Binge eating symptomatology in adolescents with polycystic ovary syndrome.

Several factors may contribute to binge eating behaviors in PCOS. However, findings are contradictory and studies in the adolescence are limited. We aimed to evaluate the eating attitudes of adolescents with PCOS and the possible etiological factors underlying the association between PCOS and binge eating symptomology. Between 2019 and 2022, 46 newly diagnosed adolescents with PCOS and 56 controls matched for age and BMI z-score were included. The Eating Disorder Examination Questionnaire, Three Factor Eating Questionnaire-R18, and a questionnaire assessing postprandial reactive hypoglycemia symptom severity were given. Binge eating symptomology, in terms of over, uncontrolled, and emotional eating, were more prevalent in the PCOS group. Uncontrolled, emotional, and binge eating were positively correlated with postprandial reactive hypoglycemia symptom score. Overeating was also associated with clinical hyperandrogenism. Improving the disease outcome and reducing the future complications requires early recognition and management of emotional and uncontrolled eating behaviors in adolescents with PCOS.

Naltrexone/bupropion for binge-eating disorder: A randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Binge-eating disorder (BED) is a prevalent psychiatric disorder associated with obesity. Few evidence-based treatments exist for BED, particularly pharmacological options. This study tested the efficacy of naltrexone/bupropion for BED. METHODS: A randomized, double-blind, placebo-controlled, 12-week trial tested naltrexone/bupropion for BED with and without obesity. Eighty-nine patients (70.8% women, 69.7% White, mean age 45.7 y, mean BMI 35.1 kg/m2 , 77.5% with BMI ≥ 30 kg/m2 ) were randomized to placebo (n = 46) or naltrexone/bupropion (n = 43), with randomization stratified by obesity status and gender; 92.1% completed post-treatment assessments. RESULTS: Mixed models of binge-eating frequency revealed significant reductions that did not differ significantly between naltrexone/bupropion and placebo. Logistic regression of binge-eating remission rates revealed that naltrexone/bupropion and placebo did not differ significantly. Obesity status did not predict, or moderate, binge-eating outcomes considered either continuously or categorically. Mixed models revealed that naltrexone/bupropion was associated with significantly greater percentage weight loss than placebo. Logistic regression revealed that naltrexone/bupropion had significantly higher rates of attaining ≥5% weight loss than placebo (27.9% vs. 6.5%). Obesity status did not predict or moderate weight-loss outcomes. CONCLUSIONS: Naltrexone/bupropion did not demonstrate effectiveness for reducing binge eating relative to placebo but showed effectiveness for weight reduction in patients with BED. Obesity status did not predict or moderate medication outcomes.

Weight-based discrimination and disordered eating behaviors in a cohort of U.S. sexual minority young adults.

OBJECTIVE: Though prevalent, weight-based discrimination is understudied and has been linked to disordered eating behaviors (DEB) among adolescents and adults. Sexual minority populations experience elevated risk of DEB, but little is known about the role of weight discrimination in this elevated risk. METHODS: Participants were 1257 sexual minority women and men (ages 18-31 years) in the US Growing Up Today Study cohort. We examined cross-sectional associations between weight discrimination victimization and three DEB in the past year: unhealthy weight control behaviors, overeating, and binge eating. Generalized estimating equations, adjusted for potential confounders, were used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). RESULTS: Three in 10 participants (31%) reported weight-based discrimination victimization. Sexual minority young adults who reported weight-based discrimination had greater relative prevalence of unhealthy weight control behaviors (PR [95% CI]: 1.92 [1.35, 2.74]), overeating (3.15 [2.24, 4.44]), and binge eating (3.92 [2.51, 6.13]), compared with those who reported no weight-based discrimination. Associations with overeating and binge eating remained significant after adjusting for BMI. DISCUSSION: The role of weight-based discrimination, and its intersections with other forms of stressors for sexual minority young adults, must be included in efforts to advance eating disorder prevention for this underserved population. PUBLIC SIGNIFICANCE: Three in 10 sexual minority young adults in this study had experienced weight-based discrimination, a common but understudied form of discrimination. Sexual minority young adults who experienced weight-based discrimination were at greater risk of disordered eating behaviors than those who had not experienced weight-based discrimination. These findings suggest that weight-based discrimination may be an important-and preventable-risk factor for disordered eating behaviors among sexual minority young adults.

