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Physical Activity, Decision-Making Abilities, and Eating Disturbances in Pre- and Postbariatric Surgery Patients

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An Erratum to this article was published on 14 September 2016

Abstract

Background

Physical activity (PA) is considered to have a beneficial influence on executive functioning, including decision-making. Enhanced decision-making after bariatric surgery may strengthen patients’ ability to delay gratification, helping to establish appropriate eating behavior. The objectives of this study were to (1) compare a preoperative group with a postoperative group with regard to daily PA, decision-making, and eating disturbances; and (2) investigate the relationship between these variables.

Methods

The study included 71 bariatric surgery candidates (55 % women, BMI [kg/m2] M = 46.9, SD = 6.0) and 73 postoperative patients (57 % women, BMI M = 32.0, SD = 4.1; 89 % Roux-en-Y gastric bypass, 11 % sleeve gastrectomy; months postoperative M = 8.2, SD = 3.5; total weight loss [%] M = 33.2, SD = 8.9) who completed SenseWear Pro2 activity monitoring. Decision-making was assessed using a computerized version of the Iowa Gambling Task and eating disorder psychopathology using the Eating Disorder Examination-Questionnaire.

Results

The number of patients who were classified as physically inactive was similarly high in the pre- and postoperative groups. No group differences emerged with regard to decision-making, but the postoperative group exhibited less eating disturbances than the preoperative group. No significant associations were found between PA, decision-making, and eating behavior.

Conclusions

Patients after bariatric surgery were not more physically active than bariatric surgery candidates, which should be considered in care programs. Additionally, future research is needed to explore the possible link between PA, patients’ decision-making abilities, and eating disturbances concerning dose-response questions.

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References

  1. Bond DS, Unick JL, Jakicic JM, et al. Objective assessment of time spent being sedentary in bariatric surgery candidates. Obes Surg. 2011;21:811–4.

    Article  PubMed  PubMed Central  Google Scholar 

  2. King WC, Belle SH, Eid GM, et al. Physical activity levels of patients undergoing bariatric surgery in the Longitudinal Assessment of Bariatric Surgery study. Surg Obes Relat Dis. 2008;4:721–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Bond DS, Jakicic JM, Vithiananthan S, et al. Objective quantification of physical activity in bariatric surgery candidates and normal-weight controls. Surg Obes Relat Dis. 2010;6:72–8.

    Article  PubMed  Google Scholar 

  4. King WC, Chen JY, Bond DS, et al. Objective assessment of changes in physical activity and sedentary behavior: pre- through 3 years post-bariatric surgery. Obesity. 2015;23:1143–50.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lokken KL, Boeka AG, Yellumahanthi K, et al. Cognitive performance of morbidly obese patients seeking bariatric surgery. Am Surg. 2010;76:55–9.

    PubMed  Google Scholar 

  6. Votruba K, Marshall D, Finks J, et al. Neuropsychological factors and bariatric surgery: a review. Curr Psychiatry Rep. 2014;16:448.

    Article  PubMed  Google Scholar 

  7. Kiunke W, Brandl C, Georgiadou E, et al. Performance in neurocognitive tasks in obese patients. Does somatic comorbidity matter? Front Psychiatry. 2013;4:84.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Spitznagel MB, Hawkins M, Alosco M, et al. Neurocognitive effects of obesity and bariatric surgery. Eur Eat Disord Rev. 2015;23:488–95.

    Article  PubMed  Google Scholar 

  9. Lipnicki DM, Gunga HC. Physical inactivity and cognitive functioning: results from bed rest studies. Eur J Appl Physiol. 2009;105:27–35.

    Article  PubMed  Google Scholar 

  10. Lipnicki DM, Gunga HC, Belavy DL, et al. Decision making after 50 days of simulated weightlessness. Brain Res. 2009;1280:84–9.

    Article  CAS  PubMed  Google Scholar 

  11. Smith PJ, Potter GG, McLaren ME, et al. Impact of aerobic exercise on neurobehavioral outcomes. Ment Health Physical Act. 2013;6:139–53.

    Article  Google Scholar 

  12. Voelcker-Rehage C, Niemann C. Structural and functional brain changes related to different types of physical activity across the life span. Neurosci Biobehav Rev. 2013;37:2268–95.

    Article  PubMed  Google Scholar 

  13. Galioto R, King WC, Bond DS, et al. Physical activity and cognitive function in bariatric surgery candidates. Int J Neurosci. 2014;124:912–8.

