College of Human Sciences and Humanities, University of Houston - Clear Lake, Houston, Texas.
Department of Psychological Sciences, Kent State University, Kent, Ohio.
Surg Obes Relat Dis. 2017 Dec;13(12):2021-2026. doi: 10.1016/j.soard.2017.09.513. Epub 2017 Sep 14.
The current investigation aims to predict 3-year postoperative percent total weight loss among a sample of bariatric surgery patients with super-super obesity.
Previous research implies that persons with presurgical super-super obesity (body mass index [BMI] ≥60 kg/m) tend to have poorer loss outcomes compared with those with a lower presurgical BMI after bariatric surgery.
Cleveland Clinic, Bariatric & Metabolic Institute, Cleveland, OH.
Bariatric surgery candidates (N = 1231; 71.9% female; 65.8% Caucasian) completed a presurgical psychological evaluation and the Minnesota Multiphasic Personality Inventory-2-Restructured Form. Participants with a baseline BMI ≥60 (n = 164) were compared with BMI<60 (n = 1067) on psychosocial and demographic factors, the Minnesota Multiphasic Personality Inventory-2-Restructured Form, and in the subset that had surgery (n = 870), percent total weight loss extending to the 3-year follow-up.
Patients with a BMI ≥60 were younger, less educated, and more likely to be male compared with lower BMI patients. Patients with a BMI ≥60 had greater psychosocial sequelae as evidenced by being more likely to have a history of sexual abuse, history of psychiatric hospitalization, more binge eating episodes, and higher prevalence of major depression disorder and binge eating disorder. On the Minnesota Multiphasic Personality Inventory-2-Restructured Form, those with BMI ≥60 reported greater demoralization, low positive emotions, ideas of persecution, and dysfunctional negative emotions. After controlling for surgery type, weight loss for individuals with BMI ≥60 did not greatly differ from weight loss in patients with BMI<60. Variables predictive of less weight loss at 3 years regardless of presurgical BMI, included being older, having a sexual abuse history, and higher ideas of persecution scores.
Although patients with BMI ≥60 evidenced more psychopathology before surgery, findings suggest that the relationship between higher BMI and poorer outcome may better be explained by other co-morbid factors.
本研究旨在预测肥胖症患者中超级肥胖患者术后 3 年的体重总减轻百分比。
先前的研究表明，与接受减重手术后 BMI 较低的患者相比，术前超级肥胖（BMI≥60kg/m）的患者减重效果较差。
克利夫兰诊所，减重与代谢研究所，克利夫兰，俄亥俄州。
接受减重手术的患者（N=1231；71.9%为女性；65.8%为白种人）完成了术前心理评估和明尼苏达多相人格问卷-2 修订版。BMI≥60 基线的患者（n=164）与 BMI<60 的患者（n=1067）在社会心理和人口统计学因素、明尼苏达多相人格问卷-2 修订版以及接受手术的亚组（n=870）中进行了比较，在 3 年随访时的体重总减轻百分比。
与 BMI<60 的患者相比，BMI≥60 的患者更年轻、受教育程度更低、男性比例更高。BMI≥60 的患者有更大的心理社会后果，表现为性虐待史、精神病住院史、更多的暴食发作以及更高的重度抑郁症和暴食障碍患病率。在明尼苏达多相人格问卷-2 修订版上，BMI≥60 的患者报告了更多的沮丧、低正性情绪、被害观念和功能失调的负性情绪。在控制手术类型后，BMI≥60 的患者的体重减轻量与 BMI<60 的患者的体重减轻量没有很大差异。无论术前 BMI 如何，预测 3 年体重减轻量较少的变量包括年龄较大、有性虐待史和更高的被害观念评分。
尽管 BMI≥60 的患者术前有更多的精神病理学，但研究结果表明，较高的 BMI 与较差的结果之间的关系可能更好地用其他合并症来解释。
