Incretin-based obesity management medications (OMMs) fill a treatment gap in a stepped-care model between lifestyle change alone and metabolic bariatric surgery, resulting in weight loss of 15% to 20% of body weight. Public interest in and demand for OMMs has recently increased dramatically. Unfortunately, cost and access to OMMs remain a significant barrier for many patients.
View Article and Find Full Text PDFCurr Obes Rep
September 2024
Purpose Of Review: The goal of this chapter was to summarize the literature on childhood adversity and obesity, discuss treatment implications with a case example, and provide recommendations for trauma-informed care for clinicians who work with individuals living with obesity.
Recent Findings: Adversity in childhood is related directly and indirectly to obesity development. Upstream contributors like adverse childhood experiences (ACEs) and other factors can lead to experiences of toxic stress and increased allostatic load, resulting in downstream effects of obesity and other chronic health conditions.
Background: Research suggests that food choices, preferences, and tastes change after bariatric surgery, but evidence regarding changes in food cravings is mixed.
Objectives: The primary aim of this cohort study was to compare food cravings during the first year following bariatric surgery in patients who had undergone sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB).
Setting: Integrated multispecialty health system, United States.
Front Endocrinol (Lausanne)
August 2022
Background: Food and activity factors may have an impact on weight in the general population, but little is known about how this affects postbariatric surgery weight loss.
Objectives: To understand the impact of environmental food and activity factors on weight loss after bariatric surgery.
Setting: A multidisciplinary integrated health system with an accredited bariatric surgery program.
Background: The benefits of bariatric surgery are well-established, however, concerns surrounding postoperative psychiatric destabilization and alcohol misuse remain. Research has initiated the process of identifying risks associated with bariatric surgery, although less is known regarding when or why psychiatric hospitalizations occur postoperatively.
Objectives: The goal of the current study was to examine the incidence of, and contributing factors to, behavioral health-related emergency room (ER) encounters and hospitalization after bariatric surgery.
Surg Clin North Am
April 2021
Despite its important treatment implications for obesity and related comorbidities, bariatric surgery requires several behavioral changes that warrant comprehensive evaluation and support before and after surgery. This article outlines emerging scientific and anecdotal evidence for addiction transfer after bariatric surgery. Other common behavioral changes that impact adherence, weight loss, and psychiatric risk after surgery are also reviewed.
View Article and Find Full Text PDFBackground: The Yale Food Addiction Scale (YFAS) was developed in 2009 to assess food addiction (FA); a revised version was released in 2016 (YFAS 2.0). The objective of this study was to determine the statistical and clinical validity of the YFAS 2.
View Article and Find Full Text PDFBackground: Adverse childhood experiences (ACEs) are related to long-term negative outcomes. The impact of these experiences on healthcare utilization in children has been understudied.
Objective: To examine the impact of ACEs on children's healthcare utilization, medical diagnoses, and pharmacological treatment.
Background: Research has focused on screening for adverse childhood experiences, rather than provision of education as a part of routine anticipatory guidance. An adverse childhood experiences 'conversation' is one method that has not been studied empirically but represents a complimentary or alternative approach to screening which could overcome many existing barriers.
Objectives: This study aims to examine parent/guardian and provider acceptability/feasibility of the adverse childhood experiences conversation during well-child visits in primary care.
Background: Prior research suggests that those experiencing adverse childhood experiences (ACEs) may be higher utilizers of the healthcare system. The frequency and financial impact of kept, cancelled and no-showed visits is largely unknown.
Objective: To examine the impact of adverse childhood experiences (ACEs) on healthcare utilization in a sample of US adults.
Background: Support after bariatric surgery is critical. Access to bariatric support groups is sometimes challenging, leading people to seek support on social media platforms like Facebook. Given the ubiquity of recommendations solicited and provided on Facebook regarding nutrition and bariatric surgery, understanding the content and accuracy of these posts is important.
View Article and Find Full Text PDFPurpose: Evidence suggests that a significant minority of individuals who undergo Roux-en-Y gastric bypass (RYGB) experience problematic alcohol and substance use following surgery. However, little research has examined characteristics, drinking patterns, and possible risk factors within this population. To provide descriptive information of a sample of adults with self-identified alcohol use problems following bariatric surgery, this study examined (1) alcohol and substance use symptoms using standardized assessments, (2) current and past psychiatric comorbidity, (3) subjective changes in alcohol sensitivity following surgery, and (4) specific patterns of alcohol use prior to and following bariatric surgery.