Overvaluation of Shape and Weight (Not BMI) Associated with Depressive Symptoms and Binge Eating Symptoms Pre- and Post-bariatric Surgery.

PURPOSE: Overvaluation of shape and weight (OSW) involves defining self-worth by body shape/weight. Among persons seeking bariatric surgery, cross-sectional studies have found associations between OSW, depressive symptoms, and disordered eating. MATERIALS AND METHODS: Relationships among OSW, depressive symptoms, binge eating symptoms, and BMI were analyzed both cross-sectionally and over time among 145 adults who had bariatric surgery. Participants completed the following measures pre-surgery and 1.5 to 3 years post-surgery: Eating Disorder Examination Questionnaire (EDE-Q), Binge Eating Scale, Patient Health Questionnaire, and body weight and height. OSW was measured by averaging two items on the EDE-Q which ask participants to rate how much their weight/shape influences how they judge themselves as a person. Analyses included Wilcoxon signed-ranks, bootstrapped Pearson correlations, and bootstrapped hierarchical linear regressions. RESULTS: OSW was significantly associated with depressive symptoms and binge eating symptoms both pre- and post-surgery, but was not associated with BMI at either timepoint. Improvements in OSW were associated with concurrent changes in depression and binge eating; reductions in BMI were not significantly associated with changes in any of these variables. CONCLUSIONS: Findings suggest that self-evaluation is more important in regard to changes in depressive and binge eating symptoms than is BMI (and vice versa), and support the importance of assessing and treating psychological considerations among persons seeking bariatric surgery.

The Role of Resilience in Psychological Health Among Bariatric Surgery Patients.

OBJECTIVE: Many individuals who undergo bariatric surgery have experienced repeated unsuccessful diet attempts and negative messages from healthcare providers, family, and others about their weight. Research pre- and post-operatively has taken a pathological or risk-based approach, investigating psychiatric problems and disordered eating. In contrast, the current study explores resilience in this population. METHODS: Participants were 148 bariatric surgery patients. Participants completed measures pre-operatively and 1.5-3 years post-operatively, including the Binge Eating Scale, Eating Disorder Examination Questionnaire, Patient Health Questionnaire, Generalized Anxiety Questionnaire, Impact of Weight on Quality of Life, Coping Responses Inventory, and Duke Social Support and Stress Scales. The Connor-Davidson Resilience Scale was measured post-operatively. RESULTS: Correlations demonstrated a significant association between post-operative resilience and lower symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life. Resilience was also associated with greater social support and less social stress, and greater use of approach coping strategies. Resilience was significantly associated with improvements in symptoms of binge eating, disordered eating, depression, anxiety, and impact of weight on quality of life from pre- to post-operative assessments. In regression models, associations remained significant after controlling for psychosocial variables at baseline (e.g., binge eating symptoms pre-operatively) and demographic covariates. CONCLUSIONS: Psychological resilience has been under-studied in the literature on obesity and bariatric surgery, with a primary focus on risk factors for poor outcomes. This study was among the first to investigate associations between resilience and post-operative psychological outcomes. Results suggest the field would benefit from consideration of patient resilience in psychological assessments and interventions.

Food Addiction and Binge Eating Impact on Weight Loss Outcomes Two Years Following Sleeve Gastrectomy Surgery.

