Galioto R, Bond D, Gunstad J, Pera V, Rathier L, Tremont G
Department of Psychiatry Rhode Island Hospital Providence RI USA; Department of Psychiatry and Human Behavior Alpert Medical School of Brown University Providence RI USA.
Department of Psychiatry and Human Behavior Alpert Medical School of Brown University Providence RI USA; The Miriam Hospital Weight Control and Diabetes Research Center Providence RI USA.
Obes Sci Pract. 2016 Dec;2(4):334-340. doi: 10.1002/osp4.70. Epub 2016 Sep 28.
Deficits in executive functions are related to poorer weight loss after bariatric surgery; however, less is known about the role that these deficits may play during participation in nonsurgical weight loss programmes. This study examined associations between objectively measured executive functions and weight loss during participation in a medically supervised weight loss programme.
Twenty-three adult patients (age 50.4 ± 15.1, BMI 44.2 ± 8.8, 68% female, 92% White) enrolled in a medically supervised weight loss programme, involving prescription of a very low calorie diet and strategies to change eating and activity behaviours, underwent comprehensive computerized testing of executive functions at baseline. Weight was obtained at baseline and 8 weeks. Demographic and clinical information were obtained through medical chart review.
Participants lost an average of 9.8 ± 3.4% of their initial body weight at 8 weeks. Fewer correct responses on a set-shifting task and faster reaction time on a response inhibition task were associated with lower weight loss percentage at 8 weeks after adjusting for age, education and depressive symptoms. There were no associations between performance on tests of working memory or planning and weight loss.
This study shows that worse performance on a set-shifting task (indicative of poorer cognitive flexibility) and faster reaction times on a response inhibition test (indicative of higher impulsivity) are associated with lower weight loss among participants in a medically supervised weight loss programme. Pre-treatment assessment of executive functions may be useful in identifying individuals who may be at risk for suboptimal treatment outcomes. Future research is needed to replicate these findings in larger samples and identify underlying mechanisms.
执行功能缺陷与减肥手术后较差的体重减轻情况相关；然而，对于这些缺陷在参与非手术减肥计划过程中可能发挥的作用，我们了解得较少。本研究调查了在参加医学监督的减肥计划期间，客观测量的执行功能与体重减轻之间的关联。
23名成年患者（年龄50.4±15.1，体重指数44.2±8.8，68%为女性，92%为白人）参加了一项医学监督的减肥计划，该计划包括规定极低热量饮食以及改变饮食和活动行为的策略，在基线时接受了全面的执行功能计算机化测试。在基线和8周时测量体重。通过病历审查获取人口统计学和临床信息。
在8周时，参与者平均减轻了初始体重的9.8±3.4%。在调整年龄、教育程度和抑郁症状后，在转换任务中正确反应较少以及在反应抑制任务中反应时间较快与8周时较低的体重减轻百分比相关。工作记忆或计划测试的表现与体重减轻之间没有关联。
本研究表明，在医学监督的减肥计划参与者中，转换任务表现较差（表明认知灵活性较差）以及反应抑制测试中反应时间较快（表明冲动性较高）与体重减轻较低相关。术前执行功能评估可能有助于识别可能有治疗效果欠佳风险的个体。需要进一步的研究在更大样本中重复这些发现并确定潜在机制。
