There are some words I despise. Dump is one.
Many women opt for bariatric surgery in order to increase chances of maintaining a healthy pregnancy. A recent study suggests that weight loss surgery can help a woman do just that, but there are risks.
Personally, my full term post bariatric surgery pregnancy was different than my pre-WLS pregnancies. I was at a more normal bodyweight at the time of my daughter's gestation, and I did not seem to suffer the ill effects of obesity on pregnancy like I had with my prior children. I had no high blood pressure, no high blood sugar, nor did I land on bedrest - which I had with previous babies. My post RNY pregnancy offered me anemia and rampant hypoglycemia. I was not well.
She was born healthy, but small, in comparison to my earlier babies. I noted a lack of body fat at birth. This is several weeks old.
While the study found some risks for women who had surgery, including more babies born too small and a greater likelihood of stillbirths, experts said that overall the results were better.
The findings have implications for an increasing number of women and children, especially in the United States, where nearly a third of women who become pregnant are obese. Obese women have more problems in pregnancy, including gestational diabetes, pre-eclampsia, and stillbirth. Their babies are more likely to be premature, overweight or underweight at birth, have certain birth defects, and develop childhood obesity.
The study, published Wednesday in The New England Journal of Medicine, sought to find out if surgery could safely mitigate some of those effects. Swedish researchers, led by Kari Johansson, a nutritionist at the Karolinska Institute, evaluated records of 2,832 obese women who gave birth between 2006 and 2011, comparing women who had bariatric surgery before becoming pregnant with women who did not.
They found that women who had had surgery were about 30 percent as likely to develop gestational diabetes, which can lead to pre-eclampsia, low blood sugar, birth defects and miscarriage. They were about 40 percent as likely to have overly large babies, whose challenges can include lung and blood problems.
The outcomes were worse in some categories. Women who had surgery were twice as likely to have babies who were small for their gestational age, suggesting the need for better nutrition for pregnant women with surgically-reduced stomachs. And more of their babies were stillborn or died within a month after birth, although the number of such deaths in each group was very small and might have been due to chance, experts and the authors said. There was no significant difference in rates of premature births or babies with birth defects.
The study via NEJM -
Maternal obesity is associated with increased risks of gestational diabetes, large-for-gestational-age infants, preterm birth, congenital malformations, and stillbirth. The risks of these outcomes among women who have undergone bariatric surgery are unclear.
We identified 627,693 singleton pregnancies in the Swedish Medical Birth Register from 2006 through 2011, of which 670 occurred in women who had previously undergone bariatric surgery and for whom presurgery weight was documented. For each pregnancy after bariatric surgery, up to five control pregnancies were matched for the mother’s presurgery body-mass index (BMI; we used early-pregnancy BMI in the controls), age, parity, smoking history, educational level, and delivery year. We assessed the risks of gestational diabetes, large-for-gestational-age and small-for-gestational-age infants, preterm birth, stillbirth, neonatal death, and major congenital malformations.
Pregnancies after bariatric surgery, as compared with matched control pregnancies, were associated with lower risks of gestational diabetes (1.9% vs. 6.8%; odds ratio, 0.25; 95% confidence interval [CI], 0.13 to 0.47; P<0.001) and large-for-gestational-age infants (8.6% vs. 22.4%; odds ratio, 0.33; 95% CI, 0.24 to 0.44; P<0.001). In contrast, they were associated with a higher risk of small-for-gestational-age infants (15.6% vs. 7.6%; odds ratio, 2.20; 95% CI, 1.64 to 2.95; P<0.001) and shorter gestation (273.0 vs. 277.5 days; mean difference −4.5 days; 95% CI, −2.9 to −6.0; P<0.001), although the risk of preterm birth was not significantly different (10.0% vs. 7.5%; odds ratio, 1.28; 95% CI, 0.92 to 1.78; P=0.15). The risk of stillbirth or neonatal death was 1.7% versus 0.7% (odds ratio, 2.39; 95% CI, 0.98 to 5.85; P=0.06). There was no significant between-group difference in the frequency of congenital malformations.
Bariatric surgery was associated with reduced risks of gestational diabetes and excessive fetal growth, shorter gestation, an increased risk of small-for-gestational-age infants, and possibly increased mortality. (Funded by the Swedish Research Council and others.)
