Gelinas Bethany L, Delparte Chelsea A, Wright Kristi D, Hart Regan
University of Regina.
University of Regina.
Eat Behav. 2015 Jan;16:34-9. doi: 10.1016/j.eatbeh.2014.10.018. Epub 2014 Nov 3.
Psychological factors (e.g., anxiety, depression) are routinely assessed in bariatric pre-surgical programs, as high levels of psychopathology are consistently related to poor program outcomes (e.g., failure to lose significant weight pre-surgery, weight regain post-surgery). Behavioral factors related to poor program outcomes and ways in which behavioral and psychological factors interact, have received little attention in bariatric research and practice. Potentially problematic behavioral factors are queried by Section H of the Weight and Lifestyle Inventory (WALI-H), in which respondents indicate the relevance of certain eating behaviors to obesity. A factor analytic investigation of the WALI-H serves to improve the way in which this assessment tool is interpreted and used among bariatric surgical candidates, and subsequent moderation analyses serve to demonstrate potential compounding influences of psychopathology on eating behavior factors. Bariatric surgical candidates (n =362) completed several measures of psychopathology and the WALI-H. Item responses from the WALI-H were subjected to principal axis factoring with oblique rotation. Results revealed a three-factor model including: (1) eating in response to negative affect, (2) overeating/desirability of food, and (3) eating in response to positive affect/social cues. All three behavioral factors of the WALI-H were significantly associated with measures of depression and anxiety. Moderation analyses revealed that depression did not moderate the relationship between anxiety and any eating behavior factor. Although single forms of psychopathology are related to eating behaviors, the combination of psychopathology does not appear to influence these problematic behaviors. Recommendations for pre-surgical assessment and treatment of bariatric surgical candidates are discussed.
心理因素（如焦虑、抑郁）在减肥手术前的程序中会常规评估，因为高水平的精神病理学与不良的程序结果始终相关（如术前未能显著减重、术后体重反弹）。与不良程序结果相关的行为因素以及行为和心理因素相互作用的方式，在减肥研究和实践中很少受到关注。《体重与生活方式量表》（WALI-H）的H部分询问了潜在的有问题的行为因素，受访者在该部分指出某些饮食行为与肥胖的相关性。对WALI-H进行因素分析调查有助于改进该评估工具在减肥手术候选人中的解释和使用方式，随后的调节分析有助于证明精神病理学对饮食行为因素的潜在复合影响。减肥手术候选人（n = 362）完成了几项精神病理学测量和WALI-H。对WALI-H的项目回答进行了主轴因素分析并进行斜交旋转。结果揭示了一个三因素模型，包括：（1）因负面情绪而进食，（2）暴饮暴食/对食物的渴望，以及（3）因正面情绪/社交暗示而进食。WALI-H的所有三个行为因素都与抑郁和焦虑测量显著相关。调节分析表明，抑郁并未调节焦虑与任何饮食行为因素之间的关系。虽然单一形式的精神病理学与饮食行为有关，但精神病理学组合似乎并未影响这些有问题的行为。文中讨论了对减肥手术候选人术前评估和治疗的建议。
