Impact of Bariatric Surgery on Bone Mineral Density: Observational Study of 110 Patients Followed up in a Specialized Center for the Treatment of Obesity in France.

INTRODUCTION: Bariatric surgery is used to treat severe obesity. We aimed to investigate the incidence of clinically significant bone mineral density (BMD) loss at 6 and 12 months after bariatric surgery. METHODS: Observational study performed in a specialized center for the treatment of obesity at the University Hospital of Reims, France. Surface BMD was measured by dual x-ray absorptiometry (DEXA). A reduction of > 0.03 g/cm2 was considered clinically significant. RESULTS: A total of 110 patients were included. A clinically significant reduction in BMD was observed in 62.1% of patients at 6 months, and in 71.6% at 12 months after surgery. No case of osteoporosis was observed. There were four cases of osteopenia and one fracture post-surgery. BMD loss was related by univariate analysis to the reduction in body mass index (BMI) (p < 0.01), weight loss (p < 0.01), fat mass (p < 0.01), and lean mass (p < 0.01). Multivariable analysis found a significant association between the reduction in BMD and the excess weight loss percentage (odds ratio 1.11, 95% confidence interval (1.05-1.18), p < 0.001). CONCLUSION: There was a clinically significant reduction in BMD at 6 months after surgery in over 60% of patients undergoing bariatric surgery. BMD loss is persistent over time and predominantly situated at the femoral level, and strongly associated with weight loss. Systematic vitamin and calcium supplementation, as well as follow-up by DEXA scan seems appropriate. Systematic DEXA scan pre- and post-surgery, and annually thereafter until weight has stabilized seems appropriate.

Food addiction, in obese patients seeking bariatric surgery, is associated with higher prevalence of current mood and anxiety disorders and past mood disorders.

The current cross-sectional study investigates the prevalence of the food addiction (FA) phenotype and its association with psychiatric disorders in bariatric surgery candidates. It also investigates the eating behavior characteristics associated with FA and the association between FA and loss of control over specific foods high in sugar, salt and/or fat. We included 128 bariatric surgery candidates and we assessed FA (YFAS 2.0), mood and anxiety disorders, suicidality, eating disorders (current bulimia nervosa and current anorexia nervosa), alcohol and tobacco use disorders (MINI 5.0.0, beck depression inventory, AUDIT, Fagerström Test for Nicotine Dependence) and eating behavior (DEBQ). Prevalence of FA in our sample was 25%. FA was significantly associated with higher prevalence of current mood and anxiety disorders and past mood disorders, higher current suicidality but not with eating disorders and alcohol use disorder. FA was significantly associated with higher emotional eating, and with loss of control over consumption of foods high in fat, sugar and/or salt, but not of fruits, vegetables or grain products. Our results provide arguments for considering psychiatric disorders and suicidality in FA and for considering FA as an addictive disorder in obese patients, with many risk factors in common with other addictions.

Rapid Eating is Linked to Emotional Eating in Obese Women Relieving from Bariatric Surgery.

BACKGROUND AND AIMS: Eating rate is associated with BMI and weight gain in various populations, and is a factor modulating the risk of complications after bariatric surgery. The aim of the present study is to determine whether common difficulties to change eating rate in subjects with obesity candidate to bariatric surgery, could be due to more extensive abnormalities in eating behavior. METHODS: A self-administered questionnaire was distributed to 116 consecutive female patients attending a nutrition consultation for obesity in a specialized center in France. This questionnaire explored eating rate (on an analog 10-point analog scale; a score ≥ 7 defines rapid eating), degree of chewing, signs of prandial overeating and scores of emotionality, externality, and restrained eating. RESULTS: Average age of the study population was 38.4 ± 12.7 years. Mean BMI was 45.5 ± 6.7, and eating rate was 6.3 ± 1.8. Rapid eating was present in 50.0% of the population. There was an inverse relationship between eating rate and degree of chewing (r = -0.59, p < 0.0001). The proportion of "rapid eating" patients was significantly higher among those who responded "all the time", "very often" or "often" (63.1%), as compared to "sometimes" or "never" (25.0%) to the question "Do you feel like you eat too much?" (p < 0.0001). There was a significant positive correlation between eating rate and emotional eating score (r = 0.30, p = 0.001) and external eating score (r = 0.30, p = 0.001), but not with restrained eating score. CONCLUSION: These data show that rapid eating, by being potentially associated to emotional eating, must be considered as an important issue in bariatric surgery.