PS. Post RNY baby is eight years and four months old now. She's fine.
Sometimes there are no words, yet there are so. many. words. It's hard to choose them.
Why is this a story? Why is it relevant?
Regardless of your feelings of Mama June's "parenting" for what it is -- or isn't -- (or why it is vastly different than yours or what you grew up with) this child is quite typical of an American Child.
Maybe she's an American Child times twenty plus some considering her life has been under a media microscope since she was very small, and she has been brought up to act for the cameras. What we see of this kid is so many of the things in our own children that are enhanced because cameras-in-her-face-act-more-goofy-we're-getting-paid for this.
And I know it makes you uncomfortable. (I know it does. That is why you watch it, or that is why you must comment about NOT watching because "That Poor Girl, Bless Her Heart!" Shut up.)
Don't pretend she isn't realistic -- kids with overweight and obesity are quite the norm. Even those with somewhat healthy, active lifestyles.
I used to get comments about my youngest ... "She's just like Honey Boo-Boo." I never really knew if those who said it meant that she was overweight, or hyperactive. Because all of my kids are diagnosed overweight or obese.
But I am not Mama June.
We do not eat like the Mama June household. But, that said, overweight still occurs.
I'd ask you to ask my youngest what her favorite food is.
It's gluten free organic vegan burritos. Thank-you. They are expensive, so if you'd like to send a case? PLEASE DO. I think they're on my Amazon Wish List. LMAO.
But why is it that her childhood obesity is a "problem" for us and requires an intervention a la The Doctors? Because the public consumed her lifestyle and promoted it by reality television? This child's weight is not our business.
A lot of it is probably our fault for promoting and exploiting it.
Stop pushing reality television.
I've often wondered about this as a post WLS epileptic. Is there more I could DO to control my symptoms? I know there are quite a few of you out there - with or without deficiencies occurring along with your seizure disorders after WLS.
From Epilepsy.com -
I live in the forest food desert where food delivery would be nice by drone. (No, really. Seven feet of snow. SEND. FOOD. SEND. RATIONS. SEND TOILET PAPER. Don't think I am not serious.)
Someone should create a quasi-healthy-food-drop service to my area and I would even accept Trader Joe's because I am between two of their locations and not within driving distance (I don't drive, still, brain still not participating in life skills training here) and haven't stepped foot inside one but once this past year or even two. I am so out of touch with what is On Store Shelves, guys. If you have something to tell me about, tell me, I mean that - I see nothing.
And that was last week. I cleared out a shelf of $100 worth frozen vegetarian products.
Because that is the way I eat now (yeah, we haven't spoken much on the blog have we? Because... I don't know...) so when I find something I like and likes me back in the bowel I BUY THEM ALL AT ONCE. I took a risk on this product "Trader Joe's Greens Beans And Grains" and assumed it would like me back 'cause WHY NOT?! I have been forcing myself to eat The Greens! The Beans and The Grains! in any form I find for a while now because I spent years being afraid to do so -- and I think my gut became afraid to digest! (Short story, it took a while to acclimate to real foods, but it works. Most of the time.)
This product. I didn't read the label closely. I just saw GREENS and grabbed it because I thought "Yummy, I love greens and it's prolly vegetarian and it's gotta be good," and the calorie count was low.
Peanut (...inspired, like?) Stew! Maybe they didn't because people might not have bought it? I honestly probably would not have bought it if I saw peanuts AT ALL. Good move, TJ's.
"If you're familiar with West African cuisine, you might find our Greens, Beans and Grains similar to a traditional peanut soup or stew; albeit with a Trader Joe's influenced interpretation. In place of the collard greens typical in an African version, we've chosen kale as the Green to accompany our beans and grains. Kale is the primary reason this entrée delivers so generously on vitamin A, vitamin C, iron, calcium, protein, and dietary fiber.