BACKGROUND: Emerging evidence suggest that problematic eating behaviors such as food addiction (FA) and binge eating (BE) may alter following bariatric surgery (BS) and impact weight outcomes. We aimed to examine the prevalence of FA and BE and their associations with weight outcomes 2 years post-sleeve gastrectomy (SG). METHODS: Forty-five women (mean age 32.4 ± 10.9 years) who underwent SG and completed 24 months of follow-up were evaluated prospectively at pre-, 3-, 6-, 12-, and 24-month post-SG. Data collected included anthropometrics, nutritional intake, and lifestyle patterns. The Yale Food Addiction Scale (YFAS) and the Binge Eating Scale (BES) were used to characterize FA and BE, respectively. RESULTS: Pre-surgery FA and BE were identified in 40.0% and 46.7% of participants, respectively. Following SG, FA and BE prevalence was 10.0%, 5.0%, 29.4%, and 14.2% (P = 0.007), and 12.5%, 4.9%, 18.4%, and 19.4% (P < 0.001) at 3, 6, 12, and 24 months, respectively. Women with BE at baseline gained significantly more weight from the nadir compared to non-BE women at baseline (P = 0.009). There was no relationship between FA at baseline and weight (P = 0.090). Weight regained from the nadir positively correlated with BES scores at baseline (r = 0.374, P = 0.019). CONCLUSIONS: FA and BE tend to decrease during the early postoperative period, but remains in a notable rates return by 2 years post-SG. Moreover, pre-surgical BE was related to higher weight-regain. Proper management pre-BS should include a comprehensive eating pathologies assessment, as these pathologies may remain or re-emerge post-surgery and lead to worse weight outcomes.

Food Addiction Is Associated with Binge Eating and Psychiatric Distress among Post-Operative Bariatric Surgery Patients and May Improve in Response to Cognitive Behavioural Therapy.

The current study examined clinical correlates of food addiction among post-operative bariatric surgery patients, compared the clinical characteristics of patients with versus without food addiction, and examined whether a brief telephone-based cognitive behavioural therapy (Tele-CBT) intervention improves food addiction symptomatology among those with food addiction. Participants (N = 100) completed measures of food addiction, binge eating, depression, and anxiety 1 year following bariatric surgery, were randomized to receive either Tele-CBT or standard bariatric post-operative care, and then, repeated the measure of food addiction at 1.25 and 1.5 years following surgery. Thirteen percent of patients exceeded the cut-off for food addiction at 1 year post-surgery, and this subgroup of patients reported greater binge eating characteristics and psychiatric distress compared to patients without food addiction. Among those with food addiction, Tele-CBT was found to improve food addiction symptomatology immediately following the intervention. These preliminary findings suggest that Tele-CBT may be helpful, at least in the short term, in improving food addiction symptomatology among some patients who do not experience remission of food addiction following bariatric surgery; however, these findings require replication in a larger sample.

Food Addiction in Sleeve Gastrectomy Patients with Loss-of-Control Eating.

OBJECTIVE: Food addiction and binge eating share overlapping and non-overlapping features; the presence of both may represent a more severe obesity subgroup among treatment-seeking samples. Loss-of-control (LOC) eating, a key marker of binge eating, is one of the few consistent predictors of suboptimal weight outcomes post-bariatric surgery. This study examined whether co-occurring LOC eating and food addiction represent a more severe variant post-bariatric surgery. METHODS: One hundred thirty-one adults sought treatment for weight/eating concerns approximately 6 months post-sleeve gastrectomy surgery. The Eating Disorder Examination-Bariatric Surgery Version assessed LOC eating, picking/nibbling, and eating disorder psychopathology. Participants completed the Yale Food Addiction Scale (YFAS), the Beck Depression Inventory-Second Edition (BDI-II), and the Short-Form Health Survey-36 (SF-36). RESULTS: 17.6% met food addiction criteria on the YFAS. Compared to those without food addiction, the LOC group with food addiction reported significantly greater eating disorder and depression scores, more frequent nibbling/picking and LOC eating, and lower SF-36 functioning. CONCLUSION: Nearly 18% of post-operative patients with LOC eating met food addiction criteria on the YFAS. Co-occurrence of LOC and food addiction following sleeve gastrectomy signals a more severe subgroup with elevated eating disorder psychopathology, problematic eating behaviors, greater depressive symptoms, and diminished functioning. Future research should examine whether this combination impacts long-term bariatric surgery outcomes.

