Nutritional Unit, Ospedale Policlinico San Martino, University of Genova, Genova, Italy.
Department of Internal Medicine, University of Genova, Largo Benzi 8, Genova, 16132, Italy.
Eat Weight Disord. 2020 Oct;25(5):1191-1196. doi: 10.1007/s40519-019-00749-x. Epub 2019 Jul 13.
Aberrant eating patterns are frequently observed in bariatric patients. Since bariatric operations produce alterations in food transit and in appetite/satiety balance, postoperative eating behavior changes are not surprising.
88 consecutive obese patients undergoing Roux-en-Y gastric bypass (RYGBP, 50 cases) and Sleeve Gastrectomy (SG, 38 cases) were retrospectively evaluated. Beside anthropometric data measurement, eating behavior was assessed by direct interview prior to the operation and at the first and second postoperative years: patients were considered as eating disordered (ED) when referred habitual occurrence of binge eating and nibbling/grazing. Weight loss was assessed by percent of BMI loss (% Δ BMI). Together with standard follow-up, patients received additional behavioral/dietetic support upon request.
Postoperative ED patients showed lower % Δ BMI than the not ED ones at one (30.7% ± 8,5 vs. 26.8% ± 10, p < 0.02) and two (32% ± 10.3 vs. 27.4% ± 12.9, p < 0.05) years after operation, the follow-up rate being 82% and 76%, respectively, without differences between RYGBP and SG group. After RYGBP, an improvement of eating behavior was observed (ED patients from 75 to 28% at 1 year and to 27% at 2 years), while no changes were observed after SG. In SG patients, the number of additional behavioral/dietetic support sessions throughout the follow-up was positively associated with % Δ BMI.
The postoperative normalization of eating pattern has a role in weight loss after bariatric surgery. Behavioral/dietetic support is indicated in all SG patient, while after RYGBP is useful only when weight loss is unsatisfactory.
III: retrospective cohort study.
在肥胖症患者中，经常观察到异常的进食模式。由于减重手术会改变食物通过和食欲/饱腹感平衡，因此术后进食行为的改变并不奇怪。
回顾性评估了 88 例连续接受 Roux-en-Y 胃旁路术（RYGBP，50 例）和袖状胃切除术（SG，38 例）的肥胖患者。除了人体测量数据测量外，还在手术前和术后第 1 年和第 2 年通过直接访谈评估进食行为：当患者习惯性出现暴食和啃咬/放牧时，被认为患有饮食障碍（ED）。体重减轻通过 BMI 减轻百分比（% Δ BMI）来评估。除了标准随访外，患者还可以根据需要接受额外的行为/饮食支持。
术后 ED 患者在术后 1 年（30.7%±8.5 比 26.8%±10，p<0.02）和 2 年（32%±10.3 比 27.4%±12.9，p<0.05）时的% Δ BMI 低于非 ED 患者，随访率分别为 82%和 76%，RYGBP 和 SG 组之间无差异。RYGBP 后，进食行为得到改善（ED 患者从 1 年的 75%降至 28%，2 年的 27%），而 SG 后无变化。在 SG 患者中，整个随访过程中额外的行为/饮食支持次数与% Δ BMI 呈正相关。
减重手术后进食模式的正常化在减重手术减肥中起作用。所有 SG 患者均需要行为/饮食支持，而 RYGBP 仅在体重减轻不满意时有用。
III：回顾性队列研究。