But just because kale/greens are named first, don't assume that's the only standout here. On the contrary, garbanzo beans play a pivotal role, filling in where West African cooks may utilize peanuts. They add fiber, protein, and iron, as well as super taste and texture. (We haven't left the peanuts out entirely, though, so peanut lovers rejoice!) As for the Grain portion of the show, we went with whole wheat couscous, a traditional ingredient in West African & North African cooking. All together, Greens, Beans and Grains is simmered in a vegetable stock with tomatoes, seasoned with garlic, onion, cilantro, cumin, coriander, caraway, cayenne, lemon juice, and salt - it's the spices that really play up the African connection and give the dish its memorable flavors.
We developed Greens, Beans and Grains with our supplier, and it's only available at your neighborhood Trader Joe's. We're selling each nine ounce package - an excellent single meal size - for $2.99, every day. You'll find it in our freezers."
I have eaten it twice now.
It is not an attractive meal. It's what my youngest calls bum-bums, and this? Is bums in sauce.
The first time, I microwaved it for the allotted time and ate the two sides separately and it was just too spicy. I actually walked away from it. I was dipping the couscous into the chickpeas and left some of the sauce behind.
This morning, I cooked it a little less, and plated the entire concoction together. I liked it much more this way. I added a spoonful of Greek Yogurt on the side to kill the heat because I am a wuss, and I really enjoyed it. I found that the couscous mixed with the peanut sauce was super moist and totally filling.
That said, I am still a gastric bypass post op, although at my stage (nearly 11 years) I can eat the entire portion, I would NOT eat this product as an early-stage post op, make sure you are cleared for legumes, nuts, greens and pasta. It's full of ALL OF THEM. And damn it, I AM EATING THEM. :P
But, I liked it enough. BECAUSE VEGETABLES.
- Via - Trader Joes
- Price - $2.99
- Pros - Greens! Beans! Grains! Vegetarian, Under 300 calories.
- Cons - Ugly as sin.
- Rating - Pouchworthy when you can digest it.
"The diet made famous by star athletes like LeBron James is risky for most people"
Adopting a vegetarian diet causes weight loss, even in the absence of exercise or calorie counting, according to a new meta-analysis published as an online advance in the Journal of the Academy of Nutrition and Dietetics on Thursday, Jan. 22, 2015.
The mega-review analyzed 15 studies, conducted with 755 participants in Finland, Norway, Poland, Spain, Sweden, and the United States. The studies varied in length, from as short as four weeks to as long as two years, with an average weight loss of 10 pounds over a 44-week period.
“The take-home message is that a plant-based diet can help you lose weight without counting calories and without ramping up your exercise routine,” saysNeal Barnard, M.D., lead author of the study, president of the Physicians Committee, and an adjunct associate professor of medicine at the George Washington University School of Medicine and Health Sciences. “We hope health care providers will take note and prescribe this approach to patients looking to manage their weight and health.”
One of the secrets behind losing weight on a plant-based diet is to fill up with fiber. The Physicians Committee recommends consuming close to 40 grams of fiber a day, which is easy to do when you move vegetables, fruits, whole grains, and legumes to the center of your plate.
More than 1.4 billion adults worldwide are overweight and at increased risk for type 2 diabetes, heart disease, osteoarthritis, and certain forms of cancer.
“If you’re overweight, losing just 5 to 10 percent of your body weight can slash the risk of both type 2 diabetes and cardiovascular disease,” says Susan Levin, M.S., R.D., C.S.S.D., a study author and director of nutrition education for the Physicians Committee. “As the weight comes off, you’ll start to see blood pressure, blood sugar, triglycerides, and cholesterol fall right along with it.”
So it's extra steps, sure, but!! removing the naughty-bready-carbs means MORE vegetable carb goodness IN MAH BELLY.
It appears they used processed cheese though in the first sandwich, no thank you. I'd use real natural dairy cheese.
I saw this video floating around a couple of weeks ago but did not click it. I just did - and glad I did. I enjoyed it, aside from the use of one phrase I don't particularly ... like?
It's inspiring for those who struggle with exercise and body image. (Because, yes.)
Lose weight without worrying about food? Imagine this?!
Via Popular Science "Safe and effective weight loss doesn't yet come in a pill, but maybe one day it will. A new study has found a chemical that keeps mice from gaining weight through overeating. The drug also seemed to protect lab mice from some of the harmful effects of obesity: When researchers measured the mice's blood, they found reduced levels of insulin, cholesterol, and other molecules, compared to obese mice who didn't get the drug."
