A preliminary comparison of the psychological impact of laparoscopic gastric banding and gastric bypass surgery for morbid obesity.

BACKGROUND: Laparoscopic gastric banding has introduced a new element into weight reduction surgery. The authors compared subjects who had undergone a laparoscopic gastric banding (lap-band) procedure with those who had undergone a gastric bypass operation on relevant psychological and behavioral parameters. METHODS: A self-report questionnaire developed by the researchers was used. It included questions about aspects of food and eating as well as attitudinal items relating to the outcome of the surgery. RESULTS: There were significant differences between the lap-band group and the gastric bypass group in their distance from their desired weight, their eating, and their attitudes. CONCLUSION: 9 months after surgery, gastric bypass surgery appears to be the superior procedure on several parameters. The surgery induction process may be critical. Evaluation at later stages is vital.

Eating behavior and the experience of hunger following gastric bypass surgery for morbid obesity.

BACKGROUND: Numerous different factors may contribute to the varying degrees of success observed following gastric bypass surgery. It is likely that alterations in the subjective experiences of hunger and satiety, as well as behavioral factors, are important. Our aim was to investigate the association of several factors, including qualitative aspects of hunger and satiety, eating patterns, and the emotional valence of different foods, to the weight loss that occurred following obesity surgery. METHODS: A questionnaire covering aspects of hunger, eating and satiety was administered to three groups: (1) a group of people who had undergone gastric bypass surgery with an acceptable weight loss; (2) a morbidly obese group of patients prior to their surgical intervention; (3) a group of people of normal weight. RESULTS: There were significant differences amongst the three groups in scoring on standardized eating disorder scales, in the amount they could eat, and in the experience of hunger. The presurgery, waiting-list group was more receptive to food-related than interoceptive cues when deciding to stop eating. 'Eating styles' also differed across the groups. CONCLUSIONS: It is concluded that changes in specific food-related behaviors and other psychological variables interact with the physical restriction to eating. The relative weighting of other variables needs further exploration.

Mental activity, health, and life-satisfaction.

Systematic study of the cultural belief in a relationship between mental health and longevity has not been undertaken. No scale to measure 'mental activity' appears available. A questionnaire measuring 'mental activity' was administered to 166 community respondents. From a factor analysis 4 clear factors emerged. Factor scores were significantly correlated with scores on life-satisfaction, but few relationships with subscales of a health measure emerged. Some relationships with choice of free-time activities were noted. Further work on the scale and its correlates is recommended.

Perceptions of disability by students, the formerly obese, and the general community.

There has been recurring interest over nearly three decades in preferences for different disabilities. In the present study, the perceptions of eight disabilities were compared across three groups, 42 occupational therapy students, 20 formerly obese, and 166 of the general community. A disability ranking task was adapted from a forced-choice task used by other researchers. Consistent with previous results, blindness was ranked as most difficult to live with. Contrary to prediction, there was no significant difference between the formerly obese subsample and the general community in their ranking of obesity; however, these groups differed in their ranking of diabetes. There were minor differences between the students and other groups. Across the entire sample, the disability of 'needing a hearing aid' was ranked as easiest to live with. Implications of the results are discussed, and suggestions made for further research.

Drinking and the brain: current evidence.

There is no question, as accumulating evidence reveals, that alcohol in excess negatively affects the brain and neuropsychological functioning, both immediately and in the long-term. The important question for social drinkers, however, is whether moderate amounts of alcohol can have deleterious effects on the brain or performance in either the medium- or long-term. It has been proposed that there is a continuum of negative consequences with light drinkers at one end and chronic alcoholics at the other end. Three levels of study of this hypothesis are distinguished; behavioural, structural, and cellular. Research into effects at these three levels is reviewed both for alcoholics and for social drinkers. A further hypothesis relates to the possibility that cognitive functioning is impaired even after blood alcohol concentration has returned to zero. It is concluded that while neither the continuity hypothesis nor a 'hangover' hypothesis is supported by current evidence, considerably more research is needed.