    Article  PubMed  Google Scholar 

  14. Langenberg S, Schulze M, Bartsch M, et al. Physical activity is unrelated to cognitive performance in pre-bariatric surgery patients. J Psychosom Res. 2015;79:165–70.

    Article  PubMed  Google Scholar 

  15. Runkel N, Colombo-Benkmann M, Huttl TP, et al. Evidence-based German guidelines for surgery for obesity. Int J Color Dis. 2011;26:397–404.

    Article  Google Scholar 

  16. Jacobi D, Ciangura C, Couet C, et al. Physical activity and weight loss following bariatric surgery. Obes Rev. 2011;12:366–77.

    Article  CAS  PubMed  Google Scholar 

  17. Vatier C, Henegar C, Ciangura C, et al. Dynamic relations between sedentary behavior, physical activity, and body composition after bariatric surgery. Obes Surg. 2012;22:1251–6.

    Article  PubMed  Google Scholar 

  18. Bond DS, Phelan S, Wolfe LG, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obesity. 2009;17:78–83.

    Article  PubMed  Google Scholar 

  19. Rosenberger PH, Henderson KE, White MA, et al. Physical activity in gastric bypass patients: associations with weight loss and psychosocial functioning at 12-month follow-up. Obes Surg. 2011;21:1564–9.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Wouters EJ, Larsen JK, Zijlstra H, et al. Physical activity after surgery for severe obesity: the role of exercise cognitions. Obes Surg. 2011;21:1894–9.

    Article  PubMed  Google Scholar 

  21. Bond DS, Jakicic JM, Unick JL, et al. Pre- to postoperative physical activity changes in bariatric surgery patients: self report vs. objective measures. Obesity. 2010;18:2395–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Berglind D, Willmer M, Eriksson U, et al. Longitudinal assessment of physical activity in women undergoing Roux-en-Y gastric bypass. Obes Surg. 2015;25:119–25.

    Article  PubMed  Google Scholar 

  23. King WC, Hsu JY, Belle SH, et al. Pre- to postoperative changes in physical activity: report from the longitudinal assessment of bariatric surgery-2 (LABS-2). Surg Obes Relat Dis. 2012;8:522–32.

    Article  PubMed  Google Scholar 

  24. Alosco ML, Galioto R, Spitznagel MB, et al. Cognitive function after bariatric surgery: evidence for improvement 3 years after surgery. Am J Surg. 2014;207:870–6.

    Article  PubMed  Google Scholar 

  25. Miller LA, Crosby RD, Galioto R, et al. Bariatric surgery patients exhibit improved memory function 12 months postoperatively. Obes Surg. 2013;23:1527–35.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Georgiadou E, Gruner-Labitzke K, Kohler H, et al. Cognitive function and nonfood-related impulsivity in post-bariatric surgery patients. Front Psychol. 2014;5:1502.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Galioto R, Gunstad J, Heinberg LJ, et al. Adherence and weight loss outcomes in bariatric surgery: does cognitive function play a role? Obes Surg. 2013;23:1703–10.

    Article  PubMed  Google Scholar 

  28. Spitznagel MB, Galioto R, Limbach K, et al. Cognitive function is linked to adherence to bariatric postoperative guidelines. Surg Obes Relat Dis. 2013;9:580–5.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Joseph RJ, Alonso-Alonso M, Bond DS, et al. The neurocognitive connection between physical activity and eating behaviour. Obes Rev. 2011;12:800–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. He Q, Xiao L, Xue G, et al. Poor ability to resist tempting calorie rich food is linked to altered balance between neural systems involved in urge and self-control. Nutr J. 2014;13:92.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Koritzky G, Dieterle C, Rice C, et al. Decision-making, sensitivity to reward and attrition in weight management. Obesity. 2014;22:1904–9.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Muller A, Brandl C, Kiunke W, et al. Food-independent tendency to disadvantageous decisions in obese individuals with regular binge eating. Compr Psychiatry. 2014;55:64–70.

    Article  PubMed  Google Scholar 

  33. Niemeier HM, Phelan S, Fava JL, et al. Internal disinhibition predicts weight regain following weight loss and weight loss maintenance. Obesity. 2007;15:2485–94.

    Article  PubMed  Google Scholar 

  34. Hall PA. Executive control resources and frequency of fatty food consumption: findings from an age-stratified community sample. Health Psychol. 2012;31:235–41.

