Gibbons Lauren M, Sarwer David B, Crerand Canice E, Fabricatore Anthony N, Kuehnel Robert H, Lipschutz Patti E, Raper Steven E, Williams Noel N, Wadden Thomas A
Department of Psychiatry, Weight and Eating Disorders Program, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Surg Obes Relat Dis. 2006 Mar-Apr;2(2):159-64. doi: 10.1016/j.soard.2006.03.013.
To describe the dieting histories of bariatric surgery candidates.
One hundred seventy-seven individuals with extreme obesity who sought bariatric surgery completed the Weight and Lifestyle Inventory, a self-report instrument that assesses several variables, including weight and dieting history. Patients' dieting histories were further explored with an aided recall during a preoperative behavioral/psychological evaluation performed by a mental health professional.
Participants who completed the Weight and Lifestyle Inventory reported an average of 4.7 +/- 2.9 successful dieting attempts, defined as those that resulted in a loss of 10 lbs (4.5 kg) or more. These individuals reported a mean total lifetime weight loss of 61.1 +/- 41.3 kg. Despite these efforts, their weight increased from 89.4 +/- 27.4 kg at the time of their first diet (age 21.2 +/- 10.1 years) to 144.5 +/- 30.8 kg at the time they underwent their behavioral/psychological evaluation (age 43.0 +/- 11.0 years). Results of the aided recall revealed that participants had made numerous other efforts to lose weight that were unsuccessful. Self-directed diets and commercial programs were used more frequently.
Individuals who sought bariatric surgery reported an extensive history of dieting, beginning in adolescence, that was not successful in halting progressive weight gain. Thus, the recommendation often made by insurance companies that patients delay surgery to attempt more conservative treatment options may be unwarranted, particularly in the presence of significant obesity-related comorbidities. Weight loss histories should be routinely examined during a behavioral evaluation to determine whether additional attempts at non-surgical weight loss are advisable. Future studies also are needed to explore the potential relationship between dieting history and postoperative outcome.
描述减肥手术候选人的节食史。
177名寻求减肥手术的极度肥胖个体完成了体重与生活方式调查问卷，这是一种自我报告工具，可评估包括体重和节食史在内的多个变量。在心理健康专业人员进行的术前行为/心理评估中，通过辅助回忆进一步探究了患者的节食史。
完成体重与生活方式调查问卷的参与者报告平均有4.7±2.9次成功的节食尝试，成功节食定义为体重减轻10磅（4.5千克）或更多。这些个体报告终身总体重减轻平均为61.1±41.3千克。尽管付出了这些努力，他们的体重从首次节食时（21.2±10.1岁）的89.4±27.4千克增加到接受行为/心理评估时（43.0±11.0岁）的144.5±30.8千克。辅助回忆的结果显示，参与者还进行了许多其他减肥努力但未成功。自我指导的节食和商业减肥项目使用得更为频繁。
寻求减肥手术的个体报告了从青春期开始的广泛节食史，但未能成功阻止体重的逐步增加。因此，保险公司经常建议患者推迟手术以尝试更保守的治疗选择可能是没有必要的，特别是在存在严重肥胖相关合并症的情况下。在行为评估期间应常规检查体重减轻史，以确定是否建议再次尝试非手术减肥。未来还需要研究来探索节食史与术后结果之间的潜在关系。
