Schäfer Lisa, Hübner Claudia, Carus Thomas, Herbig Beate, Seyfried Florian, Kaiser Stefan, Schütz Tatjana, Dietrich Arne, Hilbert Anja
Medical Psychology and Medical Sociology, Leipzig University Medical Center, Integrated Research and Treatment Center Adiposity Diseases, Philipp-Rosenthal-Strasse 27, Leipzig, 04103, Germany.
Department of General Surgery, Asklepios Clinic, Suurheid 20, Hamburg, 22559, Germany.
Int J Eat Disord. 2017 Oct;50(10):1172-1182. doi: 10.1002/eat.22760. Epub 2017 Aug 16.
The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in prebariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of this study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor postbariatric weight loss outcome.
Within a prospective multicenter registry, N = 370 prebariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors.
Five prebariatric subtypes were identified with specific profiles regarding self-control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models.
By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific prebariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for postbariatric weight loss and health-related outcomes.
减肥手术的疗效已得到证实；然而，有一部分患者术后未能实现预期的长期体重减轻。由于减肥手术结果的差异可能受到减肥前患者异质性心理特征的影响，以往的亚型分类模型根据气质特征对患者进行区分。本研究的目的是通过额外考虑情绪调节障碍和失抑制进食行为进行亚型分类来扩展这些模型，因为这些因素与适应不良的进食行为和减肥术后体重减轻效果不佳有关。
在一个前瞻性多中心登记处，对N = 370名减肥前患者使用访谈和自我报告问卷进行检查。进行潜在剖面分析以根据气质特征、情绪调节障碍和失抑制进食行为识别亚型。
识别出五种减肥前亚型，它们在自我控制、情绪调节障碍和失抑制进食行为方面具有特定特征。亚型与不同程度的饮食失调精神病理学、抑郁和生活质量相关。与基于气质的模型相比，扩展模型增加了方差解释。
通过在先前的亚型分类模型中加入情绪调节障碍和失抑制进食行为，出现了具有独特心理缺陷模式的特定减肥前亚型。未来的研究应测试这些亚型对减肥术后体重减轻和健康相关结果的预测价值。
