Concetta De Pasquale*, Coco Marinella**, Federica Sciacca*, Maria Luisa Pistorio***, Carmela Dinaro****
*Department of Educational Sciences, University of Catania, Italy - **Department of Biomedical and Biotechnological Sciences, University of Catania, Italy - ***Department of Educational Sciences, University of Catania, Italy - ****Department of Surgery, Transplantation and Advanced Technologies GF Ingrassia, University of Catania, Italy - 5Drug Addiction Health Service, SER.T - ASP3 Acireale (CT)
Introduction: Recent research has shown significant increases in depressive symptoms in long-term follow-up after bariatric surgery (BS). Also the subjects with Binge Eating Disorder (BED), regardless of weight loss in the post-BS phase, show a state of psychophysical discomfort, if not treated with a psychotherapeutic intervention. In this framework, the research aimed at evaluating psychic variables of patients before and after BS could reduce the risk of regaining weight, optimizing the effect of the procedure and maintaining a state of psychophysical wellbeing.
Materials and methods: A 33-year-old Italian woman suffering from BED weighing 96 kg (BMI 37.5 kg / m²) went to a psychologic and psychiatric visit in order to undertake the path for the second bariatric surgery (BS). Anamnestic data has revealed the problems related to weight since childhood. Results: At 20, weighing 90 kg (BMI 35.16 kg / m²), she underwent surgery for intragastric balloon (BIB). At 25, her weight reached 120 kg (BMI 46.88 kg / m²), following the pregnancy of her first daughter. Diabetes and musculoskeletal problems have been associated with its obesity. In 2011 she underwent first BS. Following this intervention, the patient's weight dropped to 59 kg (BMI 23.05 kg / m²) but increased over the years to reach the current weight of 96 kg (BMI 37.5 kg / m²). The patient was subjected to the administration of six investigative tools: the D.F.U., the MMPI-2, the SCL-90 R, the BDI-II, the SF-36 and the EDI-2, before the second bariatric surgery procedure.
Conclusions: Our study suggests that BS alone is not the best solution to treat morbid obesity in patients diagnosed with BED, as it is shown that disordered eating behavior persists post-BS. In summary, adequate preoperative psychological/psychiatric evaluation and postoperative psychotherapic support should be provided to increase the long-term success of BS and reduce the risk of complications.
Binge eating disorder, BED, bariatric surgery, obesity, Multidisciplinary assessment, psychotherapy.