Fang Ching-Tzu, Chen Vincent Chin-Hung, Ma Hsiang-Ting, Chao Hse-Huang, Ho Ming-Chou, Gossop Michael
Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi.
Taiwan Center for Metabolic and Bariatric Surgery, Jen-Ai Hospital.
J Clin Psychopharmacol. 2019 Mar/Apr;39(2):145-152. doi: 10.1097/JCP.0000000000001016.
PURPOSE/BACKGROUND: Obesity is recognized as an important risk factor for many chronic diseases and is a major health issue. The current study examined attentional bias to food and the "cool" (inhibitory control and mental flexibility) and "hot" (affective decision making) executive functions (EFs) in obese patients preparing for bariatric surgery. In addition to body mass index (BMI), this study examined the impact of the binge-eating tendency and eating styles.
The study population comprised 21 morbidly obese patients preparing to undergo bariatric surgery (BMI ≥30 kg/m) and 21 normal-weight controls (24 kg/m > BMI ≥ 18.5 kg/m). The Visual Probe Task was adopted to examine attentional bias toward food-related cues. The Stop-Signal Task and the Color Trails Test were used to assess inhibitory control and mental flexibility, respectively. The Iowa Gambling Task was administered to assess the affective decision making.
(1) The obese patients showed poorer performances on cool EFs (for Color Trails Test, P = 0.016, ηp = 0.136; for Stop-Signal Task, P = 0.049, ηp = 0.093) and hot EF (for Iowa Gambling Task, normal controls showed progressed performance, P = 0.012, ηp = 0.077, but obese patients did not show this progress, P = 0.111, ηp = 0.089) compared with the normal controls; (2) participants with low binge-eating tendency had larger attentional biases at 2000 milliseconds than at 200 milliseconds on food-related cues (P = 0.003, ηp = 0.363); and (3) low-restrained participants exhibited attentional bias toward the low-calorie food cues, compared with the high-restrained group (P = 0.009, ηp = 0.158).
The current study contributes to the development of a different therapeutic focus on obese patients and binge eaters.
目的/背景：肥胖被认为是许多慢性疾病的重要风险因素，是一个主要的健康问题。本研究调查了准备接受减肥手术的肥胖患者对食物的注意力偏向以及“冷”（抑制控制和心理灵活性）和“热”（情感决策）执行功能（EFs）。除了体重指数（BMI）外，本研究还考察了暴饮暴食倾向和饮食方式的影响。
研究人群包括21名准备接受减肥手术的病态肥胖患者（BMI≥30kg/m）和21名正常体重对照者（24kg/m＞BMI≥18.5kg/m）。采用视觉探测任务来检查对食物相关线索的注意力偏向。分别使用停止信号任务和颜色轨迹测试来评估抑制控制和心理灵活性。进行爱荷华赌博任务以评估情感决策。
（1）与正常对照组相比，肥胖患者在冷执行功能（颜色轨迹测试，P = 0.016，ηp = 0.136；停止信号任务，P = 0.049，ηp = 0.093）和热执行功能（爱荷华赌博任务，正常对照组表现出进步，P = 0.012，ηp = 0.077，但肥胖患者未表现出这种进步，P = 0.111，ηp = 0.089）方面表现较差；（2）暴饮暴食倾向低的参与者在2000毫秒时对食物相关线索的注意力偏向比200毫秒时更大（P = 0.003，ηp = 0.363）；（3）与高节制组相比，低节制参与者对低热量食物线索表现出注意力偏向（P = 0.009，ηp = 0.158）。
本研究有助于为肥胖患者和暴饮暴食者制定不同的治疗重点。
