Exploring Psychiatric Features of Patients with Long-Term Vomiting after Bariatric Surgery

Introduction: Vomiting is a common side effect of bariatric surgery, occurring in the short and long-term post-operative period. Multiple factors cause chronic vomiting in bariatric patients such as surgical complications and maladaptive eating patterns. To date, psychiatric features associated with vomiting after bariatric surgery has been poorly and not specifically investigated. We explored possible socio-demographic and psychiatric differences (age, gender, marital status, psychiatric comorbidities, impulsivity, body image dissatisfaction, binge eating, depression, quality of life) of those patients who vomit over at least the first year post-operatively compared with those without vomiting. Methods: Sixty-one participants were enrolled, 37 women and 24 men; mean age was 45.45 (SD=9.88) and mean BMI was 46.51 (SD=7.29). The “vomiting” group comprised 18 individuals with at least one weekly episode of long-term vomiting. Clinical psychiatric evaluation and psychometric assessment were performed before and one year after bariatric surgery. Results: The “vomiting” and “non-vomiting” groups did not differ in age, gender, marital status, types of surgical procedure, and % of Excess BMI Loss. Models of rm-ANOVA revealed significant “time” (pre vs. post-surgery) effects, meaning improvement of body mass index (BMI), body dissatisfaction, depression, binge eating, impulsiveness, and quality of life after surgery; “time” × “group” (vomiting vs. non vomiting) effects were not significant, revealing no differences between “vomiting” and “non vomiting” groups. Conclusions: This study didn’t find a relationship between long-term vomiting and psychiatric features. Post-operative vomiting may not require psychiatric additional interventions. If the irrelevance of psychiatric mechanism will be confirmed, the identification of factors associated with vomiting which are amenable of psychological interventions, will help the improvement of the multidisciplinary approach to bariatric patients. In particular, the development of healthy eating patterns, the adherence to nutritional recommendations can benefit from a thoughtful mental health care.