Department of Surgery, Voss Hospital, Haukeland University Hospital, Voss, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Surg Obes Relat Dis. 2019 Feb;15(2):161-167. doi: 10.1016/j.soard.2018.12.011. Epub 2018 Dec 15.
A person's confidence to control eating, eating self-efficacy (ESE), has been identified as a target for long-term weight management in nonsurgical weight loss interventions, but has to a limited extent been studied after bariatric surgery.
We investigated the association between ESE, weight loss, and obesity-specific quality of life (QOL) after sleeve gastrectomy (SG).
A single-center longitudinal study.
Data from adult patients were collected before SG, and at mean 16 months (±standard deviation 4 mo) and 55 (±4) months postoperatively. ESE was measured by the Weight Efficacy Lifestyle Questionnaire Short-Form. Multiple regression analyses were performed with excess body mass index loss (%EBMIL) and obesity-specific QOL as dependent variables. Age, sex, and other preoperative values were covariates in all models.
Of 114 preoperative patients, 91 (80%) and 84 (74%) were available for follow-up 16 and 55 months after SG, respectively. Mean %EBMIL from baseline to 16 and 55 months was 76% (95% confidence interval: 71.9, 79.6) and 67% (95% confidence interval: 61.9, 72.2), respectively. Preoperative ESE scores improved significantly at both 16 and 55 months (P = .002) but did not predict postoperative %EBMIL or QOL at 55 months (β = -.08, P = .485). Greater change in ESE from 0 to 16 months predicted higher %EBMIL (β = .34, P = .013) at 55 months, and improvements in ESE from 0 to 55 months were significantly associated with higher %EBMIL (β = .46, P = .001) and obesity-specific QOL (β = .50, P < .001) 55 months after SG.
Significant improvements in ESE were seen at 16 months, and remained high at 55 months after SG in this cohort. Patients who improved their ESE the most also experienced the highest weight loss and obesity-specific QOL 5 years postoperatively. Future research should address whether enhancement of ESE corresponds to sustained improvements in eating behavior after bariatric surgery.
一个人的进食控制信心，即饮食自我效能（ESE），已被确定为非手术减肥干预中长期体重管理的目标，但在减重手术后，对其的研究还很有限。
我们研究了袖状胃切除术（SG）后 ESE 与体重减轻和肥胖特异性生活质量（QOL）之间的关系。
单中心纵向研究。
收集成年患者在 SG 前、术后 16 个月（平均±标准差 4 个月）和 55 个月（±4 个月）时的数据。ESE 通过体重功效生活方式问卷短表进行测量。将超重指数损失百分比（%EBMIL）和肥胖特异性 QOL 作为因变量进行多元回归分析。所有模型均将年龄、性别和其他术前值作为协变量。
114 例术前患者中，91 例（80%）和 84 例（74%）分别在 SG 后 16 个月和 55 个月时可进行随访。从基线到 16 个月和 55 个月时的平均%EBMIL 分别为 76%（95%置信区间：71.9，79.6）和 67%（95%置信区间：61.9，72.2）。术前 ESE 评分在 16 个月和 55 个月时均显著提高（P=0.002），但在 55 个月时均未预测术后%EBMIL 或 QOL（β=−0.08，P=0.485）。从 0 到 16 个月时 ESE 的变化与 55 个月时的%EBMIL 较高相关（β=0.34，P=0.013），从 0 到 55 个月时 ESE 的改善与 55 个月时的%EBMIL 较高（β=0.46，P=0.001）和肥胖特异性 QOL 较高显著相关（β=0.50，P＜0.001）。
在本队列中，SG 后 16 个月时 ESE 显著提高，55 个月时仍保持较高水平。ESE 改善最多的患者在术后 5 年时体重减轻和肥胖特异性 QOL 也最高。未来的研究应探讨 ESE 的增强是否与减重手术后饮食行为的持续改善相对应。
