Chacko Sara A, Yeh Gloria Y, Davis Roger B, Wee Christina C
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.
Complement Ther Med. 2016 Oct;28:13-21. doi: 10.1016/j.ctim.2016.07.001. Epub 2016 Jul 12.
This study aimed to develop and test a novel mindfulness-based intervention (MBI) designed to control weight after bariatric surgery.
Randomized, controlled pilot trial.
Beth Israel Deaconess Medical Center, Boston, MA, USA.
Bariatric patients 1-5 years post-surgery (n=18) were randomized to receive a 10-week MBI or a standard intervention.
Primary outcomes were feasibility and acceptability of the MBI. Secondary outcomes included changes in weight, eating behaviors, psychosocial outcomes, and metabolic and inflammatory biomarkers. Qualitative exit interviews were conducted post-intervention. Major themes were coded and extracted.
Attendance was excellent (6 of 9 patients attended ≥7 of 10 classes). Patients reported high satisfaction and overall benefit of the MBI. The intervention was effective in reducing emotional eating at 6 months (-4.9±13.7 in mindfulness vs. 6.2±28.4 in standard, p for between-group difference=0.03) but not weight. We also observed a significant increase in HbA1C (0.34±0.38 vs. -0.06±0.31, p=0.03). Objective measures suggested trends of an increase in perceived stress and symptoms of depression, although patients reported reduced stress reactivity, improved eating behaviors, and a desire for continued mindfulness-based support in qualitative interviews.
This novel mindfulness-based approach is highly acceptable to bariatric patients post-surgery and may be effective for reducing emotional eating, although it did not improve weight or glycemic control in the short term. Longer-term studies of mindfulness-based approaches may be warranted in this population.
ClinicalTrials.gov identifier NCT02603601.
本研究旨在开发并测试一种新型的基于正念的干预措施（MBI），该措施旨在控制减肥手术后的体重。
随机对照试验。
美国马萨诸塞州波士顿的贝斯以色列女执事医疗中心。
将术后1至5年的减肥患者（n = 18）随机分为两组，一组接受为期10周的MBI干预，另一组接受标准干预。
主要结局是MBI的可行性和可接受性。次要结局包括体重、饮食行为、心理社会结局以及代谢和炎症生物标志物的变化。干预结束后进行定性的退出访谈。对主要主题进行编码和提取。
出勤率很高（9名患者中有6名参加了10节课中的≥7节）。患者报告对MBI高度满意且总体有益。该干预措施在6个月时有效减少了情绪化进食（正念组为-4.9±13.7，标准组为6.2±28.4，组间差异p = 0.03），但对体重没有影响。我们还观察到糖化血红蛋白有显著升高（0.34±0.38对-0.06±0.31，p = 0.03）。客观测量表明感知压力和抑郁症状有增加的趋势，尽管患者在定性访谈中报告压力反应性降低、饮食行为改善，并且希望继续获得基于正念的支持。
这种新型的基于正念的方法在减肥手术后的患者中高度可接受，并且可能对减少情绪化进食有效，尽管在短期内它并未改善体重或血糖控制。对于这一人群，可能有必要对基于正念的方法进行长期研究。
ClinicalTrials.gov标识符NCT02603601。
