Aelfers Stephanie C W, Schijns Wendy, Ploeger Nadine, Janssen Ignace M C, Berends Frits J, Aarts Edo O
Department of Surgery, Rijnstate Hospital, Postal number 1190, 6800TA, Arnhem, The Netherlands.
Obes Surg. 2017 Jul;27(7):1729-1734. doi: 10.1007/s11695-017-2556-2.
Evidence about the impact of psychological factors on weight loss after bariatric surgery is scarce. This study explores whether patients' preoperative estimate of target weight influences actual weight loss for different types of bariatric procedures.
Patients eligible for bariatric surgery were instructed twice on how to calculate their expected target weight. They were divided into three groups based on their percentage excess weight loss (%EWL) and percentage total body weight loss (%TBWL). Weight loss 12 and 24 months after surgery was analyzed for each group and per type of surgery.
Six hundred fifty-six patients participated in this study. Types of surgery performed were the Roux-en-Y gastric bypass (RYGB, 75%), sleeve gastrectomy (SG, 8.1%), REDO-RYGB (12.5%), and laparoscopic adjustable gastric banding (LAGB, 4.4%). Data of 622 and 410 patients were available for analysis at 12 and 24 months, respectively. Surprisingly, 415 patients (63.3%) overestimated their expected weight loss as opposed to our calculation, based on our own historic data. One hundred thirty-four patients (20.4%) estimated their weight loss correctly and 107 patients (16.3%) underestimated their weight loss. There was a significant higher %EWL 12 months after RYGB surgery for patients who overestimated their weight loss compared to those who estimated their weight loss correctly (p = 0.001). After 24 months and for other types of procedures, no statistically significant differences were found between the three groups.
Despite instructions on how to calculate target weight, the majority of patients overestimated their weight loss. Actual %EWL 12 months after RYGB surgery might be influenced by setting a low target weight.
关于心理因素对减肥手术后体重减轻影响的证据很少。本研究探讨了患者术前对目标体重的估计是否会影响不同类型减肥手术的实际体重减轻情况。
符合减肥手术条件的患者接受了两次关于如何计算预期目标体重的指导。根据他们的超重减轻百分比（%EWL）和总体重减轻百分比（%TBWL）将他们分为三组。对每组和每种手术类型分析术后12个月和24个月的体重减轻情况。
656名患者参与了本研究。所进行的手术类型包括Roux-en-Y胃旁路术（RYGB，75%）、袖状胃切除术（SG，8.1%）、再次RYGB手术（REDO-RYGB，12.5%）和腹腔镜可调节胃束带术（LAGB，4.4%）。分别有622名和410名患者的数据可用于12个月和24个月时的分析。令人惊讶的是，与根据我们自己的历史数据计算的结果相比，415名患者（63.3%）高估了他们预期的体重减轻。134名患者（20.4%）正确估计了他们的体重减轻，107名患者（16.3%）低估了他们的体重减轻。与正确估计体重减轻的患者相比，高估体重减轻的患者在RYGB手术后12个月时的%EWL显著更高（p = 0.001）。24个月后，对于其他类型的手术，三组之间未发现统计学上的显著差异。
尽管接受了关于如何计算目标体重的指导，但大多数患者高估了他们的体重减轻。RYGB手术后12个月的实际%EWL可能会受到设定较低目标体重的影响。