“This pill is like an imaginary meal,” says Ronald Evans, director of Salk’s Gene Expression Laboratoryand senior author of the new paper, published January 5, 2014 in Nature Medicine. “It sends out the same signals that normally happen when you eat a lot of food, so the body starts clearing out space to store it. But there are no calories and no change in appetite.”
In the United States, more than a third of adults are obese and 29.1 million people have diabetes, according to the Centers for Disease Control and Prevention. Both obesity and diabetes lead to an increase in health spending, a greater risk of health complications and a shorter lifespan.
Katie Hopkins: My Fat Story
Premieres Friday 2nd January, 9.00pm
Outspoken TV personality, Katie Hopkins has hit the headlines for her controversial views on obesity; insisting that fat people are lazy, saying that she would not employ someone who is overweight, and claiming that losing weight is easy. Earlier this year Katie hit the headlines again revealing her new three stone heavier figure. Sick of hearing people's excuses for being overweight and justifying Britain's obesity crisis, Katie had decided to prove her argument by piling on the pounds to experience being weight, before attempting to lose it again by simply eating less and moving more. This two-part special exclusively follows Katie through every step of her project, as she struggles to put the weight on and deal with her increasing size, and then as she loses the weight. Will she prove her point or will she have to eat her own words?
Probably not. It's different in the UK right now, the National Health System is socialised medicine, and the patients have their weight-loss surgeries done "on the system" sometimes waiting a long time for treatment -- and people may feel differently about the care being done on the UK's dime.
I suppose I'd have to watch it, and it's meant to be inflammatory. I mean -- "FAT PEOPLE ARE LAZY."
Really. Throw that out there and watch the reaction. BAIT. FLAME. RAWR.
Would you watch? What do you think?
My head happens to be in the video here. LOL.
I. love. this. speaker.
Give it a listen.
Clinical trial demonstrates additive effect of exercise following gastric bypass.
So. do. it. I know, I know, easier said than done.
Over 75 million adults in the US are obese. These individuals are predisposed to health complications, including diabetes, heart disease, and cancer. Gastric bypass surgery results in dramatic weight loss and can improve diabetes symptoms in obese patients. A new study in the Journal of Clinical Investigation reveals that exercise following bypass surgery provides additional benefit for obese patients. Bret Goodpaster and colleagues at the University of Pittsburgh conducted a study on individuals that had recently undergone gastric bypass surgery. One group followed a moderate exercise protocol for 6 months, while the control group underwent a health education program. Individuals in both groups exhibited dramatic weight loss and reduced fat mass. However, individuals in the exercise group had improved insulin sensitivity and cardiovascular fitness. The results of this study support the inclusion of an exercise program following gastric bypass surgery.
Read the article released earlier this week in JCI: http://buff.ly/1wlKroB
A study conducted in Brazil and presented at a poster session at the 2014 annual meeting of the International Federation for the Surgery of Obesity and Metabolic Disorders looked at six cases in which patients committed suicide or attempted suicide after bariatric surgery. The study did not specify the form of weight loss surgery that each patient underwent.
The most authentic commercial yet from Weight Watchers. WW you win with this one, although it doesn't exactly motivate me to go sign up for your plan (...was that the goal -- because I didn't catch that vibe, I just laughed and wanted a snack for a second?) I still LOVE THIS because it's truth all right here for us emotional eaters.
Sorry not sorry I agree.
As many of you -- I have had lower back pain for years, and in my normal Beth way I have ignored it or (...don't tell anyone!) medicated it with NSAIDS off and on, and heat, and exercise, and stretching. AND GOD DAMN IT, IT HURTS.
Source - Healio
NSAID use is contraindicated in gastric bypass patients as it can cause serious ulcers. I started popping them like candy recently. No. good.
The back pain comes in cycles and never really goes away. It gets to the point where I cannot ignore it and I am currently in a Flare Of I Cannot Sit Down Or Sleep Or Lay Down And Nothing Feels Right EXCEPT getting on my knees in 'downward dog' position. When I describe it to other people they chime in with "Yep. I live this."
I had my husband take me to the urgent care MD on the weekend for X-Rays. They show disc degeneration. No surprise. I suppose after ignoring it -- plus a few years of massive obesity, plus four pregnancies, losing all of the weight plus eating haphazardly and vitamin-deficiencies, it shouldn't be a surprise.
