Riscos psicológicos do ganho de peso em pacientes bariátricos pós-operatórios
DOI:
https://doi.org/10.5281/zenodo.16763798Palavras-chave:
Cirurgia bariátrica, Pós-operatório, Ganho de peso, Fatores de risco psicológicos, Saúde mentalResumo
Este artigo relata uma pesquisa que teve como objetivo identificar os riscos psicológicos associados ao reganho de peso pós-operatório em pacientes submetidos à cirurgia bariátrica dentro da estrutura da Agenda 2030 para o Desenvolvimento Sustentável, que visa garantir vidas saudáveis e promover o bem-estar, e que inclui esforços para reduzir a mortalidade por doenças não transmissíveis, como obesidade e sobrepeso, com ênfase na saúde mental. Foi adotada uma abordagem interpretativa com método qualitativo e desenho fenomenológico. Os informantes foram três pacientes submetidos à cirurgia bariátrica que atingiram um nadir ≥25% e recuperaram no pós-operatório um peso ≥15% do peso total perdido. Uma entrevista semiestruturada foi usada para coletar as informações, que foram analisadas usando o método hermenêutico, a categorização, a triangulação teórica e a triangulação por especialistas. Concluiu-se que há riscos psicológicos comuns em pacientes que perdem peso: traços de desenvolvimento e seu impacto sobre o “eu”, afetação emocional como consequência de experiências de vida, a forma de vinculação e atitudes pessoais, concepções sobre obesidade e cirurgia bariátrica e estratégias e comportamentos que afetam o peso e a saúde.
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Referências
Alfonsson, S., Weineland-Strandskov, S. y Sundbom, M. (2017). Self-reported Hedonism Predicts 12-month weight loss after Roux en-Y Gastric bypass. Obesity Surgery, 27, 2073-2078. https://doi.org/10.1007/s11695-017-2603-z
Athanasiadis, D., Martin, A., Kapsampelis, P., Monfared, S. y Stefanidis, D. (2021). Factors associated with weight regain post-bariatric surgery: a systematic review. Surgical Endoscopy, 35(8), 4069-84. https://doi.org/10.1007/s00464-021-08329-w
Baile, J., González-Calderón, M., Palomo, R., y F. Rabito-Alcón, M. (2020). La intervención psicológica de la obesidad: desarrollo y perspectivas. Clínica Contemporánea. Universidad a Distancia de Madrid, España . 11(1) 1-14 DOI https://doi.org/10.5093/cc2020a1 Recuperado de: https://www.revistaclinicacontemporanea.org/art/cc2020a1
Boyd, J. y Zimbardo, P. (2005). Time Perspective, health and risk taking. In A. Strathman & J. Joireman (Eds.). Understanding behavior in the context of time (pp. 85-107). Mahwah: LEA.
Branden, N. (1969). The Psychology of Self-esteem. New York: Bantan Books.
Busetto, L., Dicker, D., Azran, C., Batterham, R., Farpour-Lambert, N., Fried, M., Hjelmesæth, J., Kinzl, J., Leitner, D., Makaronidis, J., Schindler, K., Toplak, H. y Yumuk, V. (2017). Practical Recommendations of the Obesity Management Task Force of the European Association for the Study of Obesity for the Post-Bariatric Surgery Medical Management. Obesity Facts, 10, 597-632. https://doi.org/10.1159/000481825
Cherick, F., Te, V., Anty, R., Turchi, L., Benoit, M., Schiavo, L. y Iannelli, A. (2019). Bariatric Surgery Significantly Improves the Quality of Sexual Life and Self-esteem in Morbidly Obese Women. Obesity Surgery, 29(5), 1576-1582. https://doi.org/10.1007/s11695-019-03733-7
Corcelles, R., Daigle, C. y Schauer, P. (2016). Management of endocrine disease: metabolic effects of bariatric surgery. European Journal of Endocrinology, 174, R19– R28. https://doi.org/10.1530/EJE-15-0533
Courcoulas, A., King, W., Belle, S., Berk, P., Flum, D., Garcia, L., Gourash, W., Horlick, M., Mitchell, J., Pomp, A., Pories, W., Purnell, J., Singh, A., Spaniolas, K., Thirlby, R., Wolfe, B. y Yanovski, S. (2018). Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surg, 153(5), 427-434. https://doi.org/10.1001/jamasurg.2017.5025
Dymek, M. P., Le Grange, D., Neven, K. y Alverdy, J. (2002). Quality of Life after Gastric Bypass Surgery: A Cross-Sectional Study. Obesity Research, 10(11), 1135-1142. https://doi.org/10.1038/oby.2002.154
Ghaferi, A. y Varban, O. (2018). Setting Appropriate Expectations After Bariatric Surgery. JAMA, 320(15), 1543. https://doi.org/10.1001/jama.2018.1424
González, M. y Rodríguez, M. (2021). Creencias en obesidad y cirugía bariátrica: análisis de contenido para diseñar una escala. Revista de Psicología, Lima. 39(1), 253-287. http://dx.doi.org/10.18800/psico.202101.011
Guzmán, F. (2021). Estrategias de seguimiento de las cirugías bariátricas: una revisión sistemática. Universidad Andrés Bello - Chile.
