De Panfilis Chiara, Cero Sara, Torre Mariateresa, Salvatore Paola, Dall'Aglio Elisabetta, Adorni Aristodemo, Maggini Carlo
Unit of Psychiatry, Department of Neuroscience, Parma University Hospital, Parma, Italy.
Obes Surg. 2007 Jun;17(6):792-9. doi: 10.1007/s11695-007-9145-8.
The effectiveness of post-surgical weight loss in improving body image disturbance (BID) in morbidly obese patients is still unclear. Providing multidimensional measures of BID and controlling for the effect of co-morbid eating psychopathology may help to clarify this issue. This preliminary study explores whether 1) BID improves 1 year after laparoscopic adjustable gastric banding (LAGB), and whether 2) such improvement is related to post-surgical BMI and/or eating disorder reduction. BID was multidimensionally assessed by means of the Body Uneasiness Test (BUT).
35 obese subjects (mean BMI 45.5) were evaluated prior to and 1 year after LAGB using the BUT, and a standardized interview and questionnaire to assess eating psychopathology. BID and eating habit changes during follow-up were also investigated. Postoperative BUT values were entered as outcome measures (dependent variables) in a series of stepwise multiple regression analyses; BMI and binge eating reduction, baseline BUT scores, gender, age, and age of onset of obesity were tested as independent variables.
Some aspects of BID (body image overconcern and related avoidance behaviors, compulsive self-monitoring, and overall severity of BID) improved following LAGB, while others (weight phobia, depersonalization, and uneasiness toward body parts) did not. The post-surgical lower levels of the former were predicted by the overall decrease in binge eating symptoms, irrespective of BMI reduction, age, gender, and age of onset of obesity.
LAGB may ameliorate some BID aspects in morbidly obese patients, and an improvement in eating behaviors may contribute to this effect.
手术减肥对改善病态肥胖患者身体意象障碍（BID）的有效性仍不明确。提供BID的多维测量并控制共病饮食精神病理学的影响可能有助于阐明这一问题。这项初步研究探讨了：1）腹腔镜可调节胃束带术（LAGB）后1年BID是否改善；2）这种改善是否与术后体重指数（BMI）和/或饮食失调减轻有关。通过身体不适感测试（BUT）对BID进行多维评估。
35名肥胖受试者（平均BMI为45.5）在LAGB术前和术后1年接受了BUT评估，并通过标准化访谈和问卷评估饮食精神病理学。还调查了随访期间BID和饮食习惯的变化。在一系列逐步多元回归分析中，将术后BUT值作为结果指标（因变量）；将BMI、暴饮暴食减少情况、基线BUT评分、性别、年龄和肥胖发病年龄作为自变量进行测试。
LAGB术后，BID的某些方面（身体意象过度关注及相关回避行为、强迫性自我监测和BID的总体严重程度）有所改善，而其他方面（体重恐惧症、人格解体和对身体部位的不适感）则没有改善。无论BMI降低、年龄、性别和肥胖发病年龄如何，暴饮暴食症状的总体减轻可预测前者术后较低的水平。
LAGB可能改善病态肥胖患者的某些BID方面，饮食行为的改善可能有助于产生这种效果。
