Endocrinology and Nutrition Department, University Hospital Arnau de Vilanova, Obesity, Diabetes and Metabolism Research Group (ODIM), IRBLleida, University of Lleida, Av. Rovira Roure 80, 25198, Lleida, Catalonia, Spain.
Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Obes Surg. 2019 Oct;29(10):3348-3356. doi: 10.1007/s11695-019-04001-4.
INTRODUCTION/PURPOSE: The assessment of the patients' motivation as a predictor of behavioral change via five stages (pre-contemplation, contemplation, preparation, action, and maintenance) and four processes (emotional re-evaluation, weight management actions, environmental restructuring, and weight consequences evaluation) of change.
MATERIALS/METHODS: A total of 542 participants (251 waiting for bariatric surgery (BS), 90 undergoing BS, and 201 controls) completed the Stages (S-Weight) and Processes (P-Weight) of Change in Overweight and Obese People questionnaires in a multicenter cross-sectional study.
A higher percentage of subjects seeking BS (31.7%) were in the action stage (16.7% of post-BS patients, p < 0.001; 14.9% of controls, p < 0.001). The referred body mass index (BMI) reduction was higher in subjects in active stages (3.6 ± 4.4 kg/m in maintenance versus 1.4 ± 1.4 kg/m in contemplation, p < 0.001). In the P-Weight questionnaire, patients looking for BS scored significant higher in the four processes of change than controls. In addition, a positive and significantly correlation between BMI and the four processes was observed. In the stepwise multivariate analysis, BMI and the S-Weight allocation were constantly associated with the four processes of change.
Obesity is accompanied by a modifying behavioral stage, suggesting that subjects before BS are seriously thinking about overcoming excess weight. To identify subjects on the waiting list for BS who will be more receptive to weight lost interventions remains a challenge.
简介/目的：通过五个阶段（前沉思、沉思、准备、行动和维持）和四个过程（情感重新评估、体重管理行动、环境重构和体重后果评估）来评估患者的动机，以预测行为改变。
材料/方法：共有 542 名参与者（251 名等待减肥手术（BS），90 名接受 BS，201 名对照）完成了超重和肥胖人群改变的阶段（S-Weight）和过程（P-Weight）问卷的多中心横断面研究。
寻求 BS 的受试者中，更多的人处于行动阶段（BS 后患者中 16.7%，p<0.001；对照组中 14.9%，p<0.001）。处于积极阶段的受试者体重指数（BMI）降低幅度更高（维持阶段 3.6±4.4 kg/m，沉思阶段 1.4±1.4 kg/m，p<0.001）。在 P-Weight 问卷中，寻求 BS 的患者在四个改变过程中的得分明显高于对照组。此外，BMI 与四个过程呈正相关。在逐步多元分析中，BMI 和 S-Weight 分配与四个改变过程始终相关。
肥胖伴随着行为阶段的改变，这表明 BS 前的受试者正在认真考虑克服超重问题。确定 BS 候补名单上更愿意接受减肥干预的患者仍然是一个挑战。
