Benediktsdottir Audur, Halldorsson Thorhallur Ingi, Bragadottir Gudrun Jona, Gudmundsson Ludvig, Ramel Alfons
Unit for Nutrition Research, Landspitali National University Hospital & Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland.
Reykjalundur Rehabilitation Center, Mosfellsbaer, Iceland.
Obes Res Clin Pract. 2016 Jan-Feb;10(1):63-9. doi: 10.1016/j.orcp.2015.03.009. Epub 2015 Apr 16.
Little is known on how morbidly obese individuals who participate in different treatments differ in relation to anthropometrical measurements and psychological characteristics. In the present study we investigated attrition and treatment choice, i.e., bariatric surgery and conservative treatment, of morbidly obese subjects.
Data was collected during screening from 292 morbidly obese women who participated in a weight loss program at an Icelandic rehabilitation center. Information were available on body composition, fasting blood samples, psychological characteristics, medication use, drop-out and whether patients underwent bariatric surgery after the weight loss program at the rehabilitation center. Inclusion criteria were age between 18 and 65 years and BMI>35 kg/m(2), exclusion criteria were alcohol- or drug addiction.
Of the 292 women who finished screening, 113 (39%) dropped out, 100 (34%) finished the weight loss program and 79 (27%) finished the weight loss program and consecutively underwent surgery. According to multivariate models individuals with BMI ≥50 kg/m(2) were 4.5 times more likely (P=0.003) to undergo bariatric surgery than individuals with BMI <40 kg/m(2). Individuals with severe depression were 2.4 times more likely (P=0.01) to drop out than individuals with no depression. Serum glucose (+36% for an increase by 1 mmol/L, P=0.036) and use of psychotropic medication (+73%, P=0.05) were also associated with higher odds of dropout.
A large proportion of morbidly obese individuals dropped out of a weight loss program at an Icelandic rehabilitation center and severe depression symptoms more than doubles this risk.
对于参与不同治疗的病态肥胖个体在人体测量和心理特征方面的差异知之甚少。在本研究中，我们调查了病态肥胖受试者的退出情况和治疗选择，即减肥手术和保守治疗。
在筛选过程中收集了292名在冰岛康复中心参加减肥计划的病态肥胖女性的数据。可获得身体成分、空腹血样、心理特征、药物使用、退出情况以及患者在康复中心减肥计划后是否接受减肥手术的信息。纳入标准为年龄在18至65岁之间且BMI>35 kg/m²，排除标准为酒精或药物成瘾。
在完成筛选的292名女性中，113人（39%）退出，100人（34%）完成了减肥计划，79人（27%）完成了减肥计划并随后接受了手术。根据多变量模型，BMI≥50 kg/m²的个体接受减肥手术的可能性是BMI<40 kg/m²个体的4.5倍（P=0.003）。患有严重抑郁症的个体退出的可能性是没有抑郁症个体的2.4倍（P=0.01）。血清葡萄糖（每增加1 mmol/L增加36%，P=0.036）和使用精神药物（增加73%，P=0.05）也与更高的退出几率相关。
很大一部分病态肥胖个体退出了冰岛康复中心的减肥计划，严重的抑郁症状使这种风险增加了一倍多。
