Predictive Role of Body Image in Bulimic Behaviors Among Obese Patients Qualified for Bariatric Surgery

Bulimic behavior and the associated experience of one's own body are of great importance in the course of surgical treatment for obesity. This study determined the predictive role of multidimensional body image on bulimic-type eating behaviors among individuals scheduled for the surgical treatment of obesity. This study was conducted in a clinical setting on a group of 100 obese patients who were treated at the Centre for the Surgical Treatment of Obesity at the University Hospital in Krakow (Poland) and were qualified for bariatric surgery. Body image was examined with Cash's Multidimensional Body-Self Relations Questionnaire (MBSRQ) and bulimic behavior with David M. Garner's Eating Attitudes Test (EAT-26). Part A of the EAT-26 focused only on the bulimia and food preoccupation scale. Part B included sex, age, and body mass index (BMI) in the predictive model. A stepwise multiple regression analysis was conducted to assess psychological predictors of eating behavior. For binary variables, a logistic regression analysis was conducted for the whole group and for the women's group alone. Owing to the small sample size of men, regression analyses were not conducted. Higher values were observed in the Appearance Orientation dimension among women when compared to men. Appearance evaluation and age were found to be significant predictors for bulimic behaviors in the whole group. In regression models for behavior in the last 6 months, the predictors were found to be Health Evaluation and Appearance Orientation for laxative use, and Overweight Preoccupation for vomiting for weight control. Health-promoting behaviors in obesity treatment were conditioned as follows: for exercise, the predictors were sex and Fitness Orientation and for weight loss, they were Overweight Preoccupation and Body Areas Satisfaction. Our study shows that different bulimic behaviors are variously conditioned by body image dimensions, some of which are predictors of behaviors that are risk factors for obesity and poor outcomes of bariatric treatment, whereas others increase the chance of pro-health behaviors among obese individuals.

The bariatric patient: basic aspects preparation for surgical treatment of obesity and conducting after it. Lecture for practitioners

Over the past years and decades, in the world in general and particularly in Russia, bariatric surgery is becoming more widespread for the treatment of severe forms of obesity. There is an increase in the number of operations performed along with the effectiveness and minimising risks of the operations held due to the improvement of surgical techniques. In this lecture, there are clearly stated indications and contraindications for the surgical treatment of obesity. Here are presented various types of bariatric surgeries and their pathophysiological mechanisms which affect on body weight, carbohydrate and lipid metabolism. There is also presented their effectiveness in comorbid obesity pathology, primarily among patients with type 2 diabetes. Here was held an analysis of possible negative effects after surgical treatment for obesity, including secondary hyperparathyroidism, post-bariatric hypoglycemia, etc., as well as predictors of postoperative prognosis in relation on metabolic control among patients with obesity and type 2 diabetes.

Gastric bypass in modern bariatric surgery

The Roux-en-Y Gastric bypass surgery has long been considered as the gold standard method for the surgical treatment of obesity and its complications. But at present, this position is disputed by supporters of one-anastomotic gastric bypass and sleeve gastrectomy. The decrease in the share of gastric bypass in the structure of bariatric operations is explained by technical complexity, surgical and malabsorption complications. This review reflects the main role of gastric bypass as a bariatric surgery in the treatment of obesity and metabolic syndrome, and discloses various options for the technical implementation of gastric bypass surgery according to Roux-en-Y and alternative one-anastomotic gastric bypass surgery. The advantages and disadvantages of the stapler-use and stapleless method for performing bariatric operations are shown. In our opinion, one of the promising alternative concepts for the surgical treatment of obesity is stapleless one-anastomotic direction in gastric bypass surgery, but the known stapleless methods are imperfect and unsafe. Thus, based on the presented literature review, we can conclude that the imperfection of not only the stapler gastric bypass methods, but also the stapleless method. Therefore, a further research is needed for alternative surgical methods that would reduce the likelihood of surgical complications, reduce the cost of bariatric surgery and increase the accessibility of surgical treatment of obesity for the population.

THE CHOICE OF METHOD OF SURGICAL TREATMENT OF OBESITY (review of literature)

During the long history of obesity surgery and associated diseases, a large number of operation techniques with different mechanisms of action have been proposed. However, all currently existing options for surgical correction of obesity have their advantages and disadvantages, ultimately determining the results and side effects of treatment. This circumstance determines the exceptional importance of the correct choice of methods for bariatric surgery. The article considers the basic principles and criteria for choosing the method of surgical treatment of overweight and related diseases from different perspectives.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study. Author Guidelines contains the detailed information.

Evaluation of the Scopinaro Modified Technique in the Surgical Treatment of Obesity Compared to the Classic Scopinaro Surgery – Results after an 18-Month Randomized Clinical Trial

Resumo Objetivo Avaliar se a cirurgia de Scopinaro modificada é tão eficaz e segura quanto a cirurgia de Scopinaro clássica para reduzir o excesso de peso, controlar as comorbidades, e avaliar o surgimento de intercorrências clínicas e nutricionais, caso elas ocorram. Métodos O estudo teve 28 participantes obesos, que foram randomizados para a realização de um dos procedimentos cirúrgicos, e acompanhados por uma equipe multiprofissional em saúde para avaliar o impacto das cirurgias no tratamento da obesidade. Foram observadas as seguintes variáveis: comorbidades, e intercorrências clínicas e nutricionais. O protocolo de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa das Faculdades Integradas Pitágoras de Montes Claros (CAAE 26919414.9.0000.5109). Todos os participantes da pesquisa assinaram o termo de consentimento livre e esclarecido. Resultados A média do índice de massa corporal (IMC) pré-cirurgia do grupo Scopinaro clássica e do grupo Scopinaro modificada foi de, respectivamente, 46,89 kg/m2 e 43,22 kg/m2. Após 540 dias da realização das cirurgias, esses valores foram reduzidos para 32,16 kg/m2 e 28,79 kg/m2. A avaliação da porcentagem de IMC perdido (percentage of excess body mass index lost, %EBL, em inglês) no período comprovou o sucesso cirúrgico, com valores de 67,33% para a cirurgia de Scopinaro clássica, e de 80,37% para a cirurgia de Scopinaro modificada. Ocorreu controle das comorbidades, bem como melhora geral do quadro laboratorial para a maioria dos participantes submetidos a quaisquer das duas técnicas. Flatulência e diarreia constituíram as intercorrências clínicas predominantemente encontradas em ambos procedimentos. Conclusão A cirurgia de Scopinaro modificada mostrou-se tão eficaz e segura quanto a cirurgia de Scopinaro clássica na redução de peso e controle das comorbidades, apresentando ainda a possibilidade de acesso endoscópio a todo o estômago e duodeno, reversibilidade cirúrgica, e conversão em outro procedimento cirúrgico.