Mackey Eleanor Race, Olson Alexandra, Merwin Stephanie, Wang Jichuan, Nadler Evan P
Children's Research Institute, Children's National Health System, Washington, DC, USA.
The George Washington University School of Medicine, Washington, DC, USA.
Obes Surg. 2018 Feb;28(2):421-426. doi: 10.1007/s11695-017-2853-9.
Bariatric surgery is an effective treatment for youth with severe obesity. However, outcomes are variable and there remains sparse understanding of predictors of weight loss following surgery. The current study examines the role of adolescent-reported pre-operative social support around exercise, binge eating, and exercise to predict excess body mass index (EBMI) loss from 3 to 12 months post-surgery.
Participants were 101 adolescents ages 12-21 (M age = 16.6, SD = 1.8). Pre-operative body mass index (BMI) ranged from 35 to 87 (M = 50.3, SD = 8.6). Structural equation modeling (SEM) was used to evaluate a model of the association of adolescent report of perceived social support for exercise with less binge eating (items from the Eating Disorder Diagnostic Scale) and more self-reported exercise (items from the Youth Risk Behavior Surveillance System). The model was used to predict EBMI loss at 3, 6, 9, and 12 months post-surgery.
Social support significantly predicted exercise and demonstrated a trend for predicting binge eating, such that more social support was associated with more exercise and a trend for less binge eating. Binge eating was associated with less EBMI loss. However, there was no association of exercise with EBMI loss.
Pre-operative binge eating should be a target for identification and treatment prior to sleeve gastrectomy in adolescents. Although not directly or indirectly associated with EBMI loss, perceived social support around exercise was associated with increased exercise, which may make it a consideration for a target for intervention as well.
减肥手术是治疗重度肥胖青少年的有效方法。然而,手术效果存在差异,对于术后体重减轻的预测因素仍知之甚少。本研究探讨青少年报告的术前在运动、暴饮暴食和锻炼方面的社会支持对术后3至12个月超重体重指数(EBMI)下降的预测作用。
参与者为101名年龄在12 - 21岁的青少年(平均年龄 = 16.6,标准差 = 1.8)。术前体重指数(BMI)范围为35至87(平均 = 50.3,标准差 = 8.6)。采用结构方程模型(SEM)来评估青少年对运动感知到的社会支持与较少暴饮暴食(来自饮食失调诊断量表的项目)以及更多自我报告的运动(来自青少年风险行为监测系统的项目)之间的关联模型。该模型用于预测术后3、6、9和12个月的EBMI下降情况。
社会支持显著预测运动,并显示出预测暴饮暴食的趋势,即更多的社会支持与更多的运动以及较少暴饮暴食的趋势相关。暴饮暴食与EBMI下降较少相关。然而,运动与EBMI下降之间没有关联。
术前暴饮暴食应成为青少年袖状胃切除术之前识别和治疗的目标。尽管与EBMI下降没有直接或间接关联,但在运动方面感知到的社会支持与运动增加相关,这也可能使其成为干预目标的一个考虑因素。