Evaluation of self-esteem, emotional eating, eating attitude, depression and anxiety levels before and after bariatric surgery: A one-year follow-up study

Year 2022, , 140 - 147, 22.06.2022

Sema Nur Türkoğlu Dikmen , Şengül İlkay , Yasir Şafak

https://doi.org/10.35365/ctjpp.22.2.03

Abstract

Although there is a consensus in the literature about the effect of bariatric surgery on weight and metabolic variables, its effect on psychological variables is still unclear. Purpose of the research; To examine the effects of bariatric surgery on self-esteem, emotional eating, eating attitudes, depression, situational and chronic anxiety.
A single-group pre-test-post-test measurement model was used in the study. The sample group of the research; Volunteer patients who applied to Aksaray University Training and Research Hospital Obesity Clinic for bariatric surgery were formed. Research data were collected using the Sociodemographic form, Rosenberg self-esteem scale, Emotional appetite scale, Eating attitude test, Beck depression inventory, State trait anxiety scale data collection tools before and after surgery. The data were analyzed with the SPSS 24.0 package program.
As a result of this research; At the end of the first year after bariatric surgery, there was a statistically significant decrease in BMI (Body Mass Index) and positive-negative emotional eating desire. In addition, although not statistically significant, an increase in self-esteem; depression, trait and state anxiety levels were decreased. As a result of the correlation analysis, it was observed that there was a relationship between the decrease in BMI and only the depression score.
A 1-year follow-up study after bariatric surgery showed significant reductions in BMI and positive and negative emotional eating. Long-term follow-up studies with larger numbers of participants are needed to better understand the change in emotional eating with bariatric surgery. In addition, this result suggests that giving importance to psychotherapy interventions focusing on emotional eating, which is known to be associated with weight gain and loss, may contribute to the treatment of obesity.

Keywords

bariatric surgery, self esteem, emotional eating, eating attitude, depression, anxiety

Bariatrik cerrahi öncesi ve sonrası benlik saygısı, duygusal yeme, yeme tutumu, depresyon ve anksiyete düzeylerinin değerlendirilmesi: Bir yıllık takip çalışması

Abstract

Bariatrik cerrahinin kilo ve metabolik değişkenler üzerine etkisi konusunda literatürde görüş birliği olmakla birlikte, psikolojik değişkenler üzerine etkisi halen net değildir. Araştırmanın amacı; bariatrik cerrahinin benlik saygısı, duygusal yeme, yeme tutumları, depresyon, durumsal ve süregen kaygı üzerine etkisini incelemektir.
Araştırmada tek gruplu ön test-son test ölçümlü bir model kullanılmıştır. Araştırmanın örneklem grubunu; Aksaray Üniversitesi Eğitim ve Araştırma Hastanesi Obezite kliniğine bariatrik cerrahi için başvuran gönüllü hastalar oluşturmuştur. Araştırma verileri, ameliyat öncesi ve sonrası birinci yılda Sosyodemografik form, Rosenberg benlik saygısı ölçeği, Duygusal iştah ölçeği, Yeme tutum testi, Beck depresyon envanteri, Durumluluk süreklilik kaygı ölçeği veri toplama araçları kullanılarak toplanmıştır. Veriler SPSS 24.0 paket programıyla analiz edilmiştir.
Bu araştırma sonucunda; bariatrik cerrahi sonrası birinci yılsonunda BKİ (Beden Kitle İndeksi) ve olumlu-olumsuz duygusal yeme isteğinde istatistiksel olarak anlamlı azalma olmuştur. Ayrıca istatistiksel olarak anlamlı olmasa da benlik saygısında artış; depresyon, sürekli ve durumlu kaygı düzeylerinde düşüş bulunmuştur. Yapılan korelasyon analizleri sonucu BKİ’nin azalması ile sadece depresyon puanı arasında ilişki olduğu gözlenmiştir.
Bariatrik cerrahi sonrası 1 yıllık takip araştırmasında BKİ ve olumlu ve olumsuz duygusal yeme anlamlı azalma gösterilmiştir. Duygusal yemenin bariatrik cerrahi ile değişiminin daha net anlaşılabilmesi için daha fazla sayıda katılımcı içeren ve uzun süreli izlem çalışmalarına ihtiyaç vardır. Ayrıca bu sonuç kilo alma ve verememe ile ilişkisi bilinen duygusal yemeyi odağa alan psikoterapi müdahalelerine önem verilmesinin obezite tedavisine katkıda bulunabileceğini düşündürmektedir.

