Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Obes Rev. 2019 Oct;20(10):1413-1425. doi: 10.1111/obr.12907. Epub 2019 Jul 19.
Bariatric surgery has been recognized as the gold standard treatment for severe obesity. Although postbariatric surgery patients usually achieve and maintain substantial weight loss, a group of individuals may exhibit weight regain. Several factors are proposed to weight regain, including psychiatric comorbidity. The objective of the study is to conduct a systematic review and meta-analysis of studies investigating the relationship between psychiatric comorbidity and weight regain. A systematic review through PubMed, Web of Science, Cochrane Library, Scopus, and PsycINFO was performed, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). After a stepwise selection, 13 articles were included in the qualitative analysis and 5 were included for a meta-analysis. Women was majority in most of the studies (87.6%), and a bypass procedure was the bariatric intervention most evaluated (66.8%), followed by gastric banding (32.1%) and sleeve (1.1%). Higher rates of postbariatric surgery eating psychopathology were reported in patients with weight regain. However, the association between general psychopathology and weight regain was not consistent across the studies. In the meta-analysis, the odds of eating psychopathology in the weight regain group was higher compared with the nonweight regain group (OR = 2.2, 95% CI 1.54-3.15). Postbariatric surgery eating psychopathology seems to play an important role in weight regain.
减重手术已被公认为严重肥胖的金标准治疗方法。尽管减重手术后患者通常会实现并维持显著的体重减轻，但仍有一部分患者会出现体重反弹。一些因素被提出与体重反弹有关，包括精神共病。本研究的目的是对研究减重手术后精神共病与体重反弹之间关系的研究进行系统回顾和荟萃分析。通过 PubMed、Web of Science、Cochrane 图书馆、Scopus 和 PsycINFO 进行了系统回顾，遵循系统评价和荟萃分析的首选报告项目（PRISMA）。经过逐步筛选，13 篇文章纳入定性分析，5 篇文章纳入荟萃分析。大多数研究（87.6%）中女性占多数，评估最多的减重干预措施是旁路手术（66.8%），其次是胃束带（32.1%）和袖状胃切除术（1.1%）。体重反弹患者的减重后饮食心理病理学发生率较高。然而，一般精神病理学与体重反弹之间的关联在研究之间并不一致。荟萃分析中，体重反弹组的饮食心理病理学的可能性高于非体重反弹组（OR = 2.2，95% CI 1.54-3.15）。减重后饮食心理病理学似乎在体重反弹中起着重要作用。
