164 research outputs found
ConseqĂŒĂȘncias psiquiĂĄtricas de cirurgia bariĂĄtrica em paciente esquizofrĂȘnica: relato de caso
Comorbidades fĂsicas e psicolĂłgicas antes e depois da cirurgia bariĂĄtrica : 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 vårias implicaçÔes para
a saĂșde psicolĂłgica e fĂsica. A cirurgia bariĂĄtrica tem sido o
tratamento de escolha para essa doença crÎnica, apesar da
controvĂ©rsia sobre o impacto da cirurgia na saĂșde psicossocial.
O objetivo deste estudo foi descrever candidatos a cirurgia bariåtrica e analisar mudanças no peso, psicopatologia personalidade,
problemas e queixas de saĂșde desses pacientes em avaliaçÔes
realizadas 6 e 12 meses apĂłs a cirurgia.
MĂ©todos: Trinta pacientes obesos (20 mulheres e 10 homens)
com idade média de 39,17±8,81 anos foram avaliados em diferentes
dimensÔes antes da cirurgia e 6 e 12 meses após.
Resultados: Aos 6 e 12 meses apĂłs a cirurgia bariĂĄtrica, os
pacientes relataram significativa perda de peso e significativa
redução no nĂșmero de problemas e queixas de saĂșde. As taxas
de psicopatologia autorrelatada foram baixas antes da cirurgia e
não sofreram mudanças significativas com o tempo. As dimensÔes
conscienciosidade, extroversĂŁo e agradabilidade aumentaram,
mas o neuroticismo e a abertura permaneceram inalteradas.
Todas as mudanças apresentaram um tamanho de efeito médio.
ConclusÔes: Os nossos resultados sugerem que os pacientes
experimentam melhoras significativas em saĂșde e algumas mudanças
positivas de personalidade apĂłs a cirurgia bariĂĄtrica.
Embora esses achados reforcem o papel da cirurgia bariĂĄtrica
como um tratamento relevante para a obesidade mĂłrbida, mais
estudos longitudinais e aprofundados sĂŁo necessĂĄrios para elucidar
a evolução dos pacientes após a realização do procedimento.(undefined
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The impact of psychological support on weight loss post weight loss surgery: a randomised control trial
Background The purpose of the present study is to evaluate the impact of a health psychology-led bariatric rehabilitation service (BRS) on patient weight loss following bariatric surgery at 1 year.
Methods A single-site open-randomised parallel group control trial based at St. Richardâs Hospital in Chichester in the UK. Patients (n=162) were recruited immediately prior to Roux-en-Y gastric bypass and randomly allocated to receive either treatment as usual (n=80) or the BRS (n=82). The BRS involved three 50-min one-to-one sessions with a health psychologist and provided information, support and mentoring pre and post surgery addressing psychological issues such as dietary control, self esteem, coping and emotional eating. Weight loss was assessed at 1 year. The key outcome variable was BMI and change in BMI.
Results Follow-up weight was available for 145 patients. Intention-to-treat analysis (n=162) using last measured weights showed that mean change in BMI by 1 year post surgery was â16.49. There was no significant difference between the two groups (control group=â16.37, 95 % CI= 15.15â17.57; intervention=â16.6, 95 % CI=15.42â17.81; ηp 2=0.001). Similarly, explanatory analysis (n=145) showed
a mean change inBMI of â17.17. The difference between the two groups was not significant (control group=â16.9, 95 % CI=15.78â18.18; intervention=â17.35, 95 % CI=18.5â 16.16; ηp 2=0.001).
