de saúde desses pacientes em avaliações
realizadas 6 e 12 meses após a cirurgia.
Métodos: Trinta pacientes obesos (20 mulheres e 10 homens)
com idade média de 39,17±8,81 anos foram avaliados em diferentes
dimensões antes da cirurgia e 6 e 12 meses após.
Resultados: Aos 6 e 12 meses após a cirurgia bariátrica, os
pacientes relataram significativa perda de peso e significativa
redução no número de problemas e queixas de saúde. As taxas
de psicopatologia autorrelatada foram baixas antes da cirurgia e
não sofreram mudanças significativas com o tempo. As dimensões
conscienciosidade, extroversão e agradabilidade aumentaram,
mas o neuroticismo e a abertura permaneceram inalteradas.
Todas as mudanças apresentaram um tamanho de efeito médio.
Conclusões: Os nossos resultados sugerem que os pacientes
experimentam melhoras significativas em saúde e algumas mudanças
positivas de personalidade após a cirurgia bariátrica.
Embora esses achados reforcem o papel da cirurgia bariátrica
como um tratamento relevante para a obesidade mórbida, mais
estudos longitudinais e aprofundados são necessários para elucidar
a evolução dos pacientes após a realização do procedimento.(undefined
Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample
Correction to: International Journal of Obesity (2017) 41,1232–1236; doi:10.1038/ijo.2017.89
Since publication the authors of this paper have requested that it be made open access under the CC BY licence
Effectiveness of cognitive behavioral therapy on weight loss after two years of bariatric surgery in morbidly obese patients
To evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) in the success of postoperative weight loss after 2 years of CB.
METHODS:
A prospective observational study was conducted in consecutive patients with morbid obesity aged between 18 and 59 yrs and enrolled in the bariatric surgery program of the Obesity Surgery Unit of our hospital from June 2007 through June 2010, with two years postoperative follow-up. Participants were divided into two groups according to their participation in Cognitive Behavioral Therapy or not. Over a 3-month period, CBT was applied in 12 2-h sessions. The main dependent variables studied were body weight and height, from which we calculated BMI and percentage of excess weight lost (weight lost x 100)/(initial weight-ideal weight), classifying patients as successful (E ) those with EPP > 50%, and unsuccessful (NE) those with EPP <50%. Participants were also, assessed for general (stress, anxiety, depression and self-esteem) and specific (binge eating and food craving) psychopathology.
RESULTS:
Of the 35 patients with bariatric surgery, 30 responded postoperative evaluations, 16 underwent CBT before CB and 14 underwent surgery without receiving psycho-nutritional therapy, (76% female) with a mean age of 41 ± 9.5 years. The mean baseline BMI was 42 ± 10 and 45% of patients were classified as super obese (BMI: 56 ± 6). Mean excess weight loss (EPP) was 77%. According to the EPP were classified as "successful" (S) (59%) and "unsuccessful" (U) (41%). Of the patients assigned to S, 94% received CBT (15 individuals of 17 total), compared with only 12% who did not receive (2 individuals of the 17 total) with statistically significant differences (p 50% of EPP (p 50% y como no exitosos (NE) aquellos con EPP 50% de EPP (p < 0,04, p < 0,001, y p < 0,001, respectivamente). También se observó que este grupo de pacientes hacían menos planes para comer y comían menos por refuerzo positivo (p < 0,03 y p < 0,000, respectivamente) que el grupo de pacientes NE. Conclusiones: Los pacientes que lograron resultados exitosos en la evolución de la perdida de peso a los dos años de CB son en su mayoría (94%) aquellos que recibieron TCC, presentando menor comorbilidad psicológica que los NE. La TCC podría influir positivamente en los resultados postoperatorios
Intragastric balloon in obesity treatment
English Abstract; Journal Article; Review;Obesity is considered a chronic and epidemic illness, hece difficult to treat. As conservative treatment has a high rate of failure, and considering morbimortality and sequels of surgery, less invasive techniques appeared to contribute to the treatment of this illness. The most implanted technique nowadays is the Intragastric Balloon, considered more efficient as conservative treatments and with less risks tan surgery, but having today a lack of consensus on indications and few information on his limitations, while its apparition in medias promote an important expansion in the 4 last years. In this publication, we do a critical revision, and describe limitations of this treatment, based on the evidences given by literature. We conclude this revision with some recommendations concerning the technique and indications, material and human requiring, need of a Multidisciplinary Team, as well as an adequate control and following.YesLa obesidad es considerada una enfermedad crónica, epidémica, y de difícil tratamiento. Ante el alto índice de fracasos de los métodos conservadores, y por otra parte,
la inevitable morbimortalidad y secuelas ligadas a la cirugía, surgen nuevas técnicas poco invasivas destinadas a contribuir al tratamiento de esta enfermedad. La más implantada actualmente es el Balón intragástrico, considerado más eficaz que el tratamiento conservador, con menos riesgo que la cirugía pero que adolece a día de hoy de una falta de consenso sobre sus indicaciones
y escasa información sobre sus limitaciones, al tiempo que su aparición mediática ha propiciado su gran difusión en los 4 últimos años. En este trabajo se realiza una revisión crítica y se señalan las limitaciones de este tratamiento con base a la evidencia aportada por los estudios publicados hasta la
fecha.
Como conclusión de dicha revisión, se emiten una serie de recomendaciones respecto a la técnica y sus indicaciones, requisitos materiales y humanos, necesidad de Equipo Multidisciplinar así como del control y seguimiento adecuados