Johnson Stoklossa Carlene, Atwal Suneet
Nutriton Service, Alberta Health Services, Seventh Street Plaza, 10030-107 Street, Edmonton, AB, Canada T5J 3E4.
Gastroenterol Res Pract. 2013;2013:256145. doi: 10.1155/2013/256145. Epub 2013 Nov 19.
Achieving optimal weight outcomes for patients with obesity is important to the management of their chronic disease. All interventions present risks for weight regain. Bariatric surgery is the most efficacious treatment, producing greater weight losses that are sustained over more time compared to lifestyle interventions. However, approximately 20-30% of patients do not achieve successful weight outcomes, and patients may experience a regain of 20-25% of their lost weight. This paper reviews several factors that influence weight regain after bariatric surgery, including type of surgery, food tolerance, energy requirements, drivers to eat, errors in estimating intake, adherence, food and beverage choices, and patient knowledge. A comprehensive multidisciplinary approach can provide the best care for patients with weight regain. Nutrition care by a registered dietitian is recommended for all bariatric surgery patients. Nutrition diagnoses and interventions are discussed. Regular monitoring of weight status and early intervention may help prevent significant weight regain.
对于肥胖患者而言，实现最佳体重结果对其慢性病管理至关重要。所有干预措施都存在体重反弹的风险。减肥手术是最有效的治疗方法，与生活方式干预相比，能产生更大幅度的体重减轻，且这种减轻能持续更长时间。然而，约20%至30%的患者未能实现成功的体重结果，患者可能会出现体重反弹，反弹幅度达其减轻体重的20%至25%。本文综述了影响减肥手术后体重反弹的几个因素，包括手术类型、食物耐受性、能量需求、进食驱动因素、摄入量估计误差、依从性、食物和饮料选择以及患者知识。全面的多学科方法可为体重反弹患者提供最佳护理。建议所有减肥手术患者接受注册营养师的营养护理。文中讨论了营养诊断和干预措施。定期监测体重状况并尽早干预可能有助于防止体重显著反弹。
