Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA.
Department of Psychology, Yale University, New Haven, Connecticut, USA.
Obesity (Silver Spring). 2019 Aug;27(8):1239-1243. doi: 10.1002/oby.22514. Epub 2019 Jun 17.
Little is known regarding overvaluation of weight or shape, a key cognitive feature of eating disorders, among individuals with disordered eating following bariatric surgery. This study examined the significance of overvaluation of weight or shape among post-bariatric surgery patients with loss-of-control (LOC) eating.
Participants were 145 individuals who had undergone sleeve gastrectomy within the previous 6 months and reported regular LOC eating. Overvaluation of weight or shape, LOC eating, and eating disorder psychopathology were assessed using the Eating Disorder Examination (EDE)-Bariatric Surgery Version interview; depressive symptoms and disability were assessed by the Beck Depression Inventory (BDI-II) and the Sheehan Disability Scale (SDS), respectively.
Overvaluation of weight or shape, examined continuously, was correlated significantly with higher levels of eating disorder psychopathology (EDE), depression (BDI-II), and disability (SDS). Categorically, using established clinical cut points, relative to the subclinical overvaluation group (n = 70 [48.3%]), the clinical overvaluation group (n = 75 [51.7%]) reported significantly greater frequency of LOC eating episodes and higher EDE, BDI-II, and SDS scores. The two groups did not differ significantly in current BMI or percent weight loss following surgery.
These findings, which highlight the clinical significance of overvaluation of weight or shape among patients with LOC eating following bariatric surgery, are similar to those previously reported for binge-eating disorder. Postoperatively, overvaluation of weight or shape was associated with greater eating disorder psychopathology, depression, and disability.
在接受减重手术后出现饮食失调的个体中,对体重或体型的过度重视(进食障碍的一个关键认知特征)知之甚少。本研究调查了体重控制障碍(LOC)进食的肥胖症手术后患者中过度重视体重或体型的意义。
参与者为 145 名在过去 6 个月内接受过袖状胃切除术且报告经常出现 LOC 进食的个体。使用饮食障碍检查(EDE)-减重手术版本访谈评估对体重或体型的过度重视、LOC 进食和进食障碍心理病理学;使用贝克抑郁量表(BDI-II)和希恩残疾量表(SDS)分别评估抑郁症状和残疾。
连续检查发现,对体重或体型的过度重视与更高水平的进食障碍心理病理学(EDE)、抑郁(BDI-II)和残疾(SDS)显著相关。从分类上看,与亚临床过度重视组(n=70[48.3%])相比,临床过度重视组(n=75[51.7%])报告的 LOC 进食发作频率更高,EDE、BDI-II 和 SDS 评分也更高。两组在手术后的当前 BMI 或体重减轻百分比方面没有显著差异。
这些发现突出了肥胖症手术后出现 LOC 进食的患者对体重或体型的过度重视的临床意义,与先前报告的暴食障碍相似。手术后,对体重或体型的过度重视与更严重的进食障碍心理病理学、抑郁和残疾有关。