Collazo-Clavell Maria L, Clark Matthew M, McAlpine Donald E, Jensen Michael D
Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Mayo Clin Proc. 2006 Oct;81(10 Suppl):S11-7. doi: 10.1016/s0025-6196(11)61176-2.
The number of bariatric surgical procedures performed in the United States has increased steadily during the past decade. Currently accepted criteria for consideration of bariatric surgery include a body mass index (calculated as weight in kilograms divided by the square of height in meters) of 40 kg/m2 or greater (or >35 kg/m2 with obesity-related comorbidities), documented or high probability of failure of nonsurgical weight loss treatments, and assurance that the patient is well informed, motivated, and compliant. Appropriate patient selection is important in achieving optimal outcomes after bariatric surgery. In this article, we review our approach to the medical and psychological assessment of patients who want to undergo bariatric surgery. The medical evaluation is designed to identify and optimally treat medical comorbidities that may affect perioperative risks and long-term outcomes. The psychiatric and psychological assessment identifies factors that may influence long-term success in maintaining weight loss and prepares the patient for the lifestyle changes needed both before and after surgery.
在过去十年中，美国进行的减肥手术数量稳步增加。目前公认的考虑减肥手术的标准包括体重指数（计算方法为体重千克数除以身高米数的平方）为40kg/m²或更高（或体重指数>35kg/m²且伴有肥胖相关合并症）、非手术减肥治疗失败的记录或高可能性，以及确保患者充分知情、有积极性且依从性好。在减肥手术后实现最佳效果方面，恰当的患者选择很重要。在本文中，我们回顾了我们对想要接受减肥手术的患者进行医学和心理评估的方法。医学评估旨在识别并优化治疗可能影响围手术期风险和长期结果的医学合并症。精神科和心理评估则识别可能影响长期维持体重减轻成功的因素，并使患者为手术前后所需的生活方式改变做好准备。
