Department of Emergency Medicine, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland.
Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital and University of Bern, 3010, Bern, Switzerland.
J Gastrointest Surg. 2019 Feb;23(2):232-238. doi: 10.1007/s11605-018-3903-x. Epub 2018 Aug 8.
Mental health disorders are highly prevalent among bariatric surgery patients. Bariatric surgery induces weight loss with continuous health improvements. However, long-term follow-up data on weight loss and quality of life data of patients who have a mental illness after bariatric surgery are scarce, and it is not clear whether mental illness is associated with more pronounced weight regain. The aim was to investigate the impact of preoperative mental illness on the course of long-term weight changes after bariatric surgery.
Patients with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass surgery (RYGB) between 2005 and 2013 with a follow-up of at least 3 years were included. The study population was divided into two groups: patients with mental illness (MI) and patients without (No-MI). Weight loss outcomes over time were compared using mixed models up to 4 years after surgery.
In total, 254 patients (RYGB 61.0%, SG 39%) were included. The distribution of baseline characteristics was similar between the MI (n = 108) and No-MI groups (n = 146). The most prevalent mental illness was depressive disorder (63.9%). In the MI group, the percent of total weight loss (%TWL) was significantly smaller over the study period. After 36 months, the predicted mean group-difference of %TWL was 4.6% (95% CI 1.9, 7.2; p = 0.001), and the predicted odds ratio for weight regain was 4.9 (95% CI 1.6, 15.1) for patients in the MI group.
Preoperative mental illness leads to lower long-term weight loss and an increased risk of weight regain after bariatric surgery.
精神健康障碍在接受减重手术的患者中高度普遍。减重手术通过持续的健康改善来诱导体重减轻。然而，关于接受减重手术后患有精神疾病的患者的长期体重减轻和生活质量数据的长期随访数据很少，并且不清楚精神疾病是否与更明显的体重反弹有关。目的是调查术前精神疾病对减重手术后长期体重变化过程的影响。
纳入了 2005 年至 2013 年间接受袖状胃切除术（SG）或 Roux-en-Y 胃旁路手术（RYGB）且随访至少 3 年的患者。研究人群分为两组：患有精神疾病（MI）的患者和无精神疾病（No-MI）的患者。使用混合模型比较手术 4 年后的随时间变化的体重减轻结果。
总共纳入了 254 名患者（RYGB 占 61.0%，SG 占 39%）。MI 组（n=108）和 No-MI 组（n=146）的基线特征分布相似。最常见的精神疾病是抑郁障碍（63.9%）。在 MI 组中，研究期间的总体重减轻百分比（%TWL）明显较小。在 36 个月后，%TWL 的预测平均组间差异为 4.6%（95%CI 1.9，7.2；p=0.001），MI 组的体重反弹预测比值比为 4.9（95%CI 1.6，15.1）。
术前精神疾病导致减重手术后长期体重减轻减少和体重反弹的风险增加。
