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Development of significant disordered eating in an adolescent following gastric bypass surgery

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Abstract

The development of eating pathology is a concern following bariatric surgery, even in the absence of any pre-surgical psychopathology. No consistent risk factors have emerged in the literature to identify those at greatest risk. However, post-surgical guidelines encourage eating behaviors that would be considered disordered in other contexts. We present a case of an adolescent developing bulimia nervosa following gastric bypass surgery and the escalation of her symptoms from diligently following recommended food behaviors to a full-syndrome clinical eating disorder. We discuss the differences between appropriate post-surgical eating behaviors and disordered eating behaviors. We provide recommendations for clinicians to screen for eating pathology and referrals to an interprofessional treatment team to address eating disordered behaviors and cognitions.

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References

  1. Ogden CL, Carroll MD, Kit BK, Flegal KM (2012) Prevalence of obesity and trends in body mass index among US children and adolescents, 1999–2010. JAMA 307(5):483–490. doi:10.1001/jama.2012.40

    Article  PubMed  Google Scholar 

  2. Kelly AS, Barlow SE, Rao G, Inge TH, Hayman LL, Steinberger J, Urbina EM, Ewing LJ, Daniels SR, American Heart Association, Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young, Council on Nutrition, Physical Activity and Metabolism, and Council on Clinical Cardiology (2013) Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association. Circulation 128(15):1689–1712. doi:10.1161/CIR.0b013e3182a5cfb3

    Article  PubMed  Google Scholar 

  3. Inge Thomas H, Zeller Meg, Harmon Carroll et al (2007) Teen-longitudinal assessment of bariatric surgery (teen-labs): methodologic features of the first prospective multicenter study of adolescent bariatric surgery. J Pediatr Surg 42(11):1969–1971. doi:10.1016/j.jpedsurg.2007.08.010

    Article  PubMed  PubMed Central  Google Scholar 

  4. Olbers T, Gronowitz E, Werling M, Mårlid S, Flodmark CE, Peltonen M, Göthberg G, Karlsson J, Ekbom K, Sjöström LV, Dahlgren J, Lönroth H, Friberg P, Marcus C (2012) Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS). Int J Obes (Lond) 36(11):1388–1395. doi:10.1038/ijo.2012.160

    Article  CAS  Google Scholar 

  5. Inge TH, Jenkins TM, Zeller M, Dolan L, Daniels SR, Garcia VF, Brandt ML, Bean J, Gamm K, Xanthakos SA (2010) Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. J Pediatr 156(1):103–108e1. doi:10.1016/j.jpeds.2009.07.028

    Article  PubMed  PubMed Central  Google Scholar 

  6. Vanhala M, Vanhala P, Kumpusalo E, Halonen P, Takala J (1998) Relation between obesity from childhood to adulthood and the metabolic syndrome: population based study. BMJ 317(7154):319. doi:10.1136/bmj.317.7154.319

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH (1997) Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med 337(13):869–873. doi:10.1056/NEJM199709253371301

    Article  CAS  PubMed  Google Scholar 

  8. Garcia VF, DeMaria EJ (2006) Adolescent bariatric surgery: treatment delayed, treatment denied, a crisis invited. Obes Surg 16(1):1–4. doi:10.1381/096089206775222195

    Article  PubMed  Google Scholar 

  9. Inge TH (2006) Bariatric surgery for morbidly obese adolescents: is there a rationale for early intervention? Growth Horm IGF Res 16 Suppl A:S15–S19. doi:10.1016/j.ghir.2006.03.013

    Article  PubMed  Google Scholar 

  10. Beck NN, Mehlsen M, Stoving RK (2012) Psychological characteristics and associations with weight outcomes two years after gastric bypass surgery: postoperative eating disorder symptoms are associated with weight loss outcomes. Eat Behav 13(4):394–397. doi:10.1016/j.eatbeh.2012.06.001

    Article  PubMed  Google Scholar 

  11. Ozier AD, Henry BW (2011) Position of the American Dietetic Association: nutrition intervention in the treatment of eating disorders. J Am Diet Assoc 111(8):1236–1241. doi:10.1016/j.jada.2011.06.016

    Article  PubMed  Google Scholar 

  12. de Man Lapidoth J, Ghaderi A, Norring C (2011) Binge eating in surgical weight-loss treatments. Long-term associations with weight loss, health related quality of life (HRQL), and psychopathology. Eat Weight Disord 16(4):e263–e269. doi:10.1007/BF03327470