Keywords

bariatrik cerrahi, benlik saygısı, duygusal iştah, yeme tutumu, depresyon, anksiyete

References

• Akkayaoğlu, H., & Celik, S. (2020). Eating attitudes, perceptions of body image and patient quality of life before and after bariatric surgery. Applied Nursing Research, 53, 151270.
• Aleman R, R. F., Menzo EL, Rosenthal RJ. (2020). Outcomes of Metabolic Surgery. In The ASBM Textbook of Bariatric Surgery (pp. 341-351). Springer.
• Barnhart, W. R., Braden, A. L., & Price, E. (2021). Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study. Appetite, 158, 105038.
• Beck, A. T., Steer, R. A., & Brown, G. (1996). Beck depression inventory–II. Psychological Assessment.
• Beck, N. N., Mehlsen, M., & Støving, R. K. (2012). Psychological characteristics and associations with weight outcomes two years after gastric bypass surgery: Postoperative eating disorder symptoms are associated with weight loss outcomes. Eating behaviors, 13(4), 394-397.
• Booth, H., Khan, O., Prevost, A. T., Reddy, M., Charlton, J., Gulliford, M. C., & Group, K. s. B. S. S. (2015). Impact of bariatric surgery on clinical depression. Interrupted time series study with matched controls. Journal of affective disorders, 174, 644-649.
• Burgmer, R., Legenbauer, T., Müller, A., de Zwaan, M., Fischer, C., & Herpertz, S. (2014). Psychological outcome 4 years after restrictive bariatric surgery. Obesity surgery, 24(10), 1670-1678.
• Cella, S., Cipriano, A., Giardiello, C., & Cotrufo, P. (2019). RELATIONSHIPS BETWEEN SELF-ESTEEM, INTEROCEPTIVE AWARENESS, IMPULSE REGULATION, AND BINGE EATING. PATH ANALYSIS IN BARIATRIC SURGERY CANDIDATES. Clinical Neuropsychiatry, 16.
• Cherick, F., Te, V., Anty, R., Turchi, L., Benoit, M., Schiavo, L., & Iannelli, A. (2019). Bariatric surgery significantly improves the quality of sexual life and self-esteem in morbidly obese women. Obesity surgery, 29(5), 1576-1582.
• Çalışır, S., Çalışır, A., Arslan, M., İnanlı, İ., Çalışkan, A. M., & Eren, İ. (2020). Assessment of depressive symptoms, self-esteem, and eating psychopathology after laparoscopic sleeve gastrectomy: 1-year follow-up and comparison with healthy controls. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 25(6), 1515-1523.
• Çuhadaroğlu, F., Saygısı, A. B., & Tezi, Y. U. (1986). Hacettepe Üniversitesi Tıp Fakültesi. In: Ankara.
• Dawes, A. J., Maggard-Gibbons, M., Maher, A. R., Booth, M. J., Miake-Lye, I., Beroes, J. M., & Shekelle, P. G. (2016). Mental health conditions among patients seeking and undergoing bariatric surgery: a meta-analysis. Jama, 315(2), 150-163.
• De Zwaan, M., Enderle, J., Wagner, S., Mühlhans, B., Ditzen, B., Gefeller, O., Mitchell, J. E., & Müller, A. (2011). Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. Journal of affective disorders, 133(1-2), 61-68.
• Demirel, B., Yavuz, F. K., Karadere, M. E., Şafak, Y., & Türkçapar, M. H. (2014). Duygusal İştah Anketi'nin Türkçe geçerlik ve güvenilirliği, beden kitle indeksi ve duygusal şemalarla ilişkisi.
• Dixon, J. B., Dixon, M. E., & O'Brien, P. E. (2003). Depression in association with severe obesity: changes with weight loss. Archives of internal medicine, 163(17), 2058-2065. Erol, N., & Savasir, I. (1989). Eating attitude test: index of anorexia nervosa symptoms. Turkish Journal of Psychology, 23(1), 132-136.
• Felske, A. N., Williamson, T. M., Scurrey, S. R., Telfer, J. A., Campbell, T. S., & Rash, J. A. (2021). The Influence of Weight-Related Self-Esteem and Symptoms of Depression on Shape and Weight Concerns and Weight-Loss 12 Months After Bariatric Surgery. Obesity surgery, 31(3), 1062-1072.
