Оцінка впливу периопераційного супроводжування жінок із морбідним ожирінням на якість їхнього життя

Abstract

Aim - to assess eating disorders (ED) in female patients who are candidates for bariatric surgery (BS) and to establish psychological features of the course of the postoperative period in them. Materials and methods. The nature of ED disorders in 51 women with morbid obesity (MO) and accompanying metabolic syndrome (MS), aged from 22 to 55 years, who underwent BS was analyzed. Women with a higher body mass (BMI) underwent biliopancreatic bypass (BPS) in the Hess–Marceau modification (the group I - 21 women), patients with a lower body mass index (BMI) - sleeve gastrectomy (SG) - the group II (30 female patients). The duration of observation in the postoperative period ranged from 3 to 7 years. The BMI of women ranged from 29.2 to 62.1 kg/m2 and averaged 44.0±1.0 kg/m2. The experience of obesity varied from 5 to 21 years. A diagnostic interview using the Dutch Eating Behavior Questionnaire (DEBQ) was performed to assess ED. With the help of the questionnaire "Life satisfaction index (LSI) test (adaptation by N.V. Panina)" the degree of psychological comfort of women was assessed. Results. The average age of patients in the group I was 37.9±2.1 years, in the group II - 41.3±1.7 of the year. 20 (39.2%) women each had external eating behavior (EB) and emotiogenic disorder of EB, of which 5 (25%) cases showed a combination of external and emotiogenic EB. Compulsive EB disorder was registered in 4 (7.8%) cases of emotogenic EB disorder, "night eating" syndrome - in 16 (80%) out of 20. Restrictive EB disorder was found in 16 (31.4%) patients. In 6 (11.8%) cases, this type of ED replaced external ED. All these patients noted the fact of dietary depression. In 45 (88.2%) cases, patients had a score below 25 points, which indicated low life satisfaction; and only in 6 (11.8%) cases it was about average satisfaction. In all 6 (11.8%) cases, we were talking about women with BMI < 40 kg/m2. Conclusions. In patients with obesity, anxiety-neurotic tendencies and psychosocial maladjustment, relatively low tolerance to stress is revealed. Food, in their case, serves as a tool to fight anxiety and depression and further closes the "vicious circle" of obesity. During the initial survey, special attention should be paid to the attitude of the patient with MO to alcohol, because alcohol addiction is a contraindication for performing BPS. The indicator of the "Index of satisfaction with life" directly correlates with the indicators of a woman's body weight. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.