TY - JOUR
T1 - A modified inpatient eating disorders treatment protocol for postbariatric surgery patients
T2 - patient characteristics and treatment response
AU - Schreyer, Colleen C.
AU - Guarda, Angela S.
AU - Pletch, Allisyn W.
AU - Redgrave, Graham W.
AU - Salwen-Deremer, Jessica K.
AU - Coughlin, Janelle W.
N1 - Publisher Copyright:
© 2019 American Society for Bariatric Surgery
PY - 2019/9
Y1 - 2019/9
N2 - Background: Bariatric surgery is currently the most effective treatment for obesity. However, outcomes vary and disordered eating may persist or emerge postsurgically. Severe postsurgical eating disorders may require inpatient treatment, and guidelines for the modification of inpatient nutritional treatment protocols for this population are lacking. Objectives: This paper describes a modified inpatient nutritional protocol for postsurgical patients with eating disorders treated on a behavioral eating disorders unit, and reports patient characteristics and treatment response. Settings: This research was conducted at a university hospital. Methods: Cases (n = 19) comprised 2% of all eating disorder admissions; 5 were underweight and required weight restoration. Clinical data collected via chart review included disordered eating behaviors, medical and psychiatric co-morbidity, and treatment course. Results: All cases were status post Roux-en-Y gastric bypass (median 5 yr postsurgery). Onset of disordered eating preceded surgery in the majority, and intentional vomiting was the most commonly reported postsurgical disordered eating behavior. The sample was notable for a high level of psychiatric and medical co-morbidity. Patients responded well to the modified treatment protocols, with a majority of patients on the weight gain (60%) and weight maintenance (78%) post-bariatric surgery protocols discharged for clinical improvement. Conclusions: Postsurgical bariatric patients with eating disorders can be successfully treated on a specialized eating disorders unit. Modification of inpatient eating disorder protocols for those who have undergone bariatric surgery is necessary to address the different physiologic needs of this patient population while providing them with effective psychiatric care.
AB - Background: Bariatric surgery is currently the most effective treatment for obesity. However, outcomes vary and disordered eating may persist or emerge postsurgically. Severe postsurgical eating disorders may require inpatient treatment, and guidelines for the modification of inpatient nutritional treatment protocols for this population are lacking. Objectives: This paper describes a modified inpatient nutritional protocol for postsurgical patients with eating disorders treated on a behavioral eating disorders unit, and reports patient characteristics and treatment response. Settings: This research was conducted at a university hospital. Methods: Cases (n = 19) comprised 2% of all eating disorder admissions; 5 were underweight and required weight restoration. Clinical data collected via chart review included disordered eating behaviors, medical and psychiatric co-morbidity, and treatment course. Results: All cases were status post Roux-en-Y gastric bypass (median 5 yr postsurgery). Onset of disordered eating preceded surgery in the majority, and intentional vomiting was the most commonly reported postsurgical disordered eating behavior. The sample was notable for a high level of psychiatric and medical co-morbidity. Patients responded well to the modified treatment protocols, with a majority of patients on the weight gain (60%) and weight maintenance (78%) post-bariatric surgery protocols discharged for clinical improvement. Conclusions: Postsurgical bariatric patients with eating disorders can be successfully treated on a specialized eating disorders unit. Modification of inpatient eating disorder protocols for those who have undergone bariatric surgery is necessary to address the different physiologic needs of this patient population while providing them with effective psychiatric care.
KW - Bariatric surgery
KW - Behavioral protocol
KW - Eating disorders
KW - Inpatient treatment
KW - Nutritional rehabilitation
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U2 - 10.1016/j.soard.2019.06.042
DO - 10.1016/j.soard.2019.06.042
M3 - Article
C2 - 31439529
AN - SCOPUS:85070754791
SN - 1550-7289
VL - 15
SP - 1612
EP - 1619
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 9
ER -