Metabolic profile and psychological variables after bariatric surgery: association with weight outcomes

Purpose This study aims to examine associations between metabolic profile and psychological variables in post-bariatric patients and to investigate if metabolic and psychological variables, namely high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), glycated hemoglobin (HbA 1c), impulsivity, psychological distress, depressive and eating disorder symptoms are independently associated with percentage of excess weight loss (%EWL) after bariatric surgery.Methods One hundred and fifty bariatric patients (BMI = 33.04 +/- 5.8 kg/m(2)) who underwent to bariatric surgery for more than 28.63 +/- 4.9 months were assessed through a clinical interview, a set of self-report measures and venous blood samples. Pearson's correlations were used to assess correlations between %EWL, metabolic and psychological variables. Multiple linear regression was conducted to investigate which metabolic and psychological variables were independently associated with %EWL, while controlling for type of surgery.Results Higher TG blood levels were associated with higher disordered eating, psychological distress and depression scores. HDL-C was associated with higher depression scores. Both metabolic and psychological variables were associated with %EWL. Regression analyses showed that, controlling for type of surgery, higher % EWL is significantly and independently associated with less disordered eating symptoms and lower TG and HbA_1c blood concentrations (R-2 aj = 0.383, F (4, 82) = 14.34, p < 0.000).Conclusion An association between metabolic and psychological variables, particularly concerning TG blood levels, disordered eating and psychological distress/depression was found. Only higher levels of disordered eating, TG and HbA_1c showed and independent correlation with less weight loss. Targeting maladaptive eating behaviors may be a reasonable strategy to avoid weight regain and optimize health status post-operatively.This research was partially supported by Fundacao para a Ciencia e a Tecnologia/Foundation for Science and Technology through European Union COMPETE program Grant to Eva Conceicao (IF/01219/2014) and (PTDC/MHC-PCL/4974/2012), doctoral scholarship (SFRH/BD/104159/2014) to Ana Pinto-Bastos and doctoral scholarship (SFRH/BD/104182/2014) to Sofia Ramalho

APOLO-Bari, an internet-based program for longitudinal support of bariatric surgery patients: study protocol for a randomized controlled trial

Background: Despite evidence of successful weight loss for bariatric surgery patients, some patients experience considerable weight regain over the long term. Given the strong association between post-surgery health behaviors and outcomes, aftercare intervention to address key behaviors appears to be a reasonable relapse-prevention strategy. As the burden of obesity rates increases in healthcare centers, an internet-based program appears to be a reasonable strategy for supporting bariatric surgery patients in the long term. The primary purpose of the current project is to develop and test the efficacy and perceived utility of APOLO-Bari.Methods/design: This study is a randomized control trial, which will be conducted in two hospital centers in the North of Portugal; it includes a control group receiving treatment as usual and an intervention group receiving the APOLO-Bari program for one year in addition to treatment as usual. A total of 180 male and female participants who underwent bariatric surgery (gastric sleeve or gastric bypass surgery) for 12 to 20 months will be recruited. Both groups will complete a similar set of questionnaires at baseline, every 4 months until the end of the intervention, and at 6 and 12 months follow-up. Assessment includes anthropometric variables and psychological self-report measures. The primary outcome measure will be weight regain measured at the end of treatment, and at 6 and 12 months follow-up. The secondary aims are to test the cost-effectiveness of the intervention and to investigate psychological predictors and trajectories of weight regain. APOLO-Bari was developed to address the weight regain problem in the bariatric population by offering additional guidance to bariatric patients during the postoperative period. The program includes: (a) a psychoeducational cognitive-behavioral-based self-help manual, (b) a weekly feedback messaging system that sends a feedback statement related to information reported by the participant, and (c) interactive chat sessions scheduled witThis research was partially supported by the Fundacao para a Ciencia e a Tecnologia through a European Union COMPETE program grant to Eva Conceicao (IF/01219/2014 and PTDC/MHC-PCL/4974/2012), a doctoral scholarship to Ana Pinto-Bastos (SFRH/BD/104159/2014), a doctoral scholarship to Sofia Ramalho (SFRH/BD/104182/2014), and a postdoctoral scholarship to Ana Rita Vaz (SFRH/BPD/94490/2013), co-financed by FEDER under the PT2020 Partnership Agreement (UID/PSI/01662/2013).info:eu-repo/semantics/publishedVersio

