Nutritional Unit, University of Genova, Genoa, Italy.
Ospedale Policlinico San Martino, Department of Internal Medicine, University of Genova, Largo Benzi 8, 16132, Genoa, Italy.
Obes Surg. 2020 Jan;30(1):244-248. doi: 10.1007/s11695-019-04146-2.
Weight outcomes after bariatric surgery are due to an adequate adjustment of eating behavior to the new gastrointestinal conditions created by operation. The efficacy of dietary/behavior counseling for promoting weight loss and maintenance in a growing number of bariatric patients was investigated.
One hundred seventy-six non-diabetic obese patients undergoing Roux-en-Y gastric bypass (RYGBP) and sleeve gastrectomy (SG) were investigated. The first group (CO, 88 subjects, 16 male) attended a standard surgical follow-up, while in the second (DIET, 88 subjects, 15 male) the surgeon was supported by a dietitian, and patients received behavioral-dietary sessions on individual request. Data prior to the operation and at 2 years were considered, the weight outcome being regarded as successful when postoperative body mass index (BMI) value was lower than 30 kg/m.
Weight results were better (p < 0.01) in the RYGBP than in the SG patients. In comparison to CO, in the DIET group a greater adherence to the bariatric program was observed (76% vs. 41%, < 0.01), while body weight data and prevalence of successful cases at 2 years (87 ± 23 vs. 83 ± 16 kg and 27% vs.33%, respectively) were similar.
After RYSG and SG, postoperative dietetic/behavioral sessions delivered on patient's request does not influence weight results. The dietetic intervention promotes the adherence to bariatric program and prevents postoperative follow-up loss. In a dietitian/behavioral strategy after RYGBP and SG, a cognitive reinforcement of the compliance to bariatric program and a strengthening of the motivation to changes could promote better weight results.
减重手术后的体重结果归因于通过手术对新胃肠道条件的充分调整，从而对进食行为进行适当调整。本研究旨在调查饮食/行为咨询在促进越来越多的减重患者减肥和维持体重方面的疗效。
本研究共纳入 176 名非糖尿病肥胖患者，他们接受了 Roux-en-Y 胃旁路术（RYGBP）和袖状胃切除术（SG）。第一组（CO，88 例，16 例男性）接受了标准的手术随访，而第二组（DIET，88 例，15 例男性）由营养师支持，根据患者的个体要求进行行为饮食干预。在手术前和 2 年后都记录了相关数据，当术后体重指数（BMI）值低于 30 kg/m²时，将体重结果视为成功。
RYGBP 患者的减重效果优于 SG 患者（p<0.01）。与 CO 相比，DIET 组对减重计划的依从性更高（76% vs. 41%，<0.01），而 2 年后的体重数据和成功案例的比例（87±23 与 83±16 kg 和 27%与 33%）相似。
RYGBP 和 SG 术后根据患者要求进行的饮食和行为干预不会影响减重效果。饮食干预促进了对减重计划的依从性，并防止了术后随访的体重下降。在 RYGBP 和 SG 后采用饮食和行为策略，对患者的依从性进行认知强化，并加强对改变的动机，可能会促进更好的减重效果。
