Bradley Lauren E, Forman Evan M, Kerrigan Stephanie G, Butryn Meghan L, Herbert James D, Sarwer David B
Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
Department of Psychology, Drexel University, Philadelphia, PA, USA.
Obes Surg. 2016 Oct;26(10):2433-41. doi: 10.1007/s11695-016-2125-0.
Tens of thousands of bariatric surgery patients each year experience sub-optimal weight loss, significant regain, or both. Weight regain can contribute to a worsening of weight-related co-morbidities, and for some, leads to secondary surgical procedures. Poor weight outcomes have been associated with decreased compliance to the recommended postoperative diet. Decreased compliance may be partially due to a lack of psychological skills necessary to engage in healthy eating behaviors over the long term, especially as the effects of surgery (on appetite, hunger, and desire for food) decrease. Many behavioral interventions do not sufficiently address these challenges and often have limited effectiveness. The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of a novel 10-week acceptance-based behavioral intervention to stop postoperative weight regain.
A sample of bariatric surgery patients (n = 11) who regained at least 10 % of their maximum lost postoperative weight was recruited. All participants received the intervention, which emphasized psychological skills thought to be integral to successful weight control post-surgery.
The intervention was shown to be feasible and acceptable, with 72 % retention and high mean rating (4.25 out of 5.00) of program satisfaction among completers. Weight regain was stopped, and even reversed, with a mean total body weight loss of 3.58 ± 3.02 % throughout the 10-week intervention. There were also significant improvements in eating-related and acceptance-related variables.
These findings provide initial support for the use of a psychological acceptance-based intervention for weight regain in bariatric surgery patients.
每年数以万计的减肥手术患者体重减轻未达最佳效果,出现显著体重反弹,或二者兼有。体重反弹会导致与体重相关的合并症恶化,对一些患者而言,还会引发二次手术。体重控制不佳与术后饮食建议的依从性降低有关。依从性降低可能部分归因于长期保持健康饮食行为所需的心理技能不足,尤其是手术对食欲、饥饿感和食物欲望的影响减弱之后。许多行为干预措施未能充分应对这些挑战,效果往往有限。本研究旨在评估一种新型的为期10周的基于接纳的行为干预措施对阻止术后体重反弹的可行性、可接受性和初步效果。
招募了一组减肥手术患者样本(n = 11),这些患者术后体重反弹至少达到其最大减重的10%。所有参与者都接受了该干预措施,该措施强调了被认为对术后成功控制体重至关重要的心理技能。
该干预措施被证明是可行且可接受的,完成者的保留率为72%,对项目满意度的平均评分较高(5.00分制中为4.25分)。体重反弹得到阻止,甚至出现逆转,在整个10周的干预过程中,总体重平均减轻了3.58 ± 3.02%。在饮食相关和接纳相关变量方面也有显著改善。
这些发现为在减肥手术患者中使用基于心理接纳的干预措施来控制体重反弹提供了初步支持。