Averbukh Yelena, Heshka Stanley, El-Shoreya Hazem, Flancbaum Louis, Geliebter Allan, Kamel Sherif, Pi-Sunyer F Xavier, Laferrère Blandine
Department of Medicine, St.Luke's-Roosevelt Hospital, New York, USA.
Obes Surg. 2003 Dec;13(6):833-6. doi: 10.1381/096089203322618605.
The prevalence of obesity is increasing in the United States. Bariatric surgery is the only intervention that can reliably induce and maintain significant weight loss in obese patients. The association between pre-surgical severity of depression and success at weight loss following Roux-en-Y gastric bypass (RYGBP) has not yet been fully elucidated.
145 charts of patients who underwent RYGBP for morbid obesity were reviewed. 47 patients who filled out the Beck Depression Inventory (BDI) before surgery and completed 1 year of follow-up were studied. The relationship between pre-surgical severity of depression and success at weight loss was examined through multivariate regression analysis using percent excess weight loss (%EWL) as a dependent variable and BDI score as one of the predictors.
Weight loss at 1 year was significantly related to the BDI score before surgery (P =0.014). BDI score was also found to be a significant predictor of the amount of weight lost (kg) 1 year after surgery (P =0.027). Age (P =0.03) and initial body mass index (BMI) (P =0.011) were the only other variables with significant independent relations to %EWL.
Our data show a positive correlation between pre-surgical severity of depression as measured by BDI score and the 1-year success at weight loss after RYGBP as measured by %EWL. More depressed individuals tend to lose greater amounts of weight compared with less depressed individuals. Future prospective studies should examine possible mechanisms and effects of depression and other psychiatric disturbances on long-term weight loss after RYGBP.
美国肥胖症的患病率正在上升。减肥手术是唯一能够可靠地促使肥胖患者减重并维持显著体重减轻的干预措施。术前抑郁的严重程度与Roux-en-Y胃旁路术（RYGBP）后减肥成功之间的关联尚未完全阐明。
回顾了145例因病态肥胖接受RYGBP手术的患者病历。对47例术前填写了贝克抑郁量表（BDI）并完成1年随访的患者进行了研究。以超重体重减轻百分比（%EWL）作为因变量，BDI评分作为预测指标之一，通过多元回归分析研究术前抑郁严重程度与减肥成功之间的关系。
1年时的体重减轻与术前BDI评分显著相关（P = 0.014）。还发现BDI评分是术后1年体重减轻量（kg）的显著预测指标（P = 0.0]）。年龄（P = 0.03）和初始体重指数（BMI）（P = 0.011）是与%EWL有显著独立关系的仅有的其他变量。
我们的数据显示，用BDI评分衡量的术前抑郁严重程度与用%EWL衡量的RYGBP术后1年减肥成功率之间呈正相关。与抑郁程度较轻的个体相比，抑郁程度较重的个体往往减重更多。未来的前瞻性研究应探讨抑郁及其他精神障碍对RYGBP术后长期体重减轻的可能机制和影响。
