Krishna Mohandas

Abstract

Introduction: Bariatric surgery results in significant improvement in health related quality of life and depressive symptoms irrespective of the wide range of weight change. This experiment was planned to assess the incidence of depression in obese respondents and to analyse the change in depression after weight loss through bariatric surgery. Objectives: To analyse the incidence of depression in obese individuals undergoing bariatric surgery and the significance of change in depression status after weight loss. Materials and Methods: The study was conducted in a multispecialty hospital having obesity clinic and bariatric surgery unit. The depression level before the study and at six months post surgery was assessed using a standard tool named Beck’s inventory. Study period was from 2015 to 2017. Inclusion and Exclusion Criteria: Respondents having BMI of 33-50 Kg/m belonging to both the genders in the age range of 18-65 years. The respondents having BMI more than 50Kg/m were excluded in this study. Sample size: 18 respondents who underwent bariatric surgery were included in the study. Percentage distribution, Pearson correlation coefficient, ANOVA, and Paired t test were the tools utilised in statistical analysis of the data. Tools used: Schedule to assess change in nutritional status using a structured questionnaire considering anthropometric, biochemical, clinical and dietary parameters, and standard tool named Beck’s Depression Inventory, which is a tool for depression status. Results: The surgery patients had initial Beck Score ranging from 1 to 14 indicating mild depression which on follow up reduced to 0 to 7. The weight loss in both genders were similar to each other. The change in intake of nutrients and the scores of depression were more prominent in men than that of women. Respondents pre operatively had mild mood disturbances which after weight loss, became a normal mood. Conclusion: Thus it can be concluded that weight loss through bariatric surgery is effective in reducing depression. Keywords: Depression, Weight loss, Bariatric surgery, Beck’s depression inventory

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Abstract

Introduction: Overweight and obesity are increasing worldwide and recently has been proposed to be considered as a disease condition by the World Health Organization. South Asians are prone to deposit higher percentage of body fat in lower BMI and hence towards the development of health issues associated with overweight. For adapting a suitable diet pattern and lifestyle, every person should have a sound knowledge on scientific methods of managing weight. The present study was undertaken with an aim to assess the role of a KAP based intervention in lifestyle modifications of obese and overweight respondents. Materials and Methods: This intervention was carried out in 66 respondents selected on the basis of criteria age (20-50years), BMI (23Kg/m2- 50 Kg/m2), regularity in follow up and compliance to the modifications suggested. The respondent’s data regarding demographic parameters (viz age, gender, occupation, education and monthly income), physical activity level, obesity history, anthropometric and biochemical parameters and dietary pattern were collected. Knowledge-Attitude- Practice questionnaire was designed through a pilot study. Nutrition education was carried out through audiovisual aids and information booklet. The respondents were followed up till 3 months, baseline and follow up data were tabulated and anlaysed using SAS software. Results: Larger segment of respondents were elderly married females educated up to pre graduation level. Family obesity score values obtained ranged from 7-21 with a mean score of 16.113.84. Regression analysis of KAP scores against demographic variables revealed that family obesity score negatively influenced scores in all the three domains and education level negatively influenced attitude and practice scores. The knowledge, attitude scores, and practice scores demonstrated significant changes between pre intervention score and at all the post intervention scores (p value regression analysis showed that there was a strong influence of change in knowledge level in the change in attitude and practice scores in the immediate post intervention period but this influence was not reflected in the post intervention and final intervention phases. The significance of change in anthropometric and biochemical data were analysed using paired t test and concluded that the changes in anthropometric parameters were significant whereas the change in biochemical parameters were not significant. The mean values of change in dietary macronutrients from before to after suggest that there was decrease in intake of fat, carbohydrates and energy, and increase in fibre and protein. Rrespondents’ with good quality diet as indicated by AHEI above 51 had scored positively in knowledge, attitude and practice and the relation was statistically significant. Conclusion: It was concluded from this experiment that dietary quality had a strong influence on the nutritional status of overweight and obese persons and a nutrition intervention based on KAP questionnaire was effective in managing the weight and lifestyle pattern of the respondents. Keywords: KAP based intervention, Overweight, Obesity, Dietary quality, Nutritional status.

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