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Emotional profiles and psychopathology in severely obese patients: a psychological preoperative evaluation in bariatric surgery

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(1)

Editor in chief MJCP Salvatore Setti neri

118

Suppl. 4/2 A AIP Clinical and Oynamic Section

Proceedings SYMPOSIA By Tambelli Renata & Trentini Cristina

Obese individuals

are frequent

ly stigmatized

in multiple domains

of

Iiving including places

of

employment, educational

institutions, medicai facilities

,

interpersonal re1ationships and

the

rnass

media. This

study

tested thc hypothesis that,

contrary

to

intuitive

expectations, exposing obese

inpatients to

a weight stigmatizing stimu

lus

increases their hunger and

food

palatability through the

elicitation

of a

stress

response. Twenty-one

obese

inpatients

were

randomly assigned to an

active

or

control

conditioo.

In tbc first

one

(0

=

11

),

participants rcad

an ostcnsible

news

article about stigma

faced by

overweight individuals

in

employment settings, while

participants

assigned

to the

second

condition (n=lO)

read

a control article about

discrimination faced by

smokers

in the

same settings.

Upon arrivai,

participants

werc

told

that

thc

goa

l

of

thc study was

to

examine thcir

reactions to food

images.

After

reading the news

articles,

participants

were

exposed to a

sequence

of food pictures.

Then they

completed assessment

questionnaires

evaluating

the perception of hunger

and food

palatability. Results

showed

that

exposure to

a

weight stigmatizing stimulus caused

higher

levels of

perceived hunger and food palatability

in

obese inpatients. These findings

underline

the negative

and

counterintuitive effect

that

we

ight stigma

may have on

eating and

ultimately

on weight

loss

in

obese subjects.

EMOTIONAL PROFILES AND

PSYCHOPATHOLOGY IN

SEVERELY OBESE

PATlENTS:

A PSYCHOLOGICAL PREOPERATIVE EVALUATION

IN BARIATRIC

SURGERY

Mento Carmela (1), Muscatello M.R.Anna (I), Bruno Antonio (1), Currò Giuseppe (2),

La

Malfa Giuseppe (2), Zoccali Rocco (2), Navarra Giuseppe (2)

(1)

Department

of

Biomedical

and

Dental

Sc

iences and

Morphofunctional

Im

aging, Un

iversity

Hospital of Messina,

Ital

y

(2)

Department ofHuman Pathology

of Adult

and

Evolutive Age

"G. Barresi"

, University

Hosp

ital

of Messina, Italy

Current

intemational

guidelines suggest

that the

candidates

for bariatric

surgery sho

uld

undergo a

preoperative mental

state evaluat

ion,

to identify

contraindications for achieving a satisfactory

postoperative

outcomc. Ev

idence

from

literature shows

that the relationship between

obesity

and

mental

disorders

is

stronger

among those

with

more

severe obesity (BMI

~40

kg/m2),

who are

the

individuals

assessed

for bariatric

surgery.

Obese patients

with

comorbid Binge

eating

disorders

(BEO)

have significantly

higher rates

of

psychiatric disorders

compared

to

obese

patients

without

(2)

Editor in chief MJCP Salvatore Setti neri

119

Suppl. 4/2 A AIP Clinical and Oynamic Section

Proceedings SYMPOSIA By Tambelli Renata & Trentini Cristina

obese

patients evaluated during the bariatric preoperative assessment. The

sample was

fonned

by

87

obese subjects consecutively recruited from March 2014 to February 2016 from thc outpatients who requested an evaluation for bariatric surgery at thc University Hospital of Messina. Participants

were

divided in two

groups according

to the presence

of

BEO

according

to clinical interview and

Binge Scale Questionnaire (BSQ) total scorc. Each subject was individually assessed using thc following psychomctric instruments: Eating Disordcr lnventory (EDI), Profile of Mood States

(POMS), State-Trait Anxiety lnventory (STAI) and Beck Depression lnventory (BO/). BED group showed higher scores on thc EDI subscales Drive for Thinness, Body Dissatisfaction, lnadequacy,

Int

eroceptive awareness. Furthennore, examining emotional features

,

BEO

subjects

resulted morc

prone than non-BED controls to experience aversi ve emotional states such as Anger, Depression, as documented by an increase in somatic and cognitive components al thc POMS and BDI, high levels of Trait- and State-Anxiety. Our results showed a significant alteration of thc afTective and emotional components in BEO obese patients, possibly supporting a potential role of dysfunctional

emotional states in thc pathophysiology and clinical expression of such eating disorder. Thc present findings highlight the importance of an accurate psychological, clinical, and psychometric assessrnent in the preoperative phase of bariatric surgety with the aim of identifying potential signs

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