Probiotics may decrease symptoms of binge eating after bariatric

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Regular use of two supplements of probiotics after bariatric surgery can help reduce the symptoms of compulsion and food addiction in patients one year after the surgical procedure. The finding is from a survey carried out in the Federal University of Paraná (UFPR) with patients who were operated on at Hospital Irmandade Santa Casa in Curitiba.

The survey was conducted by nutritionist Ligia de Oliveira CarlosPhD in Clinical Surgical Medicine, and evaluated 101 patients who underwent the gastric bypass technique (surgical method most used in Brazil and in the world, in which the stomach is reduced to 10% of its original size and part of the intestine is diverted, altering the form of absorption of nutrients).

What are probiotics?

Os probiotics they are living micro-organisms which, when administered in adequate amounts, confer health benefits, including bringing balance to the intestinal microbiota. They facilitate the formation of the so-called probiotic barrier in the intestine, inhibiting the development of bacteria that cause diseases in the intestinal microbiota.

According to Lígia, studies have already shown that some strains of probiotics (usually of the Lactobacillus e Bifidobacterium) have action on the nervous system (they are called psychobiotics) and, consequently, have antidepressant and anxiolytic effect.

Thus, says the nutritionist, the idea arose to study whether the use of these probiotics would have any effect on reducing the symptoms of addiction/food addiction and binge eating disorder in patients who underwent bariatric surgery.

“There were already other studies at the university evaluating the effect of probiotics on the clinical aspect of patients, such as weight loss, body fat percentage, reduction in abdominal circumference. But there was a gap regarding the effect of this supplementation on the gut-brain axis. I decided to investigate whether there was any impact on psychiatric issues as well,” explained Lígia.

controlled study

Patients were divided into two groups: one received probiotic supplementation (Lactobacillus acidophilus e Bifidobacterium lactis) and another received placebo for 90 days after bariatric surgery, starting on the seventh postoperative day.

According to Lígia, all participants were evaluated preoperatively and postoperatively at 90 days and 1 year after surgery. All were operated on by the same surgical team and answered internationally validated questionnaires to assess addiction or binge eating.

According to the study, before surgery, 1/3 of the patients met the diagnostic criteria for addiction or binge eating – a high number, but expected within this population of people with obesity awaiting bariatric surgery. The same questionnaires were applied 90 days after starting to use the supplements and repeated after one year.

“We reapplied the questionnaire and in the first 90 days we observed a drastic reduction in symptoms. But that was expected, because at the beginning of the postoperative period, bariatric patients cannot and cannot eat much. So, we cannot say that it was the effect of the probiotics”, explained the nutritionist.

After 90 days, the use of probiotics was discontinued (excessive use can worsen intestinal flora) and patients were evaluated again one year after surgery. “We saw a very significant reduction in addiction and binge symptoms compared to the placebo group. These results open the way for a series of questions that can be answered in other studies on the subject”, adds the specialist.

There are some hypotheses to explain the results, but Lígia points out that the main objective of the research was not to identify the biochemical mechanism involved. According to her, among the possible explanations are the modification of the intestinal microbiota itself after the surgery, reflecting in a general improvement in the quality of health.

This is even the subject of another research that is being carried out at UFPR on the subject – to investigate whether there are significant changes in the intestinal microbiota of the patient who underwent bariatric surgery.

Despite the positive results, Lígia points out that probiotic supplementation is not the same as ingesting food with probiotics — such as yogurt with live lactobacilli. In general, these products are sold ready-made or compounded in specialized pharmacies (the price varies from R$ 60 to R$ 150 per month), and may contain strains of microorganisms in different concentrations depending on the expected clinical outcome.

The nutritionist also says that it is not just any probiotic that produces this effect and not anyone who can benefit from it. Therefore, it is important that the use is guided by a specialized professional. She explains that excessive or prolonged use can cause a bad effect and worsen the intestine, leading to a condition with intestinal dysbiosis.

“Probiotic therapy is not magic. Everything in this area is still very new, we are still in its infancy. For now, we have more questions than answers and this is how science evolves”, concludes the researcher.

Technical review: Alexandre R. Marra, researcher at the Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEP) and permanent professor at the Graduate Program in Health Sciences at the Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE).


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