Hansen, B. y Dye, M. (2018). Damned if You Do, Damned if You Don’t: The Stigma of Weight Loss Surgery. Deviant Behavior, 39(2), 137-147. https://doi.org/10.1080/01639625.2016.1263081
Hsu, L., Mulliken, B., McDonagh, B., Das, S., Rand, W., Fairburn, C., Rolls, B., McCrory, M., Saltzman, E., Shikora, S., Dwyer, J. y Roberts, S. (2002). Binge eating disorder in extreme obesity. International Journal of Obesity, 26(10), 1398-1403. https://doi.org/10.1002/eat.10211
Hult, M., Bonn, S. E., Brandt, L., Wirén, M. y Lagerros, Y. T. (2019). Women’s Satisfaction with and Reasons to Seek Bariatric Surgery-a Prospective Study in Sweden with 1-Year Follow-up. Obesity Surgery, 29(7), 2059-2070. https://doi.org/10.1007/s11695-019-03834-3
Husserl, E. (1998). Invitación a la fenomenología. Barcelona: Paidós.
Jiménez, L., Mendoca, F., Mendoza, F., Pimentel, M., Gestic, M., Chaim, E. y Cazzo, E. (2018). Impact of Weight Regain on the Evolution of Non- alcoholic Fatty Liver Disease After Roux-en-Y Gastric Bypass: a 3-Year Follow-up. Obesity Surgery, 28, 3131-3135. https://doi.org/10.1007/s11695-018-3286-9
Kubik, J., Gill, R., Laffin, M. y Karmali, S. (2013). The Impact of Bariatric Surgery on Psychological Health. Journal of Obesity, 2013, 1-5. https://doi.org/10.1155/2013/837989
Kushner, R. y Sorensen, K. (2015). Prevention of Weight Regain Following Bariatric Surgery. Current Obesity Report, 4, 198-206. https://doi.org/10.1007/s13679-015-0146-y
Lecube, A., Monereo, S., Rubio, M. Á., Martínez-de-Icaya, P., Martí, A., Salvador, J., Assumpta, C., Menéndez, E., Manel, P. y Casanueva, F., (2017). Prevención, diagnóstico y tratamiento de la obesidad. Posicionamiento de la Sociedad Española para el Estudio de la Obesidad de 2016. Endocrinología, Diabetes y Nutrición, 64(7), 15-22. https://doi.org/10.1016/j.endonu.2016.07.002
Lemanu, D., Singh, P., Rahman, H., Hill, A., Babor, R., y MacCormick, A. (2015). Five-year results after laparoscopic sleeve gastrectomy: a prospective study. Surgery for Obesity and Related Diseases, 11, 518–524. https://doi.org/10.1016/j.soard.2014.08.019
Merino, P., Benítez-Hernández, M., Arias, M., Borda, M. y Luque-Budia, A. (2020). Descripción del perfil psicológico del paciente bariátrico: Obesidad Infantil, Apego y satisfacción de la relación de pareja. Acción Psicológica, 17(2), 25–42. https://doi.org/10.5944/ap.17.2.27437
Monsalve, K. (2023). El impacto psicológico de la cirugía bariátrica en pacientes obesos postoperados. Psicología, tercera época 42, 1-2, 55-83.
Montanari, M. (2003). El mundo en la cocina: historia, identidad e intercambios. Buenos Aires: Paidós.
Organización de las Naciones Unidas (2023). Informe de los Objetivos de Desarrollo Sostenible. Edición especial. ISSN: 2521-690.
