Bariatric and Cosmetic Surgery in People with Eating Disorders.

Charmaine D’Souza,Phillipa Hay,Milan K Piya,Stephen Touyz

doi:10.3390/nu12092861

Abstract

Rates of eating disorders (EDs) are increasing in Australia, as are rates of bariatric and cosmetic surgery including weight-related procedures. It is known that binge eating disorder (BED) is common in bariatric surgery candidates and that people with EDs are likely to undergo weight-related cosmetic procedures, however, most of the literature is based on clinic samples and focuses on young women and BED. Aims of this study were to determine the prevalence of (1) actual or intended bariatric surgery and (2) actual or intended cosmetic surgery including weight-related procedures in people with a current ED and a lifetime history of BED or bulimia nervosa (BN), and the associations with actual or intended bariatric or cosmetic surgery and demographic features. Using a general population survey, 2977 individuals were interviewed regarding sociodemographic status, ED symptoms, mental health-related quality of life (MHRQoL) and actual or intended use of bariatric and cosmetic surgery, prevalence estimates of which were 2.0% and 1.1%, respectively. People who had planned or received either type of surgery were more likely to be (1) women and (2) have a higher BMI, (3) poorer MHRQoL and (4) a current ED, lifetime BN or BED or features of EDs (all p < 0.05). Age and household income were not significantly associated with increased use of either type of surgery. Given the potential for an ED to affect outcomes of surgery, screening and treatment for EDs should be considered in such surgical candidates.

Highlights

Bariatric surgery is an established treatment option for severe obesity and type 2 diabetes mellitus (T2DM), and can result in significant, sustained weight loss and improvement/remission of T2DM [1,2,3,4].The number of bariatric procedures performed in Australia is increasing with over 20,000 bariatric procedures having been performed in the 2018–2019 financial year [5]
Sixty (2.0%, 95% C.I. 1.57–2.59) participants were intending to have or had received bariatric surgery
This study found that the groups that had planned or received bariatric or cosmetic surgery had poorer mental health-related quality of life (MHRQoL) than those who had not reported these procedures

Summary

Introduction

Bariatric surgery is an established treatment option for severe obesity and type 2 diabetes mellitus (T2DM), and can result in significant, sustained weight loss and improvement/remission of T2DM [1,2,3,4].The number of bariatric procedures performed in Australia is increasing with over 20,000 bariatric procedures having been performed in the 2018–2019 financial year [5]. The prevalence of eating disorders (EDs) is rising and, in Australia, since 1995, ED behaviors have been rising at a higher rate in people with concurrent obesity [6,7]. Anorexia nervosa (AN), bulimia nervosa (BN) and binge-eating disorder (BED) are the main currently recognized EDs [8]. Estimates of their point prevalence in Australia are up to 0.5% for AN broadly defined, 1.2% for BN and 1.5% for BED broadly defined [9]. These figures are similar to international studies [10]. Alongside the rise in EDs are increases in body image concerns in the general population and cosmetic procedures [11,12,13]

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Results

Discussion

Conclusion