Bradley Lauren E, Forman Evan M, Kerrigan Stephanie G, Goldstein Stephanie P, Butryn Meghan L, Thomas J Graham, Herbert James D, Sarwer David B
Department of Behavioral Sciences, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 400, Chicago, IL, 60625, USA.
Department of Psychology, Drexel University, Philadelphia, PA, USA.
Obes Surg. 2017 Mar;27(3):586-598. doi: 10.1007/s11695-016-2337-3.
Weight regain following bariatric surgery is common and potentially compromises the health benefits initially attained after surgery. Poor compliance to dietary and physical activity prescriptions is believed to be largely responsible for weight regain. Patients may benefit from developing specialized psychological skills necessary to engage in positive health behaviors over the long term. Unfortunately, patients often face challenges to physically returning to the bariatric surgery program for support in developing and maintaining these behaviors. Remotely delivered interventions, in contrast, can be conveniently delivered to the patient and have been found efficacious for a number of health problems, including obesity. To date, they have received little attention with bariatric surgery patients. The study aimed to evaluate a newly developed, remote acceptance-based behavioral intervention for postoperative weight regain.
Patients at least 1.5 years out from surgery who experienced postoperative weight regain were recruited to receive the 10-week intervention. Participants were assessed at baseline, mid-treatment, post-treatment, and at 3-month follow-up.
Support for the intervention's feasibility and acceptability was achieved, with 70 % retention among those who started the program and a high mean rating (4.7 out of 5.0) of program satisfaction among study completers. On average, weight regain was reversed with a mean weight loss of 5.1 ± 5.5 % throughout the intervention. This weight loss was maintained at 3-month follow-up. Significant improvements in eating-related and acceptance-based variables also were observed.
This pilot study provides initial support for the feasibility, acceptability, and preliminary efficacy of a remotely delivered acceptance-based behavioral intervention for postoperative weight regain.
减肥手术后体重反弹很常见,可能会损害手术最初带来的健康益处。人们认为,对饮食和体育活动建议的依从性差在很大程度上导致了体重反弹。患者可能会从培养长期参与积极健康行为所需的专业心理技能中受益。不幸的是,患者在实际返回减肥手术项目以获得发展和维持这些行为的支持方面往往面临挑战。相比之下,远程提供的干预措施可以方便地提供给患者,并且已被发现对包括肥胖在内的许多健康问题有效。迄今为止,减肥手术患者对其关注甚少。本研究旨在评估一种新开发的、基于接纳的远程行为干预对术后体重反弹的效果。
招募术后至少1.5年出现体重反弹的患者接受为期10周的干预。在基线、治疗中期、治疗后和3个月随访时对参与者进行评估。
该干预措施的可行性和可接受性得到了证实,开始该项目的患者中有70%坚持下来,研究完成者对项目的平均满意度评分较高(5.0分中的4.7分)。在整个干预过程中,平均体重反弹得到逆转,平均体重减轻了5.1±5.5%。这种体重减轻在3个月随访时得以维持。在与饮食相关和基于接纳的变量方面也观察到了显著改善。
这项初步研究为一种远程提供的、基于接纳的行为干预对术后体重反弹的可行性、可接受性和初步疗效提供了初步支持。