Browsing by Author "Surwit, Richard"
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Item Open Access Postoperative Depression, Eating Behaviors, and Physical Activity as Indicators of Weight Loss in Gastric Bypass Patients(2014) Martinez, Erin ElenaBackground: Bariatric surgery produces marked weight loss and improvement in comorbid health conditions among individuals with Class II or Class III obesity (Class I = 30.0 ≤ BMI ≤ 34.9kg/m2; Class II = 35.0 ≤ BMI ≥ 39.9kg/m2; Class III = BMI ≥ 40 kg/m2). However, suboptimal weight outcomes occur in a significant minority of patients. Evidence suggests that psychological and behavioral factors might affect weight loss, but most of the literature has focused on preoperative factors, with mixed results. The current study tested the hypothesis that postoperative depressive symptoms, eating behaviors, and lower levels of physical activity would be associated with poorer weight loss outcomes. Method: Preoperative data were obtained from an extant clinical database, and postoperative data were collected via a mail or online questionnaire in a sample of 141 female Roux-en-y gastric bypass (RYGB) patients at an average of 16.80 (SD=2.20) months post-surgery. Self-report measures assessed cognitive-affective and somatic symptoms of depression; binge eating, grazing, night eating, distress about overeating or loss of control over eating; and physical activity. Results: Weight outcome measures were defined as percentage of excess BMI loss (%EBMIL) and successful weight loss (≥ 50% EBMIL). Higher distress was associated with poorer %EBMIL, and higher level of physical activity was associated with greater %EBMIL. Decreased cognitive-affective symptoms and increased somatic symptoms of depression were associated with a higher probability of successful weight loss. Increased somatic complaints predicted greater %EBMIL unless those symptoms were associated with higher sedentary behavior. Conclusions: Consistent with hypotheses, preoperative depressive symptoms and binge eating disorder did not predict weight loss. Aspects of all three postoperative domains were associated with weight outcomes. Future research should explore the relations among these psychological and behavioral factors and weight loss over a longer follow-up period.
Item Open Access The Characteristics of Depressive Subtypes among Adolescents and Their Role in the Relationship between Weight and Depression(2009) Connell, Alexa JoyFor several decades, researchers have sought to fully understand the nature of the relationship between depression and weight. To date, the research in this area has yielded highly inconsistent results, with some identifying null (Crumpton, Wine, & Groot, 1966; Moore, Stunkard, & Srole, 1962), positive (R. E. Roberts, Kaplan, Shema, & Strawbridge, 2000), negative (Silverstone, 1968; Simon, 1963) and gender specific relationships (DiPietro, Anda, Williamson, & Stunkard, 1992; Istvan, Savela, & Weidner, 1992; Onyike, Crum, Lee, Lyketsos, & Eaton, 2003). The author suggests that these inconsistencies can be explained by the use of measures of depression used which do not differentiate between various subtypes of depression associated with divergent somatic symptoms; including atypical depression (AD) and melancholic depression (MD). Adolescence may be an important intervention point to avert adult obesity and identification of subtypes may identify those at greatest risk. Yet, the characteristics of depression subtypes among adolescents are unknown. In order to identify subtypes of depression among adolescents that are differentially associated with weight, Latent Class Analysis (LCA) was conducted and resulting classes were tested for associations with weight. Six latent classes were identified. Four were uniquely associated with somatic symptoms including hyper- and hypophagia, suggesting that somatic symptoms play an important role in the distinction between depressive subtypes. Analyses showed an association with BMI for the 2 hyperphagic classes but not for the 2 hypophagic classes. The inclusion of depression class improved the fit of regression models for depression predicting BMI. This suggests that the inclusion of depression subtype in analyses may clarify the association between weight and depression.