Aspectos psicossociais em cirurgia bariátrica: a associação entre variáveis emocionais, trabalho, relacionamentos e peso corporal Psychosocial aspects in bariatric surgery: the association among emotional variables, job, relationships and body weight

RACIONAL: Operações bariátricas têm sido consideradas alternativa para o tratamento de obesidade mórbida. Alguns eventos adversos que as pessoas experimentam após o tratamento frequentemente são consequência da falta de conhecimento consistente associada a fatores psicossociais que estão relacionadas ao status pré-operatório dos pacientes. OBJETIVO: Avaliar as variáveis ?psicossociais de 414 candidatos ? cirurgia bari?trica do Hospital de Cl?nicas da Faculdade de Medicina da Universidade de S?o Paulo, Ribeir?o Preto, SP, Brasil. psicossociais de 414 candidatos à cirurgia bariátrica do Hospital de Clínicas da Faculdade de Medicina da Universidade de São Paulo, Ribeirão Preto, SP, Brasil. MÉTODOS: Foram utilizados entrevista semi-estruturada, Inventário de Depressão de Beck (BDI), Inventário de Ansiedade de Beck (BAI) e Binge Eating Scale (BES). RESULTADOS: IMC foi maior entre os pacientes que não tinham emprego (p = 0,019), do sexo feminino, os que tinham um parceiro e os pacientes com IMC <50 kg / m², todos eles desejando ter peso menor (p<0,001). Escores do BAI foram maiores entre os pacientes que não tinham emprego (p <0,05) e maior naqueles com IMC> 50 kg / m² (p <0,05). BDI foram mais altos entre as mulheres (p <0,05) e menores entre aqueles que tinham um emprego (p <0,01). Nenhuma diferença no BES foi encontrada. CONCLUSÕES: Os dados sugerem que as mulheres apresentaram indicadores mais elevados de ansiedade e depressão, sugerindo que elas tinham funcionamento psicológico mais frágil com dificuldades em lidar com a angústia. Auto-percepção, assim como competências e habilidades, podem refletir aspectos internos da personalidade do indivíduo. Pacientes que tiveram um emprego antes da operação parecia ter mais recursos emocionais. Assim, eles podiam sentir menos sofrimento, porque o emprego podia protegê-los. Mulheres e aqueles que não tinham emprego eram mais propensos a apresentar sintomas de depressão. Além disso, pacientes que não tinham emprego e aqueles com IMC> 50 kg / m² foram mais propensos a apresentar sintomas de ansiedade.<br>BACKGROUND: Bariatric surgeries have been considered an alternative for treatment of morbid obesity. Some adverse events that people experience after the treatment frequently are the consequence of the lack of consistent knowledge associated with psychosocial factors that are related to the pre-surgery status of the patients. AIM: To evaluate psychosocial variables of 414 candidates for bariatric surgery from Clinical Hospital of Medical School at University of São Paulo, Ribeirão Preto, SP, Brazil. METHODS: Semi-structured interview, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Binge Eating Scale (BES) were used. RESULTS: BMI was higher among patients who had no employment (p = 0.019). Female, patients who had a partner and patients with a BMI < 50 kg/m², all of them desired have a lower weight (p < 0.001). BAI scores were higher among patients who had no employment (p < 0.05) and higher among those with a BMI > 50 kg/m² (p < 0.05). BDI scores were higher among women (p < 0.05) and lower among those who had an employment (p < 0.01). No difference in BES was found. CONCLUSIONS: The data suggest that women showed higher indicators of anxiety and depression, suggesting that they had a more fragile psychological functioning with difficulties in coping with distress. Self-perception as well as skills and abilities, may reflect internal aspects of individual's personality. Patients who had an employment before surgery seemed have more emotional resources. So, they may feel less distress because the employment may protect them. Women and those who did not have an employment were more likely to experience depression symptoms. Furthermore, patients who did not have an employment and those with BMI> 50 kg / m² were more likely to experience anxiety symptoms