I was prescribed an anti-epileptic drug instead of a pain-medicine, at my request because I do not want to be sedated, and that I am epileptic.
Although as the doctor was describing the medication's side effects to me, he explained that it might cause "sedation, dizziness," and I stated, "... that it isn't like I do anything important anyway, I'm not using heavy machinery as it is."
I do not know that he got my seizure humor.
I don't feel much relief from a few days of this added medication -- and I do not feel that it will be of help to the pain, but there are more options. I think that I will need to use exercise somehow, because this, just isn't working.
I can't sit. I can't sleep.
I have a broken ass. I. am. old.
Bariatric Surgery Linked To Increased TASTE Sensitivity - Does Taste Perception CHANGE After Bariatric Surgery?
I hereby define this study in the flesh. Everything tastes too, everything to me.
Via Science Daily from ASMBS -
People with obesity may have an unexpected ally after weight-loss surgery: their tongues. New research from the Stanford University School of Medicine finds patients who reported a decrease in taste intensity after bariatric surgery had significantly higher excess weight loss after three months than those whose taste intensity became higher.
Findings from the new study, "Does Taste Perception Change After Bariatric Surgery?", were presented here at the 31st Annual Meeting of the American Society for Metabolic and Bariatric Surgery (ASMBS) during ObesityWeek 2014, the largest international event focused on the basic science, clinical application and prevention and treatment of obesity. ObesityWeek 2014 is hosted by the ASMBS and The Obesity Society (TOS).
In the study, the majority (87%) of patients reported a change in taste after bariatric surgery, with 42 percent reporting they ate less because food didn't taste as good. However, those who said their taste intensity decreased, lost 20 percent more weight over three months, than those whose taste intensified.
"In our clinical experience, many patients report alterations in their perception of taste after bariatric surgery. However, little evidence exists as to how and why these changes affect weight loss after surgery," said study author John M. Morton MD, Chief, Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine. "It appears it's not just the flavor that influences weight loss, it's the intensity of the flavor. Patients with diminished taste intensity lost the most weight. A potential application to these findings may include teaching taste appreciation in hopes of increasing weight loss."
Before surgery, patients with severe obesity had lower total taste scores than a control group of individuals with no obesity. The 88 patients in the study were on average, 49-years-old, had an average age of 49.2 years, more than half were female with an average preoperative body mass index (BMI) of 45.3. Prior to surgery, the patients and controls completed a baseline validated taste test that quantified their ability to identify the primary taste, using paper strips with varying concentrations of each taste solution, presented in random order. The tests were then performed again at 3-, 6- and 12-months after surgery.
"The study provides excellent new insight on taste change after bariatric surgery," said Jaime Ponce, MD, medical director for Hamilton Medical Center Bariatric Surgery program and ASMBS immediate past-president. "More research is needed to see how we can adjust for taste perception to increase weight loss."
Study - American Society for Metabolic & Bariatric Surgery (ASMBS). (2014, November 4). For some, losing weight after bariaric surgery may be a matter of taste.ScienceDaily. Retrieved November 5, 2014 from www.sciencedaily.com/releases/2014/11/141104083132.htm
"In hopes to demonstrate the absolute awfulness that is catcalling, one woman recently took to the streets of Manhattan with a hidden camera to show just how humiliating, and downright horrifying, it can be to be just that–a woman."
For what it's worth -- I lasted about ten minutes out there on my own when I went to New York City by myself for a TV show taping.
Could not hang.
I might be doing something ... right by my daily doses of unsweetened cocoa!
I have serious memory issues if you did not notice, on account of the epilepsy, and I assume that someday I'm going to be in a home for the memory impaired. So every time I see a study like this -- I go OOOOH! LOOOK! THIS! I don't take them very seriously, but I read them ALL. Firstly, it was sponsored in part by a chocolate candy-maker. And, yeah.
But check it.
Via New York Times -
In a small study in the journal Nature Neuroscience, healthy people, ages 50 to 69, who drank a mixture high in antioxidants called cocoa flavanols for three months performed better on a memory test than people who drank a low-flavanol mixture.
