Funk Luke M, Grubber Janet M, McVay Megan A, Olsen Maren K, Yancy William S, Voils Corrine I
William S. Middleton VA, Madison, WI, USA.
Department of Surgery, University of Wisconsin, Madison, WI, USA.
Eat Weight Disord. 2018 Oct;23(5):587-595. doi: 10.1007/s40519-017-0425-6. Epub 2017 Aug 29.
Identification of patient characteristics that are associated with behavioral weight loss success among bariatric surgery candidates could inform selection of optimal bariatric surgery candidates. We examined the associations between psychosocial characteristics and weight loss in a group of Veterans with severe obesity who participated in a behavioral weight loss intervention.
The MAINTAIN trial involved a 16-week weight loss program followed by randomization among participants losing at least 4 kg to a maintenance intervention or usual care. This secondary analysis was performed on Veterans who participated in the 16-week weight loss program and met NIH criteria for bariatric surgery (body mass index [BMI] 35.0-39.9 with at least 1 obesity-related comorbidity or BMI ≥ 40). Unadjusted and adjusted associations between baseline patient characteristics and weight loss during the 16-week induction phase were evaluated with linear regression. Missing weight measurements were multiply imputed, and results combined across ten imputations.
Among the 206 patients who met inclusion criteria, mean initial BMI was 40.8 kg/m (SD 6.0), and mean age was 59.2 years (SD 9.4). Approximately 20% of participants were female, 51.5% were Black, and 44.7% were White. Estimated mean 16-week weight loss was 5.16 kg (SD 4.31). In adjusted analyses, greater social support and older age were associated with greater weight loss (p < 0.05). None of the nine psychosocial characteristics we examined were associated with greater weight loss.
Understanding and strengthening the level of social support for bariatric surgery candidates may be important given that it appears to be strongly correlated with behavioral weight loss success.
Level II, Evidence obtained from well-designed controlled trials without randomization.
ClinicalTrials.gov NCT01357551 http://clinicaltrials.gov/show/NCT01357551 .
确定与减肥手术候选人行为减肥成功相关的患者特征，可为选择最佳减肥手术候选人提供参考。我们研究了一组参加行为减肥干预的重度肥胖退伍军人的心理社会特征与体重减轻之间的关联。
MAINTAIN试验包括一个为期16周的减肥计划，之后将体重减轻至少4千克的参与者随机分为维持干预组或常规治疗组。对参加了为期16周减肥计划且符合美国国立卫生研究院减肥手术标准（体重指数[BMI]为35.0 - 39.9且至少有一种肥胖相关合并症或BMI≥40）的退伍军人进行了这项二次分析。使用线性回归评估基线患者特征与16周诱导期体重减轻之间的未调整和调整后的关联。缺失的体重测量值进行了多次插补，并将十个插补结果合并。
在符合纳入标准的206名患者中，平均初始BMI为40.8kg/m²（标准差6.0），平均年龄为59.2岁（标准差9.4）。约20%的参与者为女性，51.5%为黑人，44.7%为白人。估计16周平均体重减轻5.16千克（标准差4.31）。在调整分析中，更大的社会支持和年龄较大与更大的体重减轻相关（p<0.05）。我们研究的九个心理社会特征均与更大的体重减轻无关。
鉴于社会支持水平似乎与行为减肥成功密切相关，了解并加强对减肥手术候选人的社会支持水平可能很重要。
二级，从设计良好的非随机对照试验中获得的证据。
ClinicalTrials.gov NCT01357551 http://clinicaltrials.gov/show/NCT01357551 。
