World J Gastroenterol 26(20): 2632-2644

PMC: PMC7265144

PMID: 32523316

Anhedonia and functional dyspepsia in obese patients: Relationship with binge eating behaviour

Antonella Santonicola

Antonella Santonicola, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy;

Contributor Information.

Author contributions: Santonicola A and Iovino P designed research; Asparago G, Carpinelli L, Angrisani L collected the data and revised the paper. Santonicola A and Iovino P analyzed data; Santonicola A, Iovino P and Gagliardi M wrote the paper.

Corresponding author: Paola Iovino, MD, Associate Professor, Department of Medicine, Surgery and Dentistry Scuola Medica Salernitana, University of Salerno, S Allende, Baronissi 84081, Salerno, Italy. ti.asinu@onivoip

Received 2019 Dec 31; Revised 2020 May 9; Accepted 2020 May 16.

This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

Abstract

BACKGROUND

Obese patients (Ob) with a binge eating disorders (BED) behavior pattern have a higher prevalence of postprandial distress syndrome (PDS) compared to Ob without a BED behavior pattern, while an increase of PDS has been described in Ob after sleeve gastrectomy (SG). Hedonic response to a meal is dissociable from satiation in healthy subjects. Anhedonia is the lowered ability to experience pleasure. There are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS symptoms.

AIM

To assess the relationship among anhedonia, BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without SG.

METHODS

Eighty-one Ob without SG, 45 Ob with SG and 55 healthy controls (HC) were studied. All subjects fulfilled the binge eating scale (BES) to investigate BED, the validated 14 items Snaith-Hamilton pleasure scale (SHAPS) to assess Anhedonia as well as the Beck Depression Inventory-II (BDI II) and State Trait Anxiety Inventory (STAI) questionnaires to screen for depression and anxiety. All patients underwent a standardized questionnaire investigating the intensity-frequency scores (0-6) of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia (FD) and its subtypes according to ROME IV criteria.

RESULTS

Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED (OR: 4.7; 95.0%CI 1.23-18.24; P = 0.02). STAI-Y2 scores were significantly higher in Ob without SG positive for BED (42.2 ± 1.5 vs Ob negative for BED: 39.6 ± 1 .0, P = 0.04), while SHAPS scores and BDI II did not differ in the two groups (1.16 ± 1.30 vs 0.89 ± 1.02, P = 0.49). A lower prevalence of BED (BES > 17: 11.4% vs 40.7%, P = 0.001) and BDI-II (6.8 ± 1.2 vs 13.8 ± 1.9, P = 0.005) was reported in Ob with SG than Ob without SG, on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without SG. Thirty-five percent of Ob with SG fulfilled the diagnosis of FD. SHAPS mean scores and the prevalence of anhedonia did not differ among the two groups (18.2 vs 8.1%, P = 0.2). Fifty-four percent of Ob with SG achieved surgical success excess weight loss > 50%. Excess weight loss was negatively related to SHAPS total mean scores [adjusted B: -7. 099 (95%CI: -13.91 to -0.29), P = 0.04].

CONCLUSION

Ob without SG showed a higher prevalence of PDS, mood disorders and anxiety when positive for BE behavior compared to those negative for BE behavior, whereas no differences were found in SHAPS score. Ob with SG showed a higher prevalence of PDS compared to Ob without SG. Concerning psychological aspect, BED and depression are less frequent in the Ob with SG, while both state and trait anxiety are significantly higher. Moreover, the more an Ob with SG is anhedonic, less surgical success was achieved.

Keywords: Morbid obesity, Functional dyspepsia, Postprandial distress syndrome, Epigastric pain syndrome, Anhedonia, Binge eating disorders, Sleeve gastrectomy

Core tip: Binge eating disorders (BED) co-occur with mood disorders and anxiety, whereas the relationship with anhedonia in obese patients undergoing sleeve gastrectomy (SG) is not known. We studied two group of morbidly obese patients with and without SG to assess the relationships among anhedonia, BED and functional dyspepsia. Our results suggest that a more regular screening for functional dyspepsia in SG candidates might help to disclose the presence of BED that may jeopardize postsurgical outcomes. Although anhedonia was not associated with BED in this study, worse surgical outcome was observed in patients with anhedonia independent of early satiety and postprandial fullness.

Data are expressed as percentage (%) or as mean ± SE.

Data were expressed as mean ± SE. BED: Binge eating disorders; Ob: Obese patients; SG: Sleeve gastrectomy.

Data are expressed as percentage (%) or as mean ± SE. M: Male; F: Female; BMI: Body mass index; WL: Weight loss; EWL: Excess weight loss; Ob: Obese patients; SG: Sleeve gastrectomy.

Data are expressed as mean ± SE.

Footnotes

Institutional review board statement: The study received Ethics Committee approval and was conducted in accordance with the principles of the Declaration of Helsinki and good clinical practice.

Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest statement: The authors have no proprietary, financial, professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of this manuscript.

Manuscript source: Invited manuscript

Peer-review started: December 31, 2019

First decision: April 25, 2020

Article in press: May 16, 2020

Specialty type: Gastroenterology and hepatology

Country/Territory of origin: Italy

Peer-review report’s scientific quality classification

Grade A (Excellent): 0

Grade B (Very good): B

Grade C (Good): 0

Grade D (Fair): 0

Grade E (Poor): 0

P-Reviewer: Chiarioni G S-Editor: Wang J L-Editor: A E-Editor: Liu MY

Contributor Information

Antonella Santonicola, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy.

Mario Gagliardi, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy.

Giovanni Asparago, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy.

Luna Carpinelli, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy.

Luigi Angrisani, General and Endoscopic Surgery Unit, San Giovanni Bosco Hospital, Naples 80100, Italy.

Paola Iovino, Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Baronissi 84081, Salerno, Italy. ti.asinu@onivoip..

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