    Article  CAS  PubMed  Google Scholar 

  13. Michalsky M, Reichard K, Inge T, Pratt J, Lenders C (2011) ASMBS pediatric committee best practice guidelines. Surg Obes Relat Dis 8(1):1–7. doi:10.1016/j.soard.2011.09.009

    Article  PubMed  Google Scholar 

  14. Segal A, Kussunoki DK, Larino MA (2004) Post-surgical refusal to eat: anorexia nervosa, bulimia nervosa or a new eating disorder? A case series. Obes Surg 14(3):353–360. doi:10.1381/096089204322917882

    Article  PubMed  Google Scholar 

  15. Conceicao E, Orcutt M, Mitchell J, Engel S, Lahaise K, Jorgensen M et al (2012) Eating disorders after bariatric surgery: a case series. Int J Eat Disord. doi:10.1002/eat.22074

    PubMed  PubMed Central  Google Scholar 

  16. Marino JM, Ertelt TW, Lancaster K, Steffen K, Peterson L, de Zwaan M et al (2012) The emergence of eating pathology after bariatric surgery: a rare outcome with important clinical implications. Int J Eat Disord 45(2):179–184. doi:10.1002/eat.20891

    Article  PubMed  Google Scholar 

  17. Campbell K, Peebles R (2014) Eating disorders in children and adolescents: state of the art review. Pediatrics 134(3):582–592. doi:10.1542/peds.2014-0194

    Article  PubMed  Google Scholar 

  18. Croll J, Neumark-Sztainer D, Story M, Ireland M (2002) Prevalence and risk and protective factors related to disordered eating behaviors among adolescents: relationship to gender and ethnicity. J Adolesc Health 31(2):166–175. doi:10.1016/S1054-139X(02)00368-3

    Article  PubMed  Google Scholar 

  19. Villarejo C, Fernández-Aranda F, Jiménez-Murcia S, Peñas-Lledó E, Granero R, Penelo E, Tinahones FJ, Sancho C, Vilarrasa N, Montserrat-Gil de Bernabé M, Casanueva FF, Fernández-Real JM, Frühbeck G, De la Torre R, Treasure J, Botella C, Menchón JM (2012) Lifetime obesity in patients with eating disorders: increasing prevalence, clinical and personality correlates. Eur Eat Disord Rev 20(3):250–254. doi:10.1002/erv.2166

    Article  PubMed  PubMed Central  Google Scholar 

  20. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, DSM-5, 5th edn. American Psychiatric Publishing, Arlington, VA

  21. Crisp A, Hsu L, Harding B, Hartshorn J (1980) Clinical features of anorexia nervosa: a study of a consecutive series of 102 female patients. J Psychosom Res 24:179–191. doi:10.1016/0022-3999(80)90040-9

    Article  CAS  PubMed  Google Scholar 

  22. Aills L, Blankenship J, Buffington C, Furtado M, Parrott J (2008) ASMBS allied health nutritional guidelines for the surgical weight loss patient. Surg Obes Relat Dis 4(5 Suppl):S73–S108. doi:10.1016/j.soard.2008.03.002

    Article  PubMed  Google Scholar 

  23. Fairburn CG, Beglin SJ (1994) Assessment of eating disorders: interview or self-report questionnaire? Int J Eat Disord 16(4):363–370

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Behavioral Medicine and Psychiatry, West Virginia University, Charleston, WV, USA

    Stephen B. Sondike, Emily M. Pisetsky & Jessica L. Luzier

  2. Charleston Area Medical Center, Charleston, WV, USA

    Stephen B. Sondike, Emily M. Pisetsky & Jessica L. Luzier

  3. Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA

    Emily M. Pisetsky

  4. Department of Pediatrics, West Virginia University School of Medicine, 830 Pennsylvania Avenue, Suite 103, Charleston, WV, 25302, USA

    Stephen B. Sondike

Authors
  1. Stephen B. Sondike
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  2. Emily M. Pisetsky
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  3. Jessica L. Luzier
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Correspondence to Stephen B. Sondike.

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The authors report no conflicts of interest.

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All procedures performed in studies involving the patient in the case report were performed in accordance with the ethical standards of our institutional research board and are in compliance with national and international standards.

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The patient in the case study provided signed informed consent which is available in the electronic medical record.

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Sondike, S.B., Pisetsky, E.M. & Luzier, J.L. Development of significant disordered eating in an adolescent following gastric bypass surgery. Eat Weight Disord 21, 133–136 (2016). https://doi.org/10.1007/s40519-015-0230-z

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  • DOI: https://doi.org/10.1007/s40519-015-0230-z

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