Colles Susan L, Dixon John B, O'Brien Paul E
Centre for Obesity Research and Education , Alfred Hospital, Monash University, Melbourne, Victoria, 3181, Australia.
Obes Surg. 2008 Jul;18(7):833-40. doi: 10.1007/s11695-007-9409-3. Epub 2008 Apr 12.
Bariatric surgery facilitates substantial and durable weight loss; however, outcomes vary. In addition to physiological and technical factors, weight loss efficacy is dependent on modification of behavior to maintain a long-term change in energy balance. This study aimed to assess the extent and nature of change in energy intake and physical activity and identify factors associated with percentage weight loss (%WL) 12 months after laparoscopic adjustable gastric banding (LAGB).
129 bariatric surgery candidates (26 men/103 women, mean age 45.2 +/- 11.5, mean body mass index [BMI] 44.3 +/- 6.8, range 31.9 to 66.7) completed the study. Data were collected at baseline and 12 months. Validated questionnaires included the Cancer Council Victoria Food Frequency Questionnaire, Three Factor Eating Questionnaire, Short Form-36, Baecke Physical Activity Questionnaire, and Beck Depression Inventory. Symptoms of "non-hungry eating," "emotional eating," and "grazing" were assessed.
Mean %WL was 20.8 +/- 8.5%, and excess weight loss was 50.0 +/- 20.7 (p < 0.001). Mean total energy intake reduced from 9,991 +/- 3,986 kj to 4,077 +/- 1,493 kj (p < 0.001). Average leisure time and sport-related physical activity scores increased (both p < 0.001). Regression analysis identified baseline BMI (beta = 0.241; p = 0.002), subjective hunger (beta = -0.275; p = 0.001), physical function (beta = 0.309; p < 0.001), and leisure time physical activity (beta = 0.213; p = 0.010) as independent predictors of %WL, total R (2) 0.34%. "Non-hungry eating" and symptoms of depression were also related to poorer %WL.
LAGB affects marked behavior change and facilitates substantial weight loss in the first 12 months. However, variations in adopted behaviors can affect energy balance and weight loss success. Achievement and maintenance of favorable behaviors should be an important consideration during on-going postsurgical review and counseling. Management should include adequate band adjustment to control physical hunger, optimization of physical function and activity, and reinforcement of strategies to reduce energy intake.
减肥手术有助于实现显著且持久的体重减轻；然而，手术效果存在差异。除了生理和技术因素外，体重减轻的效果还取决于行为的改变，以维持能量平衡的长期变化。本研究旨在评估腹腔镜可调节胃束带术（LAGB）后12个月能量摄入和身体活动的变化程度及性质，并确定与体重减轻百分比（%WL）相关的因素。
129名减肥手术候选者（26名男性/103名女性，平均年龄45.2±11.5岁，平均体重指数[BMI]44.3±6.8，范围31.9至66.7）完成了该研究。在基线和12个月时收集数据。经过验证的问卷包括维多利亚癌症理事会食物频率问卷、三因素饮食问卷、简短健康调查问卷-36、贝克身体活动问卷和贝克抑郁量表。评估了“非饥饿性进食”“情绪化进食”和“随意进食”的症状。
平均%WL为20.8±8.5%，超重减轻为50.0±20.7（p<0.001）。平均总能量摄入从9991±3986千焦降至4077±1493千焦（p<0.001）。平均休闲时间和与运动相关的身体活动得分增加（均p<0.001）。回归分析确定基线BMI（β=0.241；p=0.002）、主观饥饿感（β=-0.275；p=0.001）、身体功能（β=0.309；p<0.001）和休闲时间身体活动（β=0.213；p=0.010）是%WL的独立预测因素，总R（2）为0.34%。“非饥饿性进食”和抑郁症状也与较差的%WL相关。
LAGB在最初12个月影响显著的行为改变并促进大量体重减轻。然而，所采取行为的差异会影响能量平衡和减肥的成功。在术后持续的复查和咨询过程中，实现并维持良好行为应是一个重要的考虑因素。管理措施应包括适当调整束带以控制身体饥饿感、优化身体功能和活动，以及强化减少能量摄入的策略。
