van Hout Gerbrand C M, Jakimowicz Jack J, Fortuin Frederiek A M, Pelle Aline J M, van Heck Guus L
Department of Medical Psychology, Catharina Hospital, Eindhoven, the Netherlands.
Obes Surg. 2007 Sep;17(9):1226-34. doi: 10.1007/s11695-007-9205-0.
Bariatric surgery is the treatment of choice for patients with morbid obesity. In addition to surgery, postoperative dietary behavior is an important mediator of weight loss and, therefore, critical in influencing outcome. Surgical treatment of obesity is not an alternative to dieting but a method to enforce dieting.
We evaluated early weight loss and postoperative eating behavior over time. Preoperatively as well as 6 months, 1 and 2 years after vertical banded gastroplasty (VBG), 91 patients were psychologically assessed using a semi-structured interview and a psychological questionnaire focusing on eating behavior.
Over time, we found significant changes in weight, mostly in the 1st postoperative year (EWL= 52.0%); at 2 years, EWL was 61.5%. Patients reported substantial changes in feelings of hunger, appetite, satiety, and eating behavior; however, most improvements waned over time. In addition, there was a wide variability in changes within our patient group, and changes in weight loss appeared to be related to changes in restrained eating.
VBG not only leads to considerable weight loss, but also to significant improvements in eating behavior, at least within 2 years. However, most improvements wane over time and not all patients profit in the same way.
减肥手术是病态肥胖患者的首选治疗方法。除手术外,术后饮食行为是体重减轻的重要调节因素,因此对影响治疗结果至关重要。肥胖的手术治疗不是节食的替代方法,而是强化节食的一种手段。
我们评估了早期体重减轻情况以及术后不同时间的饮食行为。在垂直束带胃成形术(VBG)术前以及术后6个月、1年和2年,使用半结构化访谈和一份关注饮食行为的心理问卷对91例患者进行了心理评估。
随着时间推移,我们发现体重有显著变化,主要在术后第1年(体重减轻率=52.0%);2年时,体重减轻率为61.5%。患者报告在饥饿感、食欲、饱腹感和饮食行为方面有显著变化;然而,大多数改善随着时间的推移逐渐减弱。此外,我们患者组内的变化存在很大差异,体重减轻的变化似乎与节制饮食的变化有关。
VBG不仅能导致显著的体重减轻,还能使饮食行为得到显著改善,至少在2年内如此。然而,大多数改善会随着时间的推移而减弱,并非所有患者都以相同的方式获益。