The orexigram in patients affected by morbid obesity: a preliminary report on daily hunger sensation before bariatric surgery.

OBJECTIVE: The present study investigated the orexigram, the time-qualified self-rated estimate of hunger sensation (HS), in patients affected by morbid obesity (MO) with the aim of detecting how daily HS behaves before morbidly obese patients (MOP) undergo bariatric surgery (BS). This article is therefore a preliminary report as it is necessary to make subsequent comparisons with post-BS orexigrams. Preoperative orexigrams may be helpful in selecting the MOPs who are candidates for surgical treatment. MATERIALS AND METHODS: Ten MOPs (five males and five females, with a mean age of 34 +/- 11 yr and a mean BMI of 49.32 +/- 7.26 kg/m2), and 19 clinically healthy control subjects (CHS: nine males and ten females, with a mean age of 24 +/- 2 yr and a mean BMI of 21.00 +/- 1.70 kg/m2) gave their informed consent to participate in the study. All of the study participants were asked to compile a 24-h orexigram, which was then biometrically analysed by means of: 1) conventional methods for parametric statistics; 2) rhythm analysis for their circadian rhythms; and 3) spectral analysis for their harmonic structure. RESULTS: The orexigrams of the MOPs had significantly increased mean daily levels (daily hyperorexia), retained their circadian periodicity despite an increase in mesor, and were consistently modified in their ultradian spectral harmonic components. CONCLUSIONS: The results show that the studied MOPs complain of a daily hyperorexia that is still perceived circadically. This perception is a structured abnormality, as demonstrated by the consistent changes in the spectral analysis, and so MOPs can be diagnosed as being affected by so-called "hyperorectic obesity". It will be interesting to see whether or not presurgical hyperorexia in MOPs is corrected by BS: if so, hyperorexia may become an additional indication, and presurgery orexigrams could be suggested as an additional means of selecting the hyperorectic MOPs who are candidates for surgical treatment.