Psychological dimensions after laparoscopic sleeve gastrectomy: reduced mental burden, improved eating behavior, and ongoing need for cognitive eating control.
BACKGROUND
Obesity as a chronic disease has spread worldwide. Conservative treatment, especially with severe obesity, often fails. Obesity surgery has been shown to be an effective treatment. Laparoscopic sleeve gastrectomy (LSG), as a restrictive procedure, has low risks and results in good weight loss outcomes. However, to date, no studies have investigated the changes in psychological dimensions-especially concerning eating behavior and cognitive restraint-after LSG. The present study investigated, for the first time, eating behavior (cognitive restraint, disinhibition, hunger), depression, and perceived stress before and 1 year after LSG. The setting was a university hospital, comprehensive obesity center.


METHODS
Of 59 patients who had undergone LSG from 2008 to 2010, 40 patients were evaluated using questionnaires on eating behavior, depression, and stress, with measurements made before and 1 year after surgery.


RESULTS
The body mass index had decreased, on average, by 15.5 kg/m(2) 1 year after LSG (62.7% excess weight loss). The eating behaviors had changed, with patients experiencing less hunger, fewer food cravings, and decreased disinhibition. Depressive symptoms and perceived stress improved. However, the results showed high levels in the dimension of cognitive restraint of eating 1 year after LSG.


CONCLUSIONS
Most psychological dimensions improved as expected. The patients were less distracted by food, experienced less hunger, and were less disturbed by emotional distress. However, we found persistent cognitive restraint, reflecting an ongoing need for central eating control. Additional investigations are needed to describe the communication between the gut and brain after surgery.
Department of Internal Medicine, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.
Nicole
N
Rieber
Katrin E
KE
Giel
Tobias
T
Meile
Paul
P
Enck
Stephan
S
Zipfel
Martin
M
Teufel
D000328:Adult; D015992:Body Mass Index; D003071:Cognition / Q000502:physiology*; D017281:Cost of Illness; D003863:Depression / Q000209:etiology; D005247:Feeding Behavior / Q000523:psychology*; D005260:Female; D005743:Gastrectomy / Q000523:psychology*; D006801:Humans; D006815:Hunger / Q000502:physiology; D010535:Laparoscopy / Q000523:psychology*; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery; D012527:Satiation / Q000502:physiology; D013315:Stress, Psychological / Q000209:etiology; D015431:Weight Loss