On average, the improvement of high-flavanol drinkers meant they performed like people two to three decades younger on the study’s memory task, said Dr. Scott A. Small, a neurologist at Columbia University Medical Center and the study’s senior author. They performed about 25 percent better than the low-flavanol group.
“An exciting result,” said Craig Stark, a neurobiologist at the University of California, Irvine, who was not involved in the research. “It’s an initial study, and I sort of view this as the opening salvo.”
He added, “And look, it’s chocolate. Who’s going to complain about chocolate?”
The findings support recent research linking flavanols, especiallyepicatechin, to improved blood circulation, heart health and memory in mice, snails and humans. But experts said the new study, although involving only 37 participants and partly funded by Mars Inc., the chocolate company, goes further and was a well-controlled, randomized trial led by experienced researchers.
Besides improvements on the memory test — a pattern recognition test involving the kind of skill used in remembering where you parked the car or recalling the face of someone you just met — researchers found increased function in an area of the brain’s hippocampus called the dentate gyrus, which has been linked to this type of memory.
“Boy, this is really interesting to see it in three months,” said Dr. Steven DeKosky, a neurologist and visiting professor at the University of Pittsburgh. “They got this really remarkable increase in a place in the brain that we know is related to age-related memory change.”
There was no increased activity in another hippocampal region, theentorhinal cortex, which is impaired early in Alzheimer’s disease. That reinforces the idea that age-related memory decline is different and suggests that flavanols might not help Alzheimer’s, even though they might delay normal memory loss.
But unless you are stocking up for Halloween, do not rush to buy Milky Way or Snickers bars. To consume the high-flavanol group’s daily dose of epicatechin, 138 milligrams, would take eating at least 300 grams of dark chocolate a day — about seven average-sized bars. Or possibly about 100 grams of baking chocolate or unsweetened cocoa powder, but concentrations vary widely depending on the processing. Milk chocolate has most epicatechin processed out of it.
“You would have to eat a large amount of chocolate,” along with its fat and calories, said Hagen Schroeter, director of fundamental health and nutrition research for Mars, which funds many flavanol studies and approached Dr. Small for this one. (“I nearly threw them out,” said Dr. Small, who added that he later concluded that the company employed serious scientists who would not bias the research.) Mars financed about half the study; other funders were the National Institutes of Health and two research foundations.
“Candy bars don’t even have a lot of chocolate in them,” Dr. Schroeter said. And “most chocolate uses a process called dutching and alkalization. That’s like poison for flavanol.”
Mars already sells a supplement, CocoaVia, which it says promotes healthy circulation, including for the heart and brain. It contains 20 to 25 milligrams of epicatechin per packet of powder or capsule serving, Dr. Schroeter said; 30 packets cost $34.95. Epicatechin is also in foods like tea and apples, although may be less absorbable.
The Columbia study had important limitations. For example, the only daily dietary requirements were either 900 milligrams of flavanols with 138 milligrams of epicatechin or 10 milligrams of flavanols with less than two milligrams of epicatechin, so participants could have eaten other things that played a role.
Dr. Small, whose research previously found that exercise helped hippocampal function in younger people, suggested maybe more vigorous exercise is needed to affect older brains.
“It’s a very clever, interesting study, but there are some caveats,” said Dr. Kenneth S. Kosik, a neuroscientist at the University of California, Santa Barbara. “People are going to say, ‘It looks like I can have a lot of candy bars and not exercise.’ So it needs replication on a much larger scale.”
More extensive research is planned. As for why flavanols would help memory, one theory is that they improve brain blood flow; another, favored by Dr. Small, is that they cause dendrites, message-receiving branches of neurons, to grow.
“Everybody’s cautious about antioxidants, but this is a horse of a different color, a really elegant study,” Dr. DeKosky said.
The study -
From the no shit files, and specifically the WE COULD HAVE TOLD YOU THIS IF YOU'D HAVE JUST ASKED SECTION -
A recent Yale study has found that while bariatric surgery — a medical procedure to reduce obesity — improves the moods of the majority of obese patients, it could potentially worsen depression for some.