Organización de las Naciones Unidas para la Alimentación y la Agricultura y Organización Mundial de la Salud (2020). Dietas saludables sostenibles - Principios rectores. Roma. https://doi.org/10.4060/ca6640es
Organización Mundial de la Salud (2021). Obesidad y sobrepeso. https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Peterhänsel, C., Linde, K., Wagner, B., Dietrich, A. y Kersting, A. (2017). Subtypes of Personality and ‘Locus of Control’ in Bariatric Patients and their Effect on Weight Loss, Eating Disorder and Depressive Symptoms, and Quality of Life. Eur Eat Disord Rev, 25(5), 397-405. https://doi.org/10.1002/erv.2534
Poves, I., Macías, G., Cabrera, M.-, Situ, L. y Ballesta, C. (2005). Calidad de vida en la obesidad mórbida. Revista Española de Enfermedades Digestivas, 97(3), 192-195. http://scielo.isciii.es/scielo.php?pid=S1130-01082005000300007&script=sci_arttext&tlng=es
Puhl, R., Himmelstein, M., y Pearl, R. (2020). Weight Stigma as a Psychosocial Contributor to Obesity. American Psychologist, 75, 274–289. https://doi.org/10.1037/amp0000538
Rogerson, D., Soltani, H. y Copeland, R. (2016). The weight-loss experience: a qualitative exploration. BMC Public Health, 16 (1), 371. https://doi.org/10.1186/s12889-016-3045-6
Ruiz, M., Berrocal, C., y Valero, L. (2002). Cambios psicológicos tras cirugía bariátrica en personas con obesidad mórbida. Psicothema, 14 (3), 577-582. https://www.psicothema.com/pii?pii=768
Sabench, F., Domíngez-Adame, E., Ibarzabal, A., Socas, M., Valentí, V., García, A., Moreno, F., González, J., Villalonga, R., Vilarrasa, N. y Sánchez, R. (2017). Criterios de calidad en cirugía bariátrica: revisión de conjunto y recomendaciones de la Asociación Española de Cirujanos y de la Sociedad Española de Cirugía de la Obesidad. Cirugía Española, 95, 4-16. DOI: 10.1016/j.ciresp.2016.09.007
Sarwer, D., Allison, K.., Wadden, T., Ashare, R., Spitzer, J. C., McCuen-Wurst, C., LaGrotte, C., Williams, N., Edwards, M., Tewksburry, C., Wu, J., Tajeu, G. y Allison, K. (2019). Psychopathology, disordered eating, and impulsivity as predictors of outcomes of bariatric surgery. Surgery for Obesity and Related Diseases, 15(4), 650-655. https://doi.org/10.1016/j.soard.2019.01.029
Sarwer, D; Wadden, T. y Fabricatore, A. (2012). Psychosocial and Behavioral Aspects of Bariatric Surgery. The Obesity Society 13(4) 639-348. https://doi.org/10.1038/oby.2005.71
Shukla, A., He, D., Saunders, K., Andrew, C. y Aronne, L. (2018): Current concepts in management of weight regain following bariatric surgery. Expert Review of Endocrinology & Metabolism, 13, 67-76. https://doi.org/10.1080/17446651.2018.1447922
Song, A. y Fernstrom, M; (2008). Nutritional and Psychological Considerations After Bariatric Surgery. Aesthetic Surgery Journal, 28 (2), 195-199. https://doi.org/10.1016/j.asj.2008.01.005
Spirou, D., Raman, J. y Smith, E. (2020). Psychological outcomes following surgical and endoscopic bariatric procedures: a systematic review. Obesity Reviews, 21(6), e12998. https://doi.org/10.1111/obr.12998
Steinbrook, R. (2004). Surgery for Severe Obesity. New England Journal of Medicine, 350(11), 1075-1079. https://doi.org/10.1056/nejmp048029
Stunkard, A. y Allison, K. (2003). Two forms of disordered eating in obesity: binge eating and night eating. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity, 27(1), 1-12. https://doi.org/10.1038/sj.ijo.0802186
Troconis Mariemma, A.; Ferro de Millán, M.; Seijas Delgado, M. (2013). Primer consenso venezolano de Tratamiento del Paciente Bariátrico. Tomo 1. Nutrición y Psicología. Carcas: Ateproca.
Ugarte, C. (2019). Variables psicológicas y predicción del éxito y fracaso en pacientes sometidos a cirugía bariátrica. Universidad de Concepción ,Chile.
Ugarte, C., Quiñonez, A., Vicente, B. (2019). Predictores psicológicos de la re-ganancia del peso en pacientes bariátricos. Sociedad Chilena de Psicología Clínica 37(3), 199–209. http://dx.doi.org/10.4067/S0718-48082019000300199
Van de Laar, A., van Rijswijk, A., Kakas, H. y Bruin, S. (2018). Sensitivity and Specificity of 50% Excess Weight Loss (50%EWL) and Twelve Other Bariatric Criteria for Weight Loss Success. Obesity Surgery, 28, 2297- 2304. https://doi.org/10.1007/s11695-018-3173-4
Watson, C., Riazi, A., Ratcliffe, D. (2020). Exploring the Experiences of Women Who Develop Restrictive Eating Behaviours After Bariatric Surgery. Obesity Surgery, 30(6), 2131-2139. https:// doi.org/10.1007/s11695-020-04424-4
Williams-Kerver, G. A., Steffen, K. J., Smith, K. E., Cao, L., Crosby, R. D. y Engel, S. G. (2020). Negative Affect and Loss of Control Eating Among Bariatric Surgery Patients: an Ecological Momentary Assessment Pilot Investigation. Obesity Surgery, 30(6), 2382-2387. https://doi.org/10.1007/s11695-020-04503-6
World Obesity Federation, (2023). World Obesity Atlas 2023. https://data.worldobesity.org/publications/?cat=19
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