Service de Psychiatrie d'Adultes, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Inserm U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinière, ICM, F-75013, Paris, France.
Obes Rev. 2017 Aug;18(8):936-942. doi: 10.1111/obr.12549. Epub 2017 Apr 21.
There is evidence that obesity is associated with impairments in executive functions, such as deficits in decision-making, planning or problem solving, which might interfere with weight loss in obese individuals. We performed a systematic review and meta-analysis of decision-making abilities, as measured with the Iowa gambling task (IGT), in obesity without eating disorders.
A systematic search was conducted to identify studies comparing IGT performances between groups of obese patients without eating disorders and groups of healthy control groups. The standardized mean differences were calculated for the total IGT scores and for the course of IGT scores. Meta-regression analyses were performed to explore the influence of clinical variables on standardized mean differences.
Total IGT scores were significantly lower in obese patients compared with normal-weight healthy controls. IGT performances did not differ between groups for the first trials of the task. Significant effect sizes for the last trials of the task were subjected to a high degree of heterogeneity.
Risky decision-making is impaired in obesity. The clinical importance of non-food-related decision-making impairments remains to be assessed especially in terms of consequences in daily life or the achievement of weight loss. This meta-analysis has been registered in the Prospero database (CRD42016037533).
有证据表明，肥胖与执行功能障碍有关，例如在决策、计划或解决问题方面存在缺陷，这可能会干扰肥胖者的体重减轻。我们对无饮食障碍的肥胖症患者的决策能力（通过 Iowa 赌博任务 (IGT) 进行测量）进行了系统评价和荟萃分析。
系统搜索了比较无饮食障碍的肥胖症患者组和健康对照组组间 IGT 表现的研究。计算了总 IGT 分数和 IGT 分数变化的标准化均数差异。进行了荟萃回归分析，以探讨临床变量对标准化均数差异的影响。
与正常体重的健康对照组相比，肥胖患者的总 IGT 分数明显较低。对于任务的前几次试验，两组之间的 IGT 表现没有差异。任务最后几次试验的显著效应大小存在高度异质性。
肥胖症患者的风险决策受损。非食物相关决策障碍的临床重要性仍有待评估，特别是在日常生活中的后果或体重减轻方面。本荟萃分析已在 Prospero 数据库（CRD42016037533）中注册。