The study, published in September in the journal Obesity Surgery, examined the possible causes and frequency of depression in patients after bariatric surgery. Though the study concluded that most of the patients’ emotional well-being improved in the months following surgery, the researchers also discovered that a subgroup of the 107 study participants experienced a relative increase in depression six months after the procedure.
“The majority of patients with discernible worsening in mood experienced these mood changes between six and 12 months post-surgery,” said Valentina Ivezaj, associate Yale scientist in psychiatry and the study’s lead author. “We suggest that this may be a key period to assess for depression and associated symptoms following gastric bypass surgery.”
The participants suffering from extreme obesity completed emotional evaluations before the surgery. Six months and then a year after, they completed the same evaluations. The self-reported questionnaires assessed depression, eating disorder behavior, self-esteem and social functioning. The study used these data to produce a numerical BDI — Beck Depression Inventory — rating.
Studies suggest there is ubiquitous stigmatization of obesity in society, which can decrease obese individuals’ overall quality of life, said Yale psychiatry professor John Krystal.
The patients evaluated in the study were mildly depressed prior to surgery on average. But after a year post-surgery, 87 percent of the study participants no longer identified themselves as depressed.
According to Ivezaj, while it is generally true that bariatric surgery minimizes depression in obese patients, it is not always that simple.
The data revealed that 13 percent of patients actually experienced an increase in BDI, while another 13 percent experienced a BDI decrease. Seventy-four percent reported no psychological differences six to 12 months post-surgery. Four percent of patients reported increased depression a year after surgery. Increases in symptoms of depression correlated with higher body mass index and increased incidence of emotional difficulties like low self-esteem and poor social functioning.
Obesity does not just affect the body physically, said Gerard Sanacora, professor of psychiatry at the Yale School of Medicine and director of the Yale Depression Research Program. According to Krystal and Sanacora, obesity has biological underpinnings, which influence an individual’s health, brain function and behavior.
Ivezaj said that she conducted the research in order to dispel the common misconception that bariatric surgery is an easy way out.
“I am inspired by my work with patients who have undergone bariatric surgery,” she said. “In order to be successful following bariatric surgery, patients transform their lives and it takes hard work, determination and dedication to make the required lifestyle changes.”
She said she hoped that the research will help identify individuals with a predilection for depression after bariatric surgery, so that future prevention and intervention implementation might ameliorate the quality of patient life.
Ivezaj said that POWER — the Program for Obesity, Weight and Eating Research — led by Yale School of Medicine professor of psychology and psychiatry and the study’s senior author Carlos Grilo, intends to collaborate with the Yale Bariatric Surgery Program to organize a longitudinal study that will comprehensively assess patients’ eating behaviors, mood, weight and psychological functioning post-bariatric surgery.
According to the Centers for Disease Control, more than a third of American adults are obese.
When Mood Worsens after Gastric Bypass Surgery: Characterization of Bariatric Patients with Increases in Depressive Symptoms Following Surgery
Depression levels generally decrease substantially following bariatric surgery; however, little is known about bariatric patients who might experience increases in depression following surgery. We examined the frequency of bariatric patients who experienced discernible increases in depression levels following surgery and explored their correlates.
Participants were 107 patients with extreme obesity who underwent gastric bypass surgery and were followed up at 6 and 12 months postsurgery. Participants completed self-report questionnaires about depression (BDI), eating disorder psychopathology (EDE-Q), self-esteem (RSES), and social functioning (SF-36) at baseline and again at 6 and 12 months postsurgery.
Fourteen (13.1 %) participants reported discernible increases (BDI-Increase), 14 (13.1 %) reported discernible decreases (BDI-Decrease), and 79 (73.8 %) did not report discernible changes (no change) in BDI scores from 6 to 12 months postsurgery. Presurgically, there were no differences between the three groups. By 12 months postsurgery, the BDI-Increase group had significantly higher depression scores and significantly lower self-esteem and SF-36 mental component scores than did the other groups. For the BDI-Increase group, BDI Change was significantly associated with body mass index, self-esteem, and SF-36 physical component scores.
Findings highlight that a subgroup of individuals report discernible increases in depressive scores postsurgery and may differ in potentially clinically meaningful ways from those who do not report discernible increases in depressive symptoms. Future research is needed to better understand the long-term trajectory of patients with discernible worsening mood following gastric bypass surgery.