Colles Susan L, Dixon John B, O'Brien Paul E
Monash University, Centre for Obesity Research and Education (CORE), Alfred Hospital, Melbourne, Victoria, Australia.
Obesity (Silver Spring). 2008 Mar;16(3):615-22. doi: 10.1038/oby.2007.101. Epub 2008 Jan 17.
Gastric restrictive surgery induces a marked change in eating behavior. However, the relationship between preoperative and postoperative eating behavior and weight loss outcome has received limited attention.
This study assessed a range of eating behaviors before and 1 year after laparoscopic adjustable gastric banding (LAGB) and explored the nature and extent of change in eating patterns, their clinical associates, and impact on weight loss.
A 12-month observational study assessed presurgical and postsurgical binge eating disorder (BED), uncontrolled eating, night eating syndrome (NES), grazing, nutrient intake and eating-related behaviors, and markers of psychological distress. A total of 129 subjects (26 male and 103 female, mean age 45.2 +/- 11.5 and BMI 44.3 +/- 6.8) participated in this study.
Presurgical BED, uncontrolled eating, and NES occurred in 14%, 31%, and 17.1% of subjects, which reduced after surgery to 3.1%, 22.5%, and 7.8%, respectively (P = 0.05 for all). Grazing was prevalent before (26.3%) and after surgery (38.0%). Preoperative BED most frequently became grazers (P = 0.029). The average percentage weight loss (%WL) was 20.8 +/- 8.5%; range -0.67 to 50.0% and percentage of excess weight loss (%EWL) 50.0 +/- 20.7%; range -1.44 to 106.9% (P < 0.001). Uncontrolled eating and grazing after surgery showed high overlap and were associated with poorer %WL (P = 0.008 and P < 0.001, respectively) and elevated psychological distress.
Consistent with recent studies, uncontrolled eating and grazing were identified as two high-risk eating patterns after surgery. Clearer characterization of favorable and unfavorable postsurgical eating behaviors, reliable methods to assess their presence, and empirically tested postsurgical intervention strategies are required to optimize weight loss outcomes and facilitate psychological well-being in at-risk groups.
胃限制性手术会引起饮食行为的显著变化。然而，术前和术后饮食行为与体重减轻结果之间的关系受到的关注有限。
本研究评估了腹腔镜可调节胃束带术（LAGB）术前及术后1年的一系列饮食行为，并探讨了饮食模式变化的性质和程度、其临床相关因素以及对体重减轻的影响。
一项为期12个月的观察性研究评估了手术前和手术后的暴饮暴食症（BED）、无节制饮食、夜间饮食综合征（NES）、随意进食、营养摄入及与饮食相关的行为，以及心理困扰指标。共有129名受试者（26名男性和103名女性，平均年龄45.2±11.5岁，体重指数44.3±6.8）参与了本研究。
术前患有BED、无节制饮食和NES的受试者分别占14%、31%和17.1%，术后分别降至3.1%、22.5%和7.8%（所有P值均为0.05）。随意进食在术前（26.3%）和术后（38.0%）都很普遍。术前患有BED的人术后最常变成随意进食者（P = 0.029）。平均体重减轻百分比（%WL）为20.8±8.5%；范围为-0.67至50.0%，超重减轻百分比（%EWL）为50.0±20.7%；范围为-1.44至106.9%（P < 0.001）。术后无节制饮食和随意进食表现出高度重叠，且与较差的%WL相关（分别为P = 0.008和P < 0.001），并伴有心理困扰加剧。
与最近的研究一致，无节制饮食和随意进食被确定为术后两种高风险的饮食模式。需要更清晰地描述术后有利和不利的饮食行为，评估其存在的可靠方法，以及经过实证检验的术后干预策略，以优化体重减轻结果并促进高危人群的心身健康。
