Department of Medicine, Division Endocrinology and Metabolism, Universidade Federal de São Paulo, End: Street Leandro Duprat, 365, São Paulo, 04025-010, Brazil.
Department of Medicine, Obesity and Metabolism Syndrome Outpatient Service, Universidade de São Paulo, São Paulo, Brazil.
Eat Weight Disord. 2021 Feb;26(1):191-199. doi: 10.1007/s40519-019-00839-w. Epub 2020 Jan 2.
Weight regain (WR) after bariatric surgery (BS) is frequent.
The aim of this study was to evaluate whether the occurrence of psychiatric disorders would be associated with short- and long-term WR after BS.
Ninety-six patients (77.6% female, age 40.2 ± 10.1 years, BMI of 50 ± 8.2 kg/m) from the Obesity and Bariatric Surgery Outