Effectiveness of laparoscopic longitudinal resection of the stomach in persons with normal body weight suffering from bulimia nervosa

Introduction. Bulimia Nervosa – (BN) is a kind of eating disorders which is characterized by systematic compulsive overeating. In order to prevent development of obesity patients with BN use “purging” steps mostly by mean of self-caused vomiting. 'Purging' behavior has negative impact on both health status and quality of life. Since conservative treatment of BN is usually low-effective the efficacy of metabolic surgery is being studied by us since 2006.
Material and methods. Results of Laparoscopic Sleeve Gastrectomy (LSG) in 10 normally -weighted patients with BN (BMI was less than 25 kg/m2 to the moment of operation) aged 22-41 years are presented. The main purposes of LSG were cessation of “purging” behavior together with maintaining of weight within normal levels.
Results. All patients were achieved complete cessations of purging behavior just immediately after operation. Weight loss did not exceed low-normal levels. Normalization of eating behavior did not accompany with development of obesity. Positive emotional changes together with improvement of quality of life were observed. There were nor postoperative complications no deaths. To the 9-month of follow-up period only one of ten patients has returned to a purging behavior.
Conclusions. LSG due to new-created anatomical changes of the stomach brings opportunities for cessation of “purging” behavior in normally-weighted patients with BN. BN can be considered as a latent form of obesity and metabolic surgery- as an effective method of prevention of its development. Surgery of eating disorders can be considered as a new chapter of metabolic surgery when it is used in the non-obese patients with NB. In the absence of other psychiatric disorders NB should not be considered as a contraindication to LSG.

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