Binge eating, anxiety and depression are common symptoms in severely obese patients who are seeking and undergoing bariatric surgery, according to a recent study on mental health conditions.
Bariatric surgery is an accepted method of promoting weight loss in severely obese individuals. Mental health conditions may be common among patients seeking bariatric surgery; however, the prevalence of these conditions and whether they are associated with postoperative outcomes has not been known.
Aaron J. Dawes, M.D., of the David Geffen School of Medicine at UCLA, Los Angeles, and colleagues conducted a meta-analysis to determine the prevalence of mental health conditions among bariatric surgery candidates and recipients and the association between preoperative mental health conditions and health outcomes following bariatric surgery. The authors identified 68 publications meeting criteria for inclusion in the analysis: 59 reporting the prevalence of preoperative mental health conditions (65,363 patients) and 27 reporting associations between preoperative mental health conditions and postoperative outcomes (50,182 patients).
Results of the meta-analysis estimated that 23 percent of patients undergoing bariatric surgery reported a current mood disorder — most commonly depression (19 percent) — while 17 percent were diagnosed with an eating disorder. “Both estimates are higher than published rates for the general U.S. population, suggesting that special attention should be paid to these conditions among bariatric patients,” the researchers write. Another common mental health condition was anxiety (12 percent).
There was conflicting evidence regarding the association between preoperative mental health conditions and postoperative weight loss. Neither depression nor binge eating disorder was consistently associated with differences in weight outcomes. Bariatric surgery was, however, consistently associated with postoperative decreases in the prevalence of depression (7 studies; 8 percent-74 percent decrease) and the severity of depressive symptoms (6 studies; 40 percent-70 percent decrease).
“Previous reviews have suggested that self-esteem, mental image, cognitive function, temperament, support networks, and socioeconomic stability play major roles in determining outcomes after bariatric surgery,” the authors write. “Future studies would benefit from including these characteristics as well as having clear eligibility criteria, standardized instruments, regular measurement intervals, and transparency with respect to time-specific follow-up rates. By addressing these methodological issues, future work can help to identify the optimal strategy for evaluating patients’ mental health prior to bariatric surgery.”
Karin Kratina, PhD, RD, LD/N; Michelle Albers, PhD, RD, LD/N Effective treatment of eating disorders requires multidimensional and individualized interventions. Education that addresses the normal nutritional needs and the physiologic effects of starvation and refeeding is a critical component of treatment. Management often requires long-term nutritional counseling of the patient which may extend several years. This course will describe the rationale and use of providing Medical Nutrition Therapy (MNT) for the treatment of Anorexia Nervosa, Bulimia Nervosa, Eating Disorder Not Otherwise Specified, and Binge Eating Disorder. Included are: Criteria for Diagnosing Eating Disorders; Role of Dieting in the Development of Eating Disorders; Symptomology; Treatment Overview; Nutrition Therapy; Reconnecting with Hunger and Satiety; Use of Exercise; Working with a Therapist; Pharmacotherapy; In-Patient versus Out-Patient Treatment; Refeeding; Establishing a Dietary/Eating Pattern; Comparing Traditional and Health at Every Size (HAES) Approaches to Health Enhancement; Recovery from Eating Disorders; Nutrition Care Process; and the Core Minimum Guide.
Susan Moyers, PhD, MPH, LD/N Overweight and obesity constitute one of the nation’s ten leading health indicators with nearly two-thirds of adults in the United States now classified as either overweight or obese. Before any diet and physical activity program can be personalized and implemented, a nutrition assessment is needed, along with an understanding of the individual’s readiness to change and motivation. This course was developed by the Florida Academy of Nutrition and Dietetics for their Manual of Medical Nutrition Therapy to provide Licensed and Registered Dietitian/Nutritionists (RDNs) and technicians with evidence-based, non-biased information on the prevention and treatment of obesity in adults. Topics covered include: obesity synopsis; reimbursement considerations; nutrition assessment (diagnosis, intervention, monitoring and evaluation); pharmacotherapy for weight-loss (prescription and OTC); and physical activity. Nutrition education handouts are included at the end of the course.
This course is a self-instructional module that “walks” readers through the process of replacing their self-defeating weight issues with healthy, positive, and productive life-style behaviors. It moves beyond the “burn more calories than you consume” concept to encompass the emotional aspects of eating and of gaining and losing weight. Through 16 included exercises, you will learn how to identify your self-defeating behaviors (SDBs), analyze and understand them, and then replace them with life-giving actions that lead to permanent behavioral change.* Please note – this course contains common material on eliminating SDBs with Living a Better Life with Chronic Pain: Eliminating Self-Defeating Behaviors
Statistics report that Americans are an increasingly overweight population. Among the factors contributing to our struggle to stop tipping the scales is the component of “emotional eating” – or the use of food to attempt to fill emotional needs. Professionals in both the physical and emotional health fields encounter patients with emotional eating problems on a regular basis. Even clients who do not bring this as their presenting problem often have it on their list of unhealthy behaviors that contribute to or are intertwined with their priority concerns. While not an easy task, it is possible to learn methods for dismantling emotional eating habits. The goals of this course are to present information about the causes of emotional eating, and provide a body of cognitive and behavioral exercises that can help to eliminate the addictive pattern.
This course is designed to help clinicians enhance their working knowledge of the etiology and treatment of obesity, including assessment skills, diagnostic issues, treatment planning, and current developments in pharmacological and surgical treatments. Case studies will elucidate different aspects of treatment. The information in this course will be especially helpful to clinicians who work with obese individuals and want to provide better psychological care.
Professional Development Resources is a CPE Accredited Provider with the Commission on Dietetic Registration (CDR #PR001). CPE accreditation does not constitute endorsement by CDR of provider programs or materials. Professional Development Resources is also a provider with the Florida Council of Dietetics and Nutrition (#50-1635).