    Article  PubMed  Google Scholar 

  35. Annesi JJ, Porter KJ. Behavioural support of a proposed neurocognitive connection between physical activity and improved eating behaviour in obese women. Obes Res Clin Pract. 2014;8:e325–30.

    Article  PubMed  Google Scholar 

  36. Lowe CJ, Hall PA, Vincent CM, et al. The effects of acute aerobic activity on cognition and cross-domain transfer to eating behavior. Front Hum Neurosci. 2014;8:267.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Deitel M, Greenstein RJ. Recommendations for reporting weight loss. Obes Surg. 2003;13:159–60.

    Article  PubMed  Google Scholar 

  38. Heil DP, Brage S, Rothney MP. Modeling physical activity outcomes from wearable monitors. Med Sci Sports Exerc. 2012;44:S50–60.

    Article  PubMed  Google Scholar 

  39. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(11 Suppl):S531–43.

    Article  PubMed  Google Scholar 

  40. Tudor-Locke C, Leonardi C, Johnson WD, et al. Accelerometer steps/day translation of moderate-to-vigorous activity. Prev Med. 2011;53:31–3.

    Article  PubMed  Google Scholar 

  41. Bechara A, Damasio AR, Damasio H, et al. Insensitivity to future consequences following damage to human prefrontal cortex. Cognition. 1994;50:7–15.

    Article  CAS  PubMed  Google Scholar 

  42. Hilbert A, Tuschen-Caffier B. Eating disorder examination-questionnaire. Deutsche Übersetzung. Münster: Verlag für Psychotherapie 2006.

  43. Hilbert A, de Zwaan M, Braehler E. How frequent are eating disturbances in the population? Norms of the eating disorder examination-questionnaire. PLoS ONE. 2012;7:e29125.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Rock PL, Roiser JP, Riedel WJ, et al. Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med. 2014;44:2029–40.

    Article  CAS  PubMed  Google Scholar 

  45. van den Berg E, Kloppenborg RP, Kessels RP, et al. Type 2 diabetes mellitus, hypertension, dyslipidemia and obesity: a systematic comparison of their impact on cognition. Biochim Biophys Acta. 1792;2009:470–81.

    Google Scholar 

  46. Helgadottir B, Forsell Y, Ekblom O. Physical activity patterns of people affected by depressive and anxiety disorders as measured by accelerometers: a cross-sectional study. PLoS ONE. 2015;10:e0115894.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Strine TW, Mokdad AH, Dube SR, et al. The association of depression and anxiety with obesity and unhealthy behaviors among community-dwelling US adults. Gen Hosp Psychiatry. 2008;30:127–37.

    Article  PubMed  Google Scholar 

  48. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Gilbody S, Richards D, Brealey S, et al. Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. J Gen Intern Med. 2007;22:1596–602.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Meany G, Conceicao E, Mitchell JE. Binge eating, binge eating disorder and loss of control eating: effects on weight outcomes after bariatric surgery. Eur Eat Disord Rev. 2014;22:87–91.

    Article  PubMed  PubMed Central  Google Scholar 

  51. White MA, Kalarchian MA, Masheb RM, et al. Loss of control over eating predicts outcomes in bariatric surgery patients: a prospective, 24-month follow-up study. J Clin Psychiatry. 2010;71:175–84.

    Article  PubMed  Google Scholar 

  52. Burgmer R, Legenbauer T, Muller A, et al. Psychological outcome 4 years after restrictive bariatric surgery. Obes Surg. 2014;24:1670–8.

    Article  PubMed  Google Scholar 

  53. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273:219–34.

    Article  CAS  PubMed  Google Scholar 

  54. Niego SH, Kofman MD, Weiss JJ, et al. Binge eating in the bariatric surgery population: a review of the literature. Int J Eating Disord. 2007;40:349–59.

    Article  Google Scholar 

  55. Coluzzi I, Raparelli L, Guarnacci L, et al. Food intake and changes in eating behavior after laparoscopic sleeve gastrectomy. Obes Surg. 2016. Jan 7.

  56. Wicker P, Frick B. The relationship between intensity and duration of physical activity and subjective well-being. Eur J Pub Health. 2015;25:868–72.

    Article  Google Scholar 

  57. Xu L, Jiang CQ, Lam TH, et al. Dose-response relation between physical activity and cognitive function: Guangzhou biobank cohort study. Ann Epidemiol. 2011;21:857–63.

    Article  CAS  PubMed  Google Scholar 

  58. Baillot A, Asselin M, Comeau E, et al. Impact of excess skin from massive weight loss on the practice of physical activity in women. Obes Surg. 2013;23:1826–34.