Meal-Related Acyl and Des-Acyl Ghrelin and Other Appetite-Related Hormones in People with Obesity and Binge Eating.

OBJECTIVE: Potential mechanisms of abnormal food intake, such as dysregulation of meal-related appetite hormones, including acyl ghrelin (AG) and des-acyl ghrelin (DAG), were investigated among men and women with obesity, with and without binge eating (BE). METHODS: Participants (n = 42: 19 female, 23 male) were assigned to a liquid meal and water condition in counterbalanced order, and blood samples for measuring hormones were obtained before and after these conditions. RESULTS: Participants with BE had significantly lower fasting and postingestive AG concentrations than participants without BE in both conditions. During the meal condition, postprandial decreases in AG concentrations were significantly smaller for the BE group than for the non-BE group. There were no significant differences in DAG by BE group. Leptin increased significantly less after meals for those with BE compared with those without BE. There were no differences in other hormones by BE group. Fasting and postmeal hunger ratings were significantly higher for those with BE than for those without BE. CONCLUSIONS: In individuals with BE, lower fasting AG may be due to downregulation by habitual overeating, and a smaller postmeal decline in AG may contribute to overeating. Lower postmeal leptin concentrations may also contribute to overeating.

Body image dissatisfaction in individuals with obesity seeking bariatric surgery: exploring the burden of new mediating factors.

INTRODUCTION: For bariatric surgery candidates body image dissatisfaction (BID) may influence both psychological well-being and motivation to obtain surgery. This study aims to examine possible psychiatric predictors of BID. In particular, we explored the burden of new associated factors such as early trauma and attachment style (AS), which have not been assessed in previous literature. METHODS: In this study, 536 patients with extreme obesity (mean Body Mass Index, BMI=43 kg/m2, SD=6.62) undergoing presurgical psychiatric evaluations as part of a mandatory workup before surgery were chosen as participants. A semi-structured clinical interview was performed to assess psychiatric diagnosis and patients' history of early trauma. BID was assessed using the Body Shape Questionnaire (BSQ). Depression, binge eating, and AS were assessed using self-report instruments. RESULTS: Binge eating behavior (p<0.0001), depression severity (p<0.0001), female gender (p<0.0001), and the "need for approval" dimension of insecure AS (p<0.0001) were found to be independent and significant predictors of BSQ score. However, early trauma and BMI were not included in the significant regression model (F4,442=90.784, p<0.0001, adjR2=0.446). DISCUSSION: Our results increased the understanding of BID among individuals with extreme obesity. Similar to previous studies, we reported that binge-eating, depressive symptoms, and gender influenced BID. Neither early trauma nor BMI were associated with BID. Our novel finding was the significance of insecure AS. Implications for multidisciplinary approaches to obesity treatment are discussed. Identifying critical features of BID to be targeted in pre- and post-operative behavioral interventions may open new possibilities for providing effective support for individuals over the course of their therapy. CONCLUSIONS: For some individuals living with obesity, developmental and relational processes such as insecure AS may play a substantial role in the development of BID.

Executive functioning and psychological symptoms in food addiction: a study among individuals with severe obesity.

Food addiction (FA) has recently emerged as a new field in the study of obesity. Previous studies have contributed to identifying psychological correlates of FA. However, few researchers have examined the cognitive profile related to this condition; up until now, attentional biases related to food cues and a poorer performance monitoring have been observed. The present study aimed to examine the psychological profile and executive functioning related to FA in individuals with severe obesity and awaiting bariatric surgery. Participants (N = 86) were split into two groups, according to their level of FA symptoms (low FA vs high FA). Groups were compared on questionnaires measuring binge eating, depression and anxiety symptoms, and impulsivity as well as on measures reflecting executive functioning (D-KEFS and BRIEF-A). The relationship between FA groups and patterns of errors during the D-KEFS' Color-Word Interference Test was further analyzed. Individuals within the high FA group reported significantly more binge eating, depressive and anxiety symptoms, and more metacognitive difficulties. They also tended to show a poorer inhibition/cognitive flexibility score and a typical pattern of errors, characterized by an increased number of errors as the tasks' difficulty rose as opposed to a decreased number of errors, which characterizes an atypical pattern of errors. The present results show that the inability to learn from errors or past experiences is related to the severity of FA and overall impairments.Level of evidence Level V, descriptive study.

