Endocrine Abstracts

Introduction: Obesity is a chronic condition with great morbidity, mortality and significant economic and psychosocial impact. Bariatric surgery has proven to be an effective therapy for sustained weight loss and has allowed a reduction in medical comorbidity and an improvement in self-esteem and life quality. However, recent evidence reports an increase in eating and substance-related disorders that are diagnosed in the postoperative period worsening the prognosis.

Objectives: To evaluate the development of eating and substance-related disorders in patients undergoing bariatric surgery.

Material and methods: A retrospective review of patients undergoing bariatric surgery was performed between January 2006 and December 2014 in our center. As per protocol, all the patients underwent a complete psychiatric and psychological evaluation before the surgery. Patients with previous mental disorders were excluded.

Results: Of 500 patients that underwent bariatric surgery in this period of time, 9 cases (4 women and 5 men) presented with new psychiatric disorders 3.67±1.87 years after the surgery (1.8% of patients). The baseline characteristics of the patients were: age 41.89±8.71 years, pre-surgery BMI 43.61±6.82 kg/m². The patients underwent: Y-Roux gastric bypass (6), sleeve gastrectomy (2) and duodenum-ileal bypass over sleeve gastrectomy (1) and presented with BMI 31.20±8.53 kg/m² after three years follow-up (P<0.001). A total of 66.67% developed eating disorders (6/9 patients): 1 case met criteria for restrictive food intake disorder, 2 for atypical anorexia nervosa, 1 for binge eating disorder, and the other 2 had problems in the self-control emotions and behaviors and anxiety disorders with a loss of control over feeding. The rest of patients 33.33% developed substance-related disorders (3/9 patients): 2 cases of alcohol and 1 of alcohol+cocaine use disorders. A weight regain 17.6±7.44% during follow-up was seen in patients with binge eating disorders, problems in self-control or anxiety disorders and alcohol use disorder.

Conclusions: In our study, new mental disorders in the form of eating and substance-related disorders were higher than in general population (1.8% versus 1.01%) in patients without mental disorder before bariatric surgery. The development of eating and substance-related disorders influences the evolution of body weight after bariatric surgery. More studies are needed in order to evaluate the risk of new mental disorders in patients underwent bariatric surgery. A rigorous postoperative follow-up is needed to reinforce permanent changes with the new lifestyle, such as diet and exercise, and to detect abnormal behaviors.