Bergh Irmelin, Kvalem Ingela Lundin, Risstad Hilde, Cameron Linda D, Sniehotta Falko F
Department of Psychology, University of Oslo, P.O. Box 1094 Blindern, N-0317, Oslo, Norway,
Obes Surg. 2015 Sep;25(9):1610-7. doi: 10.1007/s11695-015-1569-y.
Preoperative weight loss is encouraged before bariatric surgery, as it is associated with improved surgical conditions. It has also been related to better postoperative outcomes, but this relationship is less clear. However, little is known about what predicts weight loss preoperatively, so the aim was to identify psychosocial and clinical predictors of preoperative weight loss.
Weight was measured at the first visit, the time of surgery approval, and on the day of surgery in 286 bariatric surgery patients (227 women). A questionnaire consisting of multiple psychosocial measures was completed before surgery.
Preoperatively, patients experienced a mean weight loss of 3.8 %. Men lost significantly more weight than women (mean = 5.4, SD = 6.0 vs. mean = 3.4, SD = 5.8, t = -2.3, p < 0.05), and 43.2 % of the patients lost ≥ 5% of their body weight. A high weight loss goal (β = 0.20, p < 0.001), frequent self-weighing (β = 0.18, p < 0.002), and being close to or at highest lifetime weight when applying for surgery (β = -0.30, p < 0.0001) were identified as predictors of weight loss, after controlling for body mass index (BMI), gender, and length of preoperative time period.
A relatively low proportion of patients lost the recommended weight preoperatively. Our results indicate that patients benefit from monitoring weight preoperatively and that allowing patients to keep their high weight loss goals may contribute to higher weight loss. Further investigation of these predictors could provide valuable knowledge regarding how to support and motivate patients to lose weight preoperatively.
减重手术前鼓励患者术前减重，因为这与改善手术条件相关。它也与更好的术后结果有关，但这种关系尚不太明确。然而，对于术前体重减轻的预测因素知之甚少，因此目的是确定术前体重减轻的心理社会和临床预测因素。
对286例减重手术患者（227例女性）在首次就诊、手术批准时和手术当天测量体重。术前完成一份包含多种心理社会测量指标的问卷。
术前，患者平均体重减轻3.8%。男性体重减轻显著多于女性（平均值=5.4，标准差=6.0，而平均值=3.4，标准差=5.8，t=-2.3，p<0.05），43.2%的患者体重减轻≥5%。在控制体重指数（BMI）、性别和术前时间段长度后，高减重目标（β=0.20，p<0.001）、频繁自我称重（β=0.18，p<0.002）以及申请手术时接近或处于最高体重（β=-0.30，p<0.0001）被确定为体重减轻的预测因素。
术前达到推荐体重减轻的患者比例相对较低。我们的结果表明，患者术前监测体重有益，允许患者保持高减重目标可能有助于更高的体重减轻。对这些预测因素的进一步研究可以提供关于如何支持和激励患者术前减重的宝贵知识。
