Impulsivity and Anger in Obese Patients Undergoing Bariatric Surgery.

Introduction: Several studies show an association between obesity, impulsivity, and anger. The condition of obesity has moreover an important correlation with Eating Disorders (EDs), the most frequent of which is Binge Eating Disorder (BED). Obese patients seem to express peculiarities regarding the expression of some emotional processes, including impulsivity, aggression and anger, compared with regular-weight patients and those without an ED.

Subject and methods: This is a cross-sectional study carried out on a population of 47 obese patients undergoing bariatric surgery. Patients underwent a psychiatric evaluation at the outpatient clinics of the Section of Psychiatry, Clinical Psychology and Psychiatric Rehabilitation of the University Hospital of Perugia. Levels of anger and impulsivity were characterized using the STAXI-2 and BIS-11 scores. Scores were compared based on sex, the presence/absence of EDs and on the presence/absence of psychiatric disorders attested during the evaluation.

Results: No statistically significative difference were detected on STAXI-2 and BIS-11 scores comparing men and women. People diagnosed with EDs had higher scores in the subscores of attention, cognitive complexity, motor impulsivity, non-planning impulsivity, and in the BIS-11 total score. No differences were detected in the STAXI-2 scores. When comparing patients on the presence/absence of psychiatric comorbidities, obese patients with a psychiatric diagnosis had higher scores on the impulsivity measures, but also a higher value on the ER index of the STAXI-2.

Conclusions: Obese subjects undergoing bariatric surgery represent a fragile population that must be carefully evaluated from a psychiatric point of view. Indeed, the co-existence of psychiatric comorbidities may underpin the present of trait-like characteristics, such as impulsivity and anger, that should be carefully considered when proposing treatment strategies.