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青少年肥胖症手术:一项关于减肥、饮食依从性和生活质量的多中心研究。

Bariatric surgery in young adults: a multicenter study into weight loss, dietary adherence, and quality of life.

机构信息

Department of Medical Psychology, ZGT Hospital, Hengelo, The Netherlands.

Department of Medical Psychology/Hospital Psychiatry, Slotervaart Hospital, Amsterdam, The Netherlands; Health Psychology Section, Department of Health Sciences, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Surg Obes Relat Dis. 2017 Jul;13(7):1204-1210. doi: 10.1016/j.soard.2017.02.026. Epub 2017 Mar 7.

Abstract

BACKGROUND

Numerous studies have demonstrated that bariatric surgery is an effective intervention for morbid obesity, but study samples are characterized by an underrepresentation of young adult patients.

OBJECTIVES

The aim of this study was to evaluate weight loss, dietary adherence, and quality of life (QoL) in a multicenter, young adult sample, in the first 6 years after bariatric surgery.

SETTING

Four general hospitals in the Netherlands.

METHODS

A total of 184 young adult patients who underwent bariatric surgery between 6 and 74 months previously at the age of 18 to 24 years were included, interviewed by phone, and sent questionnaires assessing postoperative weight, QoL, and lifestyle behaviors including dietary adherence. Complete data were available for those 96 patients who returned the questionnaires.

RESULTS

Mean percent weight loss was 30.2 (SD 10.7) for laparoscopic sleeve gastrectomy and 35.6 (SD 6.9) for laparoscopic Roux-en-Y gastric bypass. Adherence to postoperative dietary recommendations declined over the years (r = -.25, P = .02) and explained 8.3% of the variance in weight loss (r = .29, P = .005). QoL scores lagged behind national norms for young adults and were largely unrelated to weight loss. A quarter of patients (25%) turned out to be not in education, employment, or training and 38% had used mental healthcare services since surgery, which occurred independent of weight loss and concurred with poorer QoL.

CONCLUSION

Young adult patients achieve weight loss comparable to adult patients after bariatric surgery. However, postoperative adherence to behavioral recommendations and psychosocial functioning clearly demonstrate room for improvement and require adjunctive interventions.

摘要

背景

许多研究表明,减重手术是治疗病态肥胖的有效干预手段,但研究样本的特点是年轻成年患者代表性不足。

目的

本研究旨在评估多中心年轻成年患者队列在减重手术后 6 年内的体重减轻、饮食依从性和生活质量(QoL)。

设置

荷兰四家综合医院。

方法

共纳入 184 例年龄在 18 至 24 岁之间,在 6 至 74 个月前接受过减重手术的年轻成年患者,通过电话进行访谈,并寄发问卷评估术后体重、QoL 和生活方式行为,包括饮食依从性。那些返回问卷的 96 例患者提供了完整的数据。

结果

腹腔镜袖状胃切除术的平均体重减轻百分比为 30.2(SD 10.7),腹腔镜 Roux-en-Y 胃旁路术为 35.6(SD 6.9)。术后饮食建议的依从性随着时间的推移而下降(r = -.25,P =.02),并解释了体重减轻的 8.3%的方差(r = -.29,P =.005)。QoL 评分落后于年轻成年人的全国标准,与体重减轻基本无关。四分之一的患者(25%)没有接受教育、就业或培训,38%的患者在手术后使用了精神保健服务,这与体重减轻无关,且与较差的 QoL 并存。

结论

年轻成年患者在接受减重手术后可实现与成年患者相当的体重减轻。然而,术后行为建议的依从性和心理社会功能明显显示出需要改进的空间,需要辅助干预措施。

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