Una mirada al estilo de personalidad tendiente a los desórdenes alimentarios desde el constructivismo hermenéutico / A look at the personality style tending to food disorders from the hermeneutical constructivism

El estilo de personalidad tendiente a los trastornos alimentarios se refiere a una lucha de sentido con el propio cuerpo, que regula la dialéctica entre la co-percepción del otro y el sentido de sí mismo, el problema alimentario va comprendido como un problema con la dialéctica del cuerpo, no con la imagen del cuerpo. El punto fundamental para comprender el trastorno alimentario es en relación a la imagen corporal, la mujer y los medios de información. Adicionalmente, se ha encontrado que la tecnología juega un papel importante al afectar no sólo la experiencia de la percepción, a través de acelerar el cambio en contextos específicos, sino la introducción de nuevos recursos de signi- ficado; nuevos puntos de referencia que proporcionan el anclaje para crear y mantener la identidad propia. Esto sitúa al hombre en una nueva forma de orientarse emocional- mente en relación a su contexto.

The eating disorder-prone style of personality refers to a feeling struggle with the same body, which regulates the dialectic between the other co-perception and the sense of self, the eating disorder is understood as a problem related to the dialectic of the body itself but not to the image of the body. The main point in order to understand the eating disorder is associated with the body image, the female gender and media. On the other hand, it has been found that technology plays a vital role not only by afecting the experience perception by accelerating the change in specific contexts but also by introducing new resources of meaning; new points of reference which provide the basis to create and keep the own identity. Thus, it sets the human in a new way of emotional orientation in relationship with his context.

Does the Interpersonal Model Generalize to Obesity Without Binge Eating?

The interpersonal model has been validated for binge eating disorder (BED), but it is not yet known if the model applies to individuals who are obese but who do not binge eat. The goal of this study was to compare the validity of the interpersonal model in those with BED versus those with obesity, and normal weight samples. Data from a sample of 93 treatment-seeking women diagnosed with BED, 186 women who were obese without BED, and 100 controls who were normal weight were examined for indirect effects of interpersonal problems on binge eating psychopathology mediated through negative affect. Findings demonstrated the mediating role of negative affect for those with BED and those who were obese without BED. Testing a reverse model suggested that the interpersonal model is specific for BED but that this model may not be specific for those without BED. This is the first study to find support for the interpersonal model in a sample of women with obesity but who do not binge. However, negative affect likely plays a more complex role in determining overeating in those with obesity but who do not binge. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.

Gastrojejunostomy for pyloric stenosis after acute gastric dilatation due to overeating.

A 34-year-old woman presented at our hospital with abdominal distention due to overeating. Acute gastric dilatation was diagnosed. The patient was hospitalized, and nasogastric decompression was initiated. On hospitalization day 3, she developed shock, and her respiratory state deteriorated, requiring intubation and mechanical ventilation. Nasogastric decompression contributed to the improvement in her clinical condition. She was discharged 3 mo after admission. During outpatient follow-up, her dietary intake decreased, and her body weight gradually decreased by 14 kg. An upper gastrointestinal series and endoscopy revealed pyloric stenosis; therefore, we performed gastrojejunostomy 18 mo after her initial admission. The patient was discharged from the hospital with no postoperative complications. Gastric necrosis and perforation due to overeating-induced gastric dilatation are life-threatening conditions. Surgical intervention may be required if delayed pyloric stenosis occurs after conservative treatment. We report a case of pyloric stenosis due to overeating-induced gastric dilatation treated by gastrojejunostomy 18 mo after the initial presentation.