View Article and Find Full Text PDFBackground: Support following bariatric surgery is vital to ensure long-term postoperative success. Many individuals undergoing bariatric surgery are turning to online modalities, especially the popular social media platform Facebook, to access support groups and pages. Despite evidence suggesting that the majority of patients considering bariatric surgery are utilizing online groups, little is known about the actual content of these groups.
View Article and Find Full Text PDFPurpose: Pain catastrophizing and acceptance represent distinct but interrelated constructs that influence adaptation to chronic pain. Clinical and laboratory research suggest that higher levels of catastrophizing and lower levels of acceptance predict worse functioning; however, findings have been mixed regarding which specific outcomes are associated with each construct. The current study evaluates these constructs in relation to pain, affect, and functioning in a treatment-seeking clinical sample.
View Article and Find Full Text PDFContext: Although practice guidelines suggest that primary care providers working with children and adolescents incorporate BMI surveillance and counseling into routine practice, the evidence base for this practice is unclear.
Objective: To determine the effect of brief, primary care interventions for pediatric weight management on BMI.
Data Sources: Medline, CENTRAL, Embase, PsycInfo, and CINAHL were searched for relevant publications from January 1976 to March 2016 and cross-referenced with published studies.
Purpose: To elicit patient experiences of weight management discussions with providers and provide recommendations for future weight-related discussions.
Methods: 1000 patients who recently saw their provider for non-weight specific appointments were mailed measures of demographics, self-reported height and weight, activity level, adherence, perceptions of and recommendations for weight-related discussions, and internalized weight bias. This study was primarily descriptive and utilized a mixed method design including collection of quantitative and qualitative data.
Objective: To examine the impact of weight status on physical and psychological outcomes of patients enrolled in a comprehensive pain rehabilitation programme.
Methods: Participants (n = 314; mean body mass index 30.34) were administered measures of pain perception, depression, and physical functioning.
Introduction/purpose: Distress intolerance is characterized by a low threshold for negative emotional experiences and lack of emotion regulation and has been shown to predict various health outcomes. As such, the primary aim of this study was to determine the association between distress tolerance and psychological variables (eating behaviors, mood, substance use, trauma history), completion of bariatric surgery, and post-bariatric surgery weight loss outcomes and follow up with a provider.
Materials And Methods: Two hundred forty-eight patients (75 % female, 89 % Caucasian) underwent a multidisciplinary evaluation for bariatric surgery and were assessed for psychiatric disorders via semi-structured clinical interview and psychometric questionnaires.
Background: Screening for depressive symptoms is important when evaluating bariatric surgery candidates, as worse outcomes can be seen with higher pre-surgical and post-surgical psychiatric comorbidities. The Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) are two widely used depression screening instruments. This study evaluated whether both instruments have similar performance in an outpatient bariatric surgery clinic setting.
View Article and Find Full Text PDFBackground: Food addiction (FA) may be related to poor weight loss outcomes; however, the literature on food addiction in bariatric surgery-seeking populations is limited.
Objectives: The aim of the present study was to identify the prevalence of FA in a bariatric surgery-seeking population and its association with mood, problematic eating behaviors, and substance use. The relationship between prebariatric surgery food addiction screening and postsurgical outcomes was assessed.
Staggering health implications are associated with poor child diet. Given the importance of parents in impacting children's eating outcomes, the current study examined a theoretical framework in which both parental feeding goals and practices impact specific healthy and unhealthy child eating behaviors. Participants were 171 mothers of 3-6year old children who were diverse both socioeconomically and with regard to BMI.
View Article and Find Full Text PDFPurpose: In this brief report, an unanswered question in implicit weight bias research is addressed: Is weight bias stronger when obese and thin people are pictured engaging in stereotype consistent behaviors (e.g., obese-watching TV/eating junk food; thin-exercising/eating healthy) as opposed to the converse?
Methods: Implicit Associations Test (IAT) data were collected from two samples of overweight/obese adults participating in weight loss treatment.
Objective: The Multi-Threat Framework accounts for potentially different forms of stereotype threat that differ in target (i.e., the individual or the group) and source (i.
View Article and Find Full Text PDFBackground: In a stepped-down approach, patients begin with a more intensive treatment and are stepped down to a less intensive treatment based on achieving treatment goals. This study compared a standard behavioural weight loss programme (BWLP) to a stepped-down approach to treatment.
Methods: Fifty-two overweight/obese adults (Age: M = 47 years, SD = 13.