Conclusions Psychological support pre and post bariatric surgery had no impact on weight loss as measured by BMI and change in BMI by 1 year. It is argued that psychological support should be targeted to patients who start to demonstrate weight regain at a later stage
A Prospective Assessment of Psychosocial Factors Among Bariatric Versus Non-bariatric Surgery Candidates
A cluster-randomised feasibility trial of a children's weight management programme:the Child weigHt mANaGement for Ethnically diverse communities (CHANGE) study
Background: Community-based programmes for children with excess weight are widely available, but few have been developed to meet the needs of culturally diverse populations. We adapted an existing children's weight management programme, focusing on Pakistani and Bangladeshi communities. We report the evaluation of this programme to assess feasibility of programme delivery, acceptability of the programme to participants from diverse communities, and feasibility of methods to inform a future trial. Methods: A cluster-randomised feasibility trial was undertaken in a large UK city. Children's weight management programmes (nâ=â24) were randomised to be delivered as the adapted or the standard programme (2:1 ratio). Routine data on participant attendance (nâ=â243) at the sessions were used to estimate the proportion of families completing the adapted and standard programmes (to indicate programme acceptability). Families planning to attend the programmes were recruited to participate in the feasibility study (nâ=â92). Outcome data were collected from children and parents at baseline, end of programme, and 6 months post-programme. A subsample (nâ=â24) of those attending the adapted programme participated in interviews to gain their views of the content and delivery and assess programme acceptability. Feasibility of programme delivery was assessed through observation and consultation with facilitators, and data on costs were collected. Results: The proportion of Pakistani and Bangladeshi families and families of all ethnicities completing the adapted programme was similar: 78.8% (95% CI 64.8-88.2%) and 76.3% (95% CI 67.0-83.6%) respectively. OR for completion of adapted vs. standard programme was 2.40 (95% CI 1.32-4.34, pâ=â0.004). The programme was feasible to deliver with some refinements, and participant interview data showed that the programme was well received. Study participant recruitment was successful, but attrition was high (35% at 6 months). Data collection was mostly feasible, but participant burden was high. Data collection on cost of programme delivery was feasible, but costs to families were more challenging to capture. Conclusions: This culturally adapted programme was feasible to deliver and highly acceptable to participants, with increased completion rates compared with the standard programme. Consideration should be given to a future trial to evaluate its clinical and cost-effectiveness. Trial registration: ISRCTN81798055, registered: 13/05/2014
The impact of living with morbid obesity on psychological need frustration: A study with bariatric patients
Guided by selfâdetermination theory, the purpose of this study was to gain an understanding of the previous experiences of living with morbid obesity of 10 postbariatric patients enrolled in a physical activity programme. Qualitative data were collected through interviews and diarized observations. A thematic analysis revealed that participants suffered from health and mobility troubles in their daily life and experienced stigmatization and discrimination in most areas of their social functioning. Participants described how these experiences resulted in the thwarting of their basic psychological needs for autonomy, competence and relatedness. In turn, psychological need frustration contributed to negative consequences such as body image concerns, low selfâesteem, anxiety and depression; controlled regulation of their eating behaviour and extrinsic goals; rigid behaviours such as avoiding social situations; and compensatory and selfâdefeating behaviours such as giving up diet and physical activity regimens and binge eating (i.e., oppositional defiance). This study highlights how living with morbid obesity can impair optimal functioning and wellâbeing via experiences of psychological need frustration
Psychiatric Factors and Weight Loss Patterns Following Gastric Bypass Surgery in a Veteran Population
Preoperative Factors and Three Year Weight Change in the Longitudinal Assessment of Bariatric Surgery (LABS) Consortium
The Efficacy of Energy-Restricted Diets in Achieving Preoperative Weight Loss for bariatric Pateints: A Systematic Review
The final publication is available at Springer via https://doi.org/10.1007/s11695-018-3451-1In bariatric practice, a preoperative weight loss of at least 5% is recommended. However, the hypocaloric diets prescribed vary
and no consensus exists. This study examined the efficacy of preoperative diets in achieving 5% weight loss. From a systematic
literature search, eight randomised controlled trials (n = 862) were identified. Half of the trials used a Bvery-low-calorie diet^
whilst the rest employed a Blow-calorie diet^. Only five diets achieved â„ 5% weight loss over varying durations and energy
intakes. By inference, compliance with a 700â1050 kcal (2929â4393 kJ) diet, consisting of moderate carbohydrate, high protein
and low/moderate fat, for 3 weeks is likely to achieve 5% weight loss. A low-carbohydrate diet (< 20 g/day) may achieve this
target within a shorter duration. Additional research is required to validate these conclusions
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