Weight Loss and Postoperative Complications in Morbidly Obese Patients with Binge Eating Disorder Treated by Laparoscopic Adjustable Gastric Banding

Obesity Unit, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy.
Obesity Surgery (Impact Factor: 3.75). 02/2005; 15(2):195-201. DOI: 10.1381/0960892053268327
Source: PubMed


The authors investigated the outcome of morbidly obese patients with binge eating disorder (BED) treated surgically with laparoscopic adjustable gastric banding.
The 5-year outcomes of 130 patients with BED and 249 patients without BED are described. The diagnosis of BED was made preoperatively and all patients with BED were supported with psychological therapy.
Patients with and without BED had similar BMI levels before surgery. More patients with than without BED had depressive symptoms and associated minor disturbances of eating behavior (night eating and grazing). Percent excess weight loss (%EWL) in the first 5 years after surgery was similar in patients with and without BED. The percentage of BED patients showing %EWL >50% at the 5-year evaluation was 23.1, and 25.7% in non-BED patients. The percentage of patients showing weight regain in the last 4 years of follow-up was similar in binge eaters (20.8%) and in non-binge eaters (22.5%). The 5-year frequency of gastric pouch and esophageal dilatation was significantly higher in binge eaters than in non-binge eaters (25.4 vs 17.7 %, P<0.05 and 10.0 vs 4.8%, P<0.05, respectively). Binge eaters underwent a higher number of postoperative band adjustments than non-binge eaters (3.0+/-2.1 vs 2.6+/-1.9, P<0.05) and the maximum band fill after surgery was higher in the BED patients than in non-BED patients (3.2+/-1.2 vs 2.8+/-1.3 ml, P<0.01).
Morbidly obese patients with BED supported by adequate psychological treatment can have good outcomes after gastric banding.

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Available from: Luca Busetto
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    • "In our study, patients in the surgical group were younger and had higher BMI than those in the non-surgical group. Eating disorders, especially binge eating disorder, is prevalent in bariatric surgery patients [11] and has affected the outcome of weight loss after surgery [27,28]. Postoperative binge eating disorder can predict a poor surgical outcome. "
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    ABSTRACT: Background Obese and overweight people have a higher risk of both chronic physical illness and mental illness. Obesity is reported to be positively associated with psychiatric disorders, especially in people who seek obesity treatment. At the same time, obesity treatment may be influenced by psychological factors or personality characteristics. This study aimed to understand the prevalence of mental disorders among ethnic Chinese who sought obesity treatment. Methods Subjects were retrospectively recruited from an obesity treatment center in Taiwan. The obesity treatments included bariatric surgery and non-surgery treatment. All subjects underwent a standardized clinical evaluation with two questionnaires and a psychiatric referral when needed. The psychiatric diagnosis was made thorough psychiatric clinic interviews using the SCID. A total of 841 patients were recruited. We compared the difference in psychiatric disorder prevalence between patients with surgical and non-surgical treatment. Results Of the 841 patients, 42% had at least one psychiatric disorder. Mood disorders, anxiety disorders and eating disorders were the most prevalent categories of psychiatric disorders. Females had more mood disorders and eating disorders than males. The surgical group had more binge-eating disorder, adjustment disorder, and sleep disorders than the non-surgical group. Conclusion A high prevalence of psychiatric disorders was found among ethnic Chinese seeking obesity treatment. This is consistent with study results in the US and Europe.
    Full-text · Article · Jan 2013 · BMC Psychiatry
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    • "Some reports show that not all patients benefi t from surgery; there are signifi cant differences in variations of weight in the short and long term after surgery (Kinzl et al., 2006); an example of this is that 20% of patients who undergo weight loss surgery, don't lose a signifi cant amount of weight or recover it in the short term (Greenberg, Sogg & Perna, 2009). The failure of this surgery in 20% of patients who do not achieve a signifi cant weight loss is generally attributed to psychological or behavioral reasons (Busetto et al., 2005). While most post-operative patients of bariatric surgery show improvement in psychopathology and quality of life, psychological recurrences have been identifi ed thereafter. "
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    ABSTRACT: Obesity has been declared by the World Health Organization (WHO) as an epidemic, due to a growth trend in obesity rates over the past 60 years and it is estimated that by 2015 there will be approximately 2.3 billion overweighed adults and 700 million obese adults worldwide. Bariatric surgery has shown to be the most effective intervention for the treatment of severe obesity with better long-term results. While most post-operative patients of bariatric surgery show improvement in psychopathology and quality of life, psychological recurrences have been identified thereafter. It has been reported that for people who have not been able to implement changes in their lifestyle, the result of the operation may not be optimal and may even be counterproductive with undesirable outcomes, such as recovery of lost weight, malnutrition, depression and anxiety, as well as using food as a soothing agent to stressful stimuli, present failures in following the diet, as well as dissatisfaction with the staff of the clinic In recent years the number of bariatric surgeries performed annually has tripled showing a tendency to continue increasing, psychosocial and behavioral factors play a fundamental role in the long- term effects of the surgery; for this reason, the objective of this study is to describe the main psychological recurrences after bariatric surgery as well as a proposal for post-surgical cognitive behavioral group psychological support.
    Full-text · Article · Jan 2013
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    • "Regardless of which assessment tool is utilized, some studies find smaller % EWL for patients with presurgical binge eating, but still report significant weight loss. Patients with presurgical binge eating who have undergone laparoscopic banding surgery have been reported to undergo more frequent band adjustments and have more postsurgical complications than patients without disordered eating (Busetto et al., 2005). "

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