Sarwer David B, Wadden Thomas A, Moore Reneé H, Baker Alexander W, Gibbons Lauren M, Raper Steven E, Williams Noel N
Department of Psychiatry, Center for Weight and Eating Disorders, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA.
Surg Obes Relat Dis. 2008 Sep-Oct;4(5):640-6. doi: 10.1016/j.soard.2008.04.013. Epub 2008 Jun 30.
To investigate the relationship between preoperative eating behavior, postoperative dietary adherence and weight loss after gastric bypass surgery in a major, urban medical center with a comprehensive bariatric surgery program. Despite the significant weight loss and dramatic improvements in co-morbidities associated with bariatric surgery, a significant minority of patients appear to experience suboptimal weight loss. The reasons for this are not well understood, but the suboptimal weight loss is often attributed to preoperative psychosocial characteristics and/or eating behaviors, as well as poor adherence to the recommended postoperative diet.
A prospective investigation was performed of 200 female and male patients who were studied both preoperatively and 20, 40, 66, and 92 weeks postoperatively. All patients underwent either open or laparoscopic Roux-en-Y gastric bypass surgery. The measures were the percentage of weight loss, macronutrient intake, dietary adherence, and eating behavior.
Gender, baseline cognitive restraint, and self-reported adherence to the postoperative diet at postoperative week 20 were associated with the percentage of weight loss at postoperative week 92. Those high in dietary adherence had lost 4.5% more weight at postoperative week 92 than those low in dietary adherence.
Baseline cognitive restraint and adherence to the recommended postoperative diet were associated with the percentage of weight loss after gastric bypass surgery. These results suggest the potential utility of pre- and/or postoperative dietary counseling interventions to improve the postoperative outcomes.
在一家设有综合减肥手术项目的大型城市医疗中心，研究胃旁路手术后术前饮食行为、术后饮食依从性与体重减轻之间的关系。尽管减肥手术能带来显著的体重减轻以及与共病相关的显著改善，但仍有相当一部分患者的体重减轻效果不理想。其原因尚不完全清楚，但体重减轻不理想往往归因于术前的心理社会特征和/或饮食行为，以及对术后推荐饮食的依从性差。
对200名男女患者进行前瞻性研究，在术前以及术后20、40、66和92周对他们进行研究。所有患者均接受了开放式或腹腔镜Roux-en-Y胃旁路手术。测量指标包括体重减轻百分比、常量营养素摄入量、饮食依从性和饮食行为。
性别、基线认知抑制以及术后20周时自我报告的术后饮食依从性与术后92周时的体重减轻百分比相关。饮食依从性高的患者在术后92周时的体重比饮食依从性低的患者多减轻了4.5%。
基线认知抑制和对术后推荐饮食的依从性与胃旁路手术后的体重减轻百分比相关。这些结果表明术前和/或术后饮食咨询干预措施可能有助于改善术后效果。