Características sociodemográficas, alterações orais e prevalência da Candida spp em pacientes com transtornos alimentares / Sociodemographic characteristics, oral status and prevalence of Candida spp in patients of eating disorders

As alterações orais nos pacientes com transtornos alimentares (TAs) são estudadas na literatura, porém poucos artigos abrangem a relação entre as alterações orais, candidose bucal e avaliação sociodemográfica. O presente estudo avaliou as características sociodemográficas, orais e a prevalência de Candida spp em pacientes com TAs. Foram avaliados 14 pacientes, destes 6 possuíam o diagnóstico estabelecido de Anorexia purgativa, 7 de Bulimia Nervosa e 1 TANE (transtorno alimentar não especificado). A idade média dos pacientes do estudo foi de 30,7 anos e todos eram do sexo feminino. Os pacientes responderam a um questionário elaborado pela pesquisadora e em seguida foram submetidos ao exame clínico inicial, para avaliação geral da saúde bucal, com enfoque na presença de lesões de mucosa, cáries, erosões e candidose. Também foi coletado saliva para a avaliação do fluxo salivar. As seguintes características sociodemográficas foram encontradas: 28,4% exerciam atividade remunerada; 42,8% possuíam terceiro grau completo e 78,6% eram solteiras; o tempo médio do transtorno alimentar foi de 14,8 anos e o tempo de diagnóstico médico foi de 8,07 anos. Na avaliação odontológica foram encontrados: CPO-d (dentes-cariados, perdidos e obturados) médio de 10,57; IHOS (índice de higiene oral) médio de 1,3; 71,4% das pacientes possuíam perda de brilho na face palatina dos dentes e 14,2% apresentaram perimólise. As pacientes purgativas apresentaram um índice CPO-d maior que as pacientes restritivas, a classe social mais prevalente foi a classe média. A Candida spp foi mais isolada em pacientes do serviço público e a xerostomia não foi um fator predisponente à colonização de Candida spp. A perimólise teve relação com o tempo de TAs das pacientes. Os resultados obtidos demonstram a necessidade de acompanhamento odontológico regular em pacientes com TAs.

The oral changes in patients with eating disorders (ED) are studied in literature, but few articles disclose the connection between oral changes, oral candidiasis and sociodemographic characteristics. This study evaluated the sociodemographic characteristics, oral changes and the prevalence of Candida spp. Fourteen patients were evaluated. Six subjects were diagnosed with Anorexia (purging subtype), seven with Bulimia and one with EDNOS (eating disorders no specified). Every subject included was female with a mean age of 30,7 years. All of them answered a questionnaire and passed through a clinical exam to evaluate the oral health focusing on oral lesions, erosion, decayed and candidiasis. Saliva was collected for analysis. The social demographics characteristics were observed 28.4% of subjects exercise a paid activity, 42.8% had college degree and 78.5% were single. The mean time of ED was 14.8 years and mean time of medical diagnosis was 8.07 years. The clinical exam revealed the following data: DMFT mean of 10.57; Plaque index (oral hygiene) mean of 1.3; 71.4% of subjects showed tooth wear in enamel on palatine surface and 14,2%, perimolysis. This results suggest that patients with purging habits had higher DMFT than restrictive patients, the social class can be a predisposing factor for ED, the local where treatment was done influenced in isolation of Candida spp; and xerostomia did not influence in colonization of the fungus. The perimolysis presented relation with time of manifestation ED. This results showed the importance of concomitant treatment with dentistry.

Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life.

OBJECTIVE: To assess psychiatric symptoms, substance use, quality of life and eating behavior of patients undergoing bariatric surgery before and after the procedure. METHODS: We conducted a prospective longitudinal study of 32 women undergoing bariatric surgery. To obtain data, the patients answered specific, self-administered questionnaires. RESULTS: We observed a reduction in depressive and anxious symptoms and also in bulimic behavior, as well as an improved quality of life in the physical, psychological and environmental domains. There was also a decrease in use of antidepressants and appetite suppressants, but the surgery was not a cessation factor in smoking and / or alcoholism. CONCLUSION: a decrease in psychiatric symptoms was observed after bariatric surgery, as well as the reduction in the use of psychoactive substances. In addition, there was an improvement in quality of life after surgical treatment of obesity.

Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life / O impacto da cirurgia bariátrica nos sintomas depressivos e ansiosos, comportamento bulímico e na qualidade de vida

OBJECTIVE: To assess psychiatric symptoms, substance use, quality of life and eating behavior of patients undergoing bariatric surgery before and after the procedure. METHODS: We conducted a prospective longitudinal study of 32 women undergoing bariatric surgery. To obtain data, the patients answered specific, self-administered questionnaires. RESULTS: We observed a reduction in depressive and anxious symptoms and also in bulimic behavior, as well as an improved quality of life in the physical, psychological and environmental domains. There was also a decrease in use of antidepressants and appetite suppressants, but the surgery was not a cessation factor in smoking and / or alcoholism. CONCLUSION: a decrease in psychiatric symptoms was observed after bariatric surgery, as well as the reduction in the use of psychoactive substances. In addition, there was an improvement in quality of life after surgical treatment of obesity. .

OBJETIVO: avaliar a sintomatologia psiquiátrica, o uso de substâncias, a qualidade de vida e o comportamento alimentar de pacientes submetidos a cirurgia bariátrica antes e após o procedimento. MÉTODOS: estudo longitudinal prospectivo com 32 mulheres submetidas à cirurgia báriatrica. Para a obtenção de dados, as pacientes responderam a questionários específicos, autoaplicados. RESULTADOS: foi identificada uma redução na sintomatologia depressiva e ansiosa e também no comportamento bulímico, bem como uma melhora na qualidade de vida nos domínios físico, psíquico e ambiental. Houve diminuição do uso de antidepressivos e de moderadores de apetite, porém a cirurgia não foi um fator determinante na cessação do tabagismo e/ou etilismo. . CONCLUSÃO: foi observada uma diminuição da sintomatologia psiquiátrica após a cirurgia bariátrica, bem como redução do uso de substâncias psicoativas. Além disso, houve melhora na qualidade de vida após o tratamento cirúrgico da obesidade. .

Recurrent aborted sudden cardiac death with seizures and rhabdomyolysis due to bulimia-induced hypokalemia: Report of one case / Muerte súbita abortada recurrente con convulsiones y rabdomiolisis causada por hipokalemia: Informe de una paciente con bulimia

Recurrent vomiting due to bulimia associated with abuse of furosemide and laxatives causing severe hypokalemia may result in recurrent aborted sudden cardiac death (SCD) and seizures. We report a 25-year-old female with a history of bulimia associated with abuse of furosemide and laxatives since the age of 15 years, migraine since puberty, renal abscesses at age 20 y, and rhabdomyolysis of unknown cause at age 24 y. She experienced aborted SCD due to severe hypokalemia with symptomatic seizures at 21 and 25 years of age. Bulimia patients additionally taking laxatives or furosemide are at particular risk of SCD and rhabdomyolysis and require periodic determination of electrolytes, potassium substitution, and adequate psychiatric therapy and surveillance.

Los vómitos recurrentes debidos a bulimia, asociados a abuso de furosemida y laxantes que causan hipokalemia severa, pueden llevar a muerte súbita abortada y convulsiones. Informamos una mujer de 25 años con una historia de bulimia asociada a abuso de furosemida y laxantes desde los 15 años, migrañas desde la pubertad, abscesos renales a los 20 años y rabdomiolisis de causa desconocida a los 24 años. La paciente tuvo dos episodios de muerte súbita abortada con convulsiones a los 21 y 25 años, debido a hipokalemia severa. Los pacientes con bulimia y abuso de furosemida y laxantes tienen un riesgo mayor de tener muerte súbita y rabdomiolisis, requieren de controles periódicos de electrolitos y tratamiento psiquiátrico.