    Article  CAS  PubMed  Google Scholar 

  59. Zabatiero J, Hill K, Gucciardi DF, et al. Beliefs, barriers and facilitators to physical activity in bariatric surgery candidates. Obes Surg. 2016;26(5):1097–109.

    Article  PubMed  Google Scholar 

  60. Hubner C, Baldofski S, Zenger M, et al. Influences of general self-efficacy and weight bias internalization on physical activity in bariatric surgery candidates. Surg Obes Relat Dis. 2015;11:1371–6.

    Article  PubMed  Google Scholar 

  61. Sarwer DB, Steffen KJ. Quality of life, body image and sexual functioning in bariatric surgery patients. Eur Eat Disord Rev. 2015;23:504–8.

    Article  PubMed  Google Scholar 

  62. Dymek MP, le Grange D, Neven K, et al. Quality of life and psychosocial adjustment in patients after Roux-en-Y gastric bypass: a brief report. Obes Surg. 2001;11:32–9.

    Article  CAS  PubMed  Google Scholar 

  63. Julia C, Ciangura C, Capuron L, et al. Quality of life after Roux-en-Y gastric bypass and changes in body mass index and obesity-related comorbidities. Diabetes Metab. 2013;39:148–54.

    Article  CAS  PubMed  Google Scholar 

  64. Kostrzewa E, Kas MJ. The use of mouse models to unravel genetic architecture of physical activity: a review. Genes Brain Behav. 2014;13:87–103.

    Article  CAS  PubMed  Google Scholar 

  65. Fernandez-Aranda F, Sauchelli S, Pastor A, et al. Moderate-vigorous physical activity across body mass index in females: moderating effect of endocannabinoids and temperament. PLoS ONE. 2014;9, e104534.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Buelow MT, Suhr JA. Construct validity of the Iowa Gambling Task. Neuropsychol Rev. 2009;19:102–14.

    Article  PubMed  Google Scholar 

  67. Conceicao E, Mitchell JE, Vaz AR, et al. The presence of maladaptive eating behaviors after bariatric surgery in a cross sectional study: importance of picking or nibbling on weight regain. Eat Behav. 2014;15:558–62.

    Article  PubMed  Google Scholar 

  68. de Zwaan M, Hilbert A, Swan-Kremeier L, et al. Comprehensive interview assessment of eating behavior 18–35 months after gastric bypass surgery for morbid obesity. Surg Obes Relat Dis. 2010;6:79–85.

    Article  PubMed  Google Scholar 

  69. Adams MA, Sallis JF, Norman GJ, et al. An adaptive physical activity intervention for overweight adults: a randomized controlled trial. PLoS ONE. 2013;8, e82901.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Bond DS, Thomas JG. Measurement and intervention on physical activity and sedentary behaviours in bariatric surgery patients: emphasis on mobile technology. Eur Eating Disord Rev. 2015;23:470–8.

    Article  Google Scholar 

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Acknowledgments

This work was supported by a grant from the Federal Ministry of Education and Research within the German Obesity Competence Network (01GI1323). We wish to thank our colleagues Eva Malenka Voth, M.D.; Christian Pek; Ekaterini Georgiadou, Ph.D.; and Laszlo Gaal, Ph.D., for their support during the course of the study.

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Authors and Affiliations

  1. Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Merle Bartsch, Svenja Langenberg, Martina de Zwaan & Astrid Müller

  2. Department of Surgery, Herzogin Elisabeth Hospital, Braunschweig, Germany

    Kerstin Gruner-Labitzke & Hinrich Köhler

  3. Peter L. Reichertz Institut for Medical Informatics, University of Braunschweig—Institute of Technology and Hannover Medical School, Hannover, Germany

    Mareike Schulze & Michael Marschollek

  4. Neuropsychiatric Research Institute and Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA

    Ross D. Crosby

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  1. Merle Bartsch
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  2. Svenja Langenberg
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  3. Kerstin Gruner-Labitzke
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  4. Mareike Schulze
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Corresponding author

Correspondence to Astrid Müller.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

An erratum to this article is available at http://dx.doi.org/10.1007/s11695-016-2369-8.

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Bartsch, M., Langenberg, S., Gruner-Labitzke, K. et al. Physical Activity, Decision-Making Abilities, and Eating Disturbances in Pre- and Postbariatric Surgery Patients. OBES SURG 26, 2913–2922 (2016). https://doi.org/10.1007/s11695-016-2208-y

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