Niego Sara H, Kofman Michele D, Weiss Jeffrey J, Geliebter Allan
Department of Psychiatry, Hartford Hospital Institute of Living, Hartford, Connecticut 06016, USA.
Int J Eat Disord. 2007 May;40(4):349-59. doi: 10.1002/eat.20376.
This article reviews the status of the literature addressing clinically significant binge eating in the bariatric surgery patient. The goal is to provide a background that will guide patients, surgeons, and mental health practitioners toward the most successful long-term surgical outcome when binge eating is identified.
Pubmed and Medline search with subsequent reference list search of identified articles. We searched literature through April 2006 on the influence of binge eating (BE) on surgical outcome.
Those with pre-surgical BE are more likely to retain the eating pathology and, if they do, to have poorer weight loss outcome. Many people who binge ate prior to surgery report continued feelings of loss of control when eating small amounts of food after surgery. Studies that employed the DSM-IV definition of a binge episode reported absence of BE after surgery, unlike those that modified binge criteria after surgery.
Clinically significant BE is related to poorer surgical outcomes, and additional interventions may be needed to improve long term outcomes. Though surgery does alter body's physiology, claims that the psychological aspects of BE are "cured" by obesity surgery must be viewed with caution. Researchers and practitioners must reach a consensus on how to define BE after gastric surgery so that future long-term prospective studies may further evaluate the effect of BE on surgical outcome and vice versa.
本文综述了有关肥胖症手术患者中具有临床意义的暴饮暴食的文献现状。目的是提供一个背景知识，以便在识别出暴饮暴食情况时，指导患者、外科医生和心理健康从业者实现最成功的长期手术效果。
通过PubMed和Medline进行检索，并随后对已识别文章的参考文献列表进行检索。我们检索了截至2006年4月关于暴饮暴食（BE）对手术效果影响的文献。
术前有暴饮暴食行为的患者更有可能保留饮食方面的病态情况，并且如果确实如此，体重减轻效果会更差。许多术前有暴饮暴食行为的人报告称，术后即使吃少量食物仍会持续有失控感。采用《精神疾病诊断与统计手册》第四版（DSM-IV）对暴饮暴食发作定义的研究报告称术后不存在暴饮暴食情况，这与那些术后修改了暴饮暴食标准的研究不同。
具有临床意义的暴饮暴食与较差的手术效果相关，可能需要额外的干预措施来改善长期效果。尽管手术确实会改变身体的生理机能，但对于肥胖症手术“治愈”暴饮暴食心理方面问题的说法必须谨慎看待。研究人员和从业者必须就如何定义胃手术后的暴饮暴食达成共识，以便未来的长期前瞻性研究能够进一步评估暴饮暴食对手术效果的影响，反之亦然。
