Obesity surgery and eating and weight disorders: a new topical collection of EWD
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EDITORIAL
Obesity surgery and eating and weight disorders: a new topical collection of EWD Gianfranco Silecchia1 Received: 19 May 2020 / Accepted: 19 May 2020 © Springer Nature Switzerland AG 2020
Keywords Obesity surgery · Metabolic surgery · Eating and weight disorders It is a pleasure and honor to accept the invitation of the Editor-in-chief to introduce and to launch the new topical collection on obesity surgery and eating and weight disorders. Bariatric/metabolic surgery represents the most effective therapeutic modality for morbid obesity and related major co-morbidities with long-term results, including sustained weight loss and co-morbidities control/remission. Metabolic surgery achieves reduction of the mortality rate (45%), cardiovascular events (65%) and DMT2 (60%) [1–5]. However, the way out from morbid obesity (chronic disease) also for the bariatric population is not easy. Three steps are crucial for favorable long-term outcomes: 1. patients selection (multidisciplinary team involvement mandatory) 2. intensive peri-operative period monitoring (1–3 months) 3. end of bariatric surgery “honeymoon” (1–2 years) and risk of follow-up dropout and weight regain. There is a worldwide agreement on the essential role of the multidisciplinary team (obesiologist, endocrinologist, cardiologist, pneumologist, psychologist, registered dietician and bariatric surgeon) in the weight loss program. Moreover, in a bariatric surgical center, it is mandatory the “permanent” support by a nutritionist /registered dietician and a psychologist or, when appropriate, a psychiatrist. The multidisciplinary management is advocated to guarantee the best long-term outcomes after all the different bariatric procedures. * Gianfranco Silecchia [email protected] 1
Department of Medico‑Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, Corso della repubblica 79, 040100 Latina, Italy
The perioperative period is a “critical zone” and the psychological events are often under-evaluated: reactions to the loss of food, regrets having surgery, relationship changes, fear of weight regain, addiction transfer such as alcohol abuse. After that, several studies reported maladaptive eating behaviors after bariatric surgery that may contribute to weight regain. The diagnosis and management of new-onset disordered eating behaviors after metabolic/bariatric surgery represent a new field of multidisciplinary research. There is a highlight on the increasing evidence of new eating and psychological disorders in the subset of bariatric patients. The bariatric surgery represents a new model for the gastrointestinal physiology and a potential pandora box of eating patterns and disorders. Insufficient weight loss and weight regain are reported by up to 25–30% after bariatric surgery [4]. Guidelines for multidisciplinary management and robust evidence on management are lacking and offer an opportunity for future research. The patients require an “alliance” among the professionals involved i
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