• Figura, A., Rose, M., Ordemann, J., Klapp, B. F., & Ahnis, A. (2017). Changes in self-reported eating patterns after laparoscopic sleeve gastrectomy: a pre-post analysis and comparison with conservatively treated patients with obesity. Surgery for Obesity and Related Diseases, 13(2), 129-137.
• Gariepy, G., Nitka, D., & Schmitz, N. (2010). The association between obesity and anxiety disorders in the population: a systematic review and meta-analysis. International journal of obesity, 34(3), 407-419.
• Garner, D. M., & Garfinkel, P. E. (1979). The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological medicine, 9(2), 273-279.
• Gill, H., Kang, S., Lee, Y., Rosenblat, J. D., Brietzke, E., Zuckerman, H., & McIntyre, R. S. (2019). The long-term effect of bariatric surgery on depression and anxiety. Journal of affective disorders, 246, 886-894.
• Guerdjikova, A. I., West-Smith, L., McElroy, S. L., Sonnanstine, T., Stanford, K., & Keck, P. E. (2007). Emotional eating and emotional eating alternatives in subjects undergoing bariatric surgery. Obesity surgery, 17(8), 1091-1096.
• Haghighi, M., Jahangard, L., Ahmadpanah, M., Bajoghli, H., Holsboer-Trachsler, E., & Brand, S. (2016). The relation between anxiety and BMI–is it all in our curves? Psychiatry research, 235, 49-54.
• Hamurcu, P., Öner, C., Telatar, B., & Yeşildağ, Ş. (2015). Obezitenin benlik saygısı ve beden algısı üzerine etkisi.
• Hisli, N. (1989). Beck depresyon envanterinin universite ogrencileri icin gecerliligi, guvenilirligi.(A reliability and validity study of Beck Depression Inventory in a university student sample). J. Psychol., 7, 3-13.
• Janse Van Vuuren, M. A., Strodl, E., White, K. M., & Lockie, P. D. (2018). Emotional food cravings predicts poor short‐term weight loss following laparoscopic sleeve gastrectomy. British journal of health psychology, 23(3), 532-543.
• Jolfaei, A. G., Lotfi, T., Pazouki, A., Meybod, A. M., Soheilipour, F., & Jesmi, F. (2016). Comparison between marital satisfaction and self-esteem before and after bariatric surgery in patients with obesity. Iranian journal of psychiatry and behavioral sciences, 10(3).
• Karlsson, J., Taft, C., Ryden, A., Sjöström, L., & Sullivan, M. (2007). Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. International journal of obesity, 31(8), 1248-1261.
• Kauppila, J. H., Tao, W., Santoni, G., von Euler-Chelpin, M., Lynge, E., Tryggvadóttir, L., Ness-Jensen, E., Romundstad, P., Pukkala, E., & Lagergren, J. (2019). Effects of obesity surgery on overall and disease-specific mortality in a 5-country population-based study. Gastroenterology, 157(1), 119-127. e111.
• Lynch, A. (2016). “When the honeymoon is over, the real work begins:” Gastric bypass patients' weight loss trajectories and dietary change experiences. Social Science & Medicine, 151, 241-249.
• Milaneschi, Y., Simmons, W. K., van Rossum, E. F., & Penninx, B. W. (2019). Depression and obesity: evidence of shared biological mechanisms. Molecular psychiatry, 24(1), 18-33.
• Miller-Matero, L. R., Bryce, K., Saulino, C. K., Dykhuis, K. E., Genaw, J., & Carlin, A. M. (2018). Problematic eating behaviors predict outcomes after bariatric surgery. Obesity surgery, 28(7), 1910-1915.
• Mitchell, J. E., King, W. C., Chen, J. Y., Devlin, M. J., Flum, D., Garcia, L., Inabet, W., Pender, J. R., Kalarchian, M. A., & Khandelwal, S. (2014). Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS‐2) study. Obesity, 22(8), 1799-1806.
• Mizgier, M., Jarząbek-Bielecka, G., Opydo-Szymaczek, J., Wendland, N., Więckowska, B., & Kędzia, W. (2020). Risk factors of overweight and obesity related to diet and disordered eating attitudes in adolescent girls with clinical features of polycystic ovary syndrome. Journal of Clinical Medicine, 9(9), 3041.
• Müller, A., Hase, C., Pommnitz, M., & de Zwaan, M. (2019). Depression and suicide after bariatric surgery. Current psychiatry reports, 21(9), 1-6.
• Nasirzadeh, Y., Kantarovich, K., Wnuk, S., Okrainec, A., Cassin, S. E., Hawa, R., & Sockalingam, S. (2018). Binge eating, loss of control over eating, emotional eating, and night eating after bariatric surgery: results from the Toronto Bari-PSYCH Cohort Study. Obesity surgery, 28(7), 2032-2039.
• Nicolau, J., Ayala, L., Rivera, R., Speranskaya, A., Sanchís, P., Julian, X., Fortuny, R., & Masmiquel, L. (2015). Postoperative grazing as a risk factor for negative outcomes after bariatric surgery. Eating behaviors, 18, 147-150.
• Nolan, L. J., Halperin, L. B., & Geliebter, A. (2010). Emotional Appetite Questionnaire. Construct validity and relationship with BMI. Appetite, 54(2), 314-319. Oner, N., & Le Compte, A. (1985). Durumluk-Surekli Kaygi Envanteri El Kitabi. istanbul Bogazici Universitesi Yayinlari. In.
• Opolski, M., Chur‐Hansen, A., & Wittert, G. (2015). The eating‐related behaviours, disorders and expectations of candidates for bariatric surgery. Clinical obesity, 5(4), 165-197.
• Özdemir İlhan, B. (2018). Obezite cerrahisinin benlik saygısı ve yaşam kalitesine etkisi Maltepe Üniversitesi, Sağlık Bilimleri Enstitüsü].
• Pekkarinen, T., Koskela, K., Huikuri, K., & Mustajoki, P. (1994). Long-term results of gastroplasty for morbid obesity: binge-eating as a predictor of poor outcome. Obesity surgery, 4(3), 248-255.
• Pereira-Miranda, E., Costa, P. R., Queiroz, V. A., Pereira-Santos, M., & Santana, M. L. (2017). Overweight and obesity associated with higher depression prevalence in adults: a systematic review and meta-analysis. Journal of the American College of Nutrition, 36(3), 223-233.
• Spielberger, C. D. (2010). State‐Trait anxiety inventory. The Corsini encyclopedia of psychology, 1-1.
• Tae, B., Pelaggi, E. R., Moreira, J. G., Waisberg, J., Matos, L. L. d., & D'Elia, G. (2014). Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life. Revista do Colégio Brasileiro de Cirurgiões, 41(3), 155-160.
• Tayefi, A., Pazouki, A., Alavi, K., Salehian, R., Soheilipour, F., & Jolfaei, A. G. (2020). Relationship of personality characteristics and eating attitude with the success of bariatric surgery. Medical Journal of the Islamic Republic of Iran, 34, 89.
• Van Hout, G. C., Verschure, S. K., & Van Heck, G. L. (2005). Psychosocial predictors of success following bariatric surgery. Obesity surgery, 15(4), 552-560.
• Wade, K. H., Kramer, M. S., Oken, E., Timpson, N. J., Skugarevsky, O., Patel, R., Bogdanovich, N., Vilchuck, K., Davey Smith, G., & Thompson, J. (2017). Prospective associations between problematic eating attitudes in midchildhood and the future onset of adolescent obesity and high blood pressure. The American journal of clinical nutrition, 105(2), 306-312.
• Welbourn, R., Hollyman, M., Kinsman, R., Dixon, J., Liem, R., Ottosson, J., Ramos, A., Våge, V., Al-Sabah, S., & Brown, W. (2019). Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth IFSO global registry report 2018. Obesity surgery, 29(3), 782-795.
• White, M. A., Kalarchian, M. A., Levine, M. D., Masheb, R. M., Marcus, M. D., & Grilo, C. M. (2015). Prognostic significance of depressive symptoms on weight loss and psychosocial outcomes following gastric bypass surgery: a prospective 24-month follow-up study. Obesity surgery, 25(10), 1909-1916.
• YILDIZ, Ş., Alphan, E., & Batar, N. Sleeve (2020) Gastrektomi Operasyonu Geçirmiş Hastaların Yeme Tutum ve Davranışlarını ile Beden Kütle İndeksi Değişiminin Değerlendirilmesi. Kafkas Tıp Bilimleri Dergisi, 10(2), 136-144.