Success of surgery depends on patients’ support network
6 August 2015

Hi All,
I love this type of research! It looks at the things that everyone wonders about and turns them into scientific research that can be quoted. I have always wondered about how the nearest and dearest of the people I operate on cope with the changes that my patients go through following life changing surgery such as Gastric Sleeve or Bypass or Banding. There is no denying that everything changes for people who I am privileged enough to operate on... mostly for the better. But that shouldn't be the assumption. It is reassuring to hear that this study backs up the assumption that most changes are positive and with positive spin offs for their support crew as well! It certainly echoes what I hear from my Bariatric surgery patients on a daily basis - this is "the best thing I have ever done" for myself, and "I should have done this years ago". More information is essential and if you think it would help you with the biggest decision you have ever made regarding whether Gastric Bypass, Sleeve or Banding surgery is right for you, then don't hesitate to get in contact with me. Time to quit wondering! Kind regards, Steph.
Bariatric surgery can lead to greater intimacy between patients and their life partners and could impact how successful surgery is, according to a study looking at the experience of couples after one of the partners underwent weight loss surgery. The findings, ‘Following Bariatric Surgery: an Exploration of the Couples’ Experience’, are published in the journal Obesity Surgery.
The study by Mary Lisa Pories and colleagues from East Carolina University is thought to be the first on obesity's impact on relationships since 2000, during which time surgical interventions, methods of support and the knowledge of the general public about bariatric surgery have evolved.
The research team interviewed ten couples about how bariatric surgery had affected the partners that had undergone surgery. All of the patients and their significant others viewed the surgery, and subsequent adjustments that needed to be made, as part of a team effort. They all described ways in which the partners supported and helped the patients care for themselves, including assistance with staying on track with the new routine.
"All of the couples felt their post-operative success was due to a joint effort on the part of both members of the couple," said Pories. She explained that the importance placed on couples' shared experiences of the surgery raises questions about how patients without active support systems manage post-operatively.
Several other themes also emerged. For example, couples highlighted the adjustment that was needed to adapt to their partners' significant weight loss. The couples also had more energy, and needed to adjust to new eating habits.
On an emotional level, the couples reported more positive moods and better self-esteem. They also reported sharing greater intimacy and affection, and being better able to resolve conflict. Their sexual relationships also improved and, in many cases, became more enjoyable.
Pories believes that a better understanding of how bariatric surgery impacts the dynamics of a couple's relationship could help physicians, nurses and social workers to support patients and their partners more effectively.
“This research provides greater insight into the experience of the couple than has been previously reported,” the authors concluded. “The use of qualitative research techniques offer new approaches to examine the biopsychosocial outcomes and needs of bariatric surgery patients. Further research is warranted in order to develop culturally appropriate interventions to improve the patient’s surgical and biopsychosocial outcomes.”
Highly processed foods linked to addictive eating
11 June 2015

Hi fellow foodies,
This is an interesting line of research, and whilst I don't necessarily believe in the concept of food addiction, I think it is well worth looking into. Food is something we all have to eat ideally three times a day, so on some level we are all addicted to it!! True addiction, however, is known to produce certain stimulatory pathways in the brain that cause people to do things that they don't want to or know is not good for them. The other question is one of chicken or egg- ie does the fact that we do it regularly produce the stimulatory pathways to form, or do the stimulatory pathways cause us to do the act in the first place..? All very difficult questions to answer. But, hey, looking for solutions to our obesity epidemic is what we need to focus on - and I don't think anyone disagrees with that! Anyway, I wish you well on your information gathering quest and please be sure to contact me if you have questions you need answering regarding bariatric surgery, bypass, sleeve or gastric banding.
Kind regards, Steph
A University of Michigan (U-M) study has concluded that highly processed foods such as chocolate, pizza and French fries are among the most addictive. This is thought to be one of the first studies to examine specifically which foods may be implicated in ‘food addiction’, which has become of growing interest to scientists and consumers in light of the obesity epidemic.
Previous studies in animals have concluded that highly processed foods or foods with added fat or refined carbohydrates (like white flour and sugar), may be capable of triggering addictive-like eating behaviour. Clinical studies in humans have observed that some individuals meet the criteria for substance dependence when the substance is food.
Despite highly processed foods generally known to be highly tasty and preferred, it is unknown whether these types of foods can elicit addiction-like responses in humans, nor is it known which specific foods produce these responses, said Ashley Gearhardt, U-M assistant professor of psychology.
Unprocessed foods, with no added fat or refined carbohydrates like brown rice and salmon, were not associated with addictive-like eating behaviour. The study, Which Foods May Be Addictive? The Roles of Processing, Fat Content, and Glycemic Load. was published in PlosOne.
Individuals with symptoms of food addiction or with higher BMIs reported greater problems with highly processed foods, suggesting some may be particularly sensitive to the possible ‘rewarding’ properties of these foods, commented Erica Schulte, a U-M psychology doctoral student and the study's lead author.
"If properties of some foods are associated with addictive eating for some people, this may impact nutrition guidelines, as well as public policy initiatives such as marketing these foods to children," said Schulte.
Nicole Avena, assistant professor of pharmacology and systems therapeutics at Icahn School of Medicine at Mount Sinai in New York City, and a co-author on the study, explained the significance of the findings.
"This is a first step towards identifying specific foods, and properties of foods, which can trigger this addictive response," she said. "This could help change the way we approach obesity treatment. It may not be a simple matter of 'cutting back' on certain foods, but rather, adopting methods used to curtail smoking, drinking and drug use."
They added that the findings “provide preliminary evidence for the foods and food attributes implicated in ‘food addiction’ and for proposed parallels between pharmacokinetic properties of drugs of abuse and highly processed foods.”
They said that future research should examine whether addictive foods are capable of triggering changes in brain circuitry and behaviour like drugs of abuse.
Bariatric surgery makes people feel better!
29 May 2015

Hi All,
This confirms something that I see evidence of everyday in my rooms! People not only feeling physically better following weight loss surgery but also feeling happier. It seems like a no-brainer, but it is only when quantitative, scientific research is done that you can actually claim that the benefits are real. A patient said to me last week that "even my children have told me that I am happier and I tell them off less." Ahh, the honesty of children. The SF-36 is the best questionnaire that we have to measure psychological wellbeing. It is highly accurate and can detect changes very sensitively because of the comprehensive nature of the questions. I like research like this - it is simple, yet meaningful. Especially to a Bariatric Surgeon!
Kind regards,
Steph
The effects of bariatric surgery are not only physical but also psychological, according to research from the National University of Distance Education (Universidad Nacional de Educación a Distancia), Madrid, Spain, which analysed the psychological consequences of surgery.
Dr Alejandro Magallares, a researcher at UNED, and co-author of the study, reviewed 21 scientific articles regarding the relationship between quality of life and weight (gauged with the questionnaire SF-36, which sheds light on the state of health of the person) in the obese population before (2,680 subjects) and after (2,251 subjects) undergoing this surgery.
The results reveal that obese patients scored less in the mental health component of the Short-Form 36 before bariatric surgery than after. The same pattern was observed in the case of the physical health component of the Short-Form 36. The results show the strong improvement that obese patients experience in both mental and physical components of the Short-Form 36 after receiving bariatric surgery
"An increase was found in the quality of life related to both psychological and physical aspects after the surgical intervention," said Magallares, who published a paper ‘Mental and physical health-related quality of life in obese patients before and after bariatric surgery: A meta-analysis.’ in the journal Psychology, Health & Medicine. "Both physical and psychological health improve after the operation, and that increase in quality of life is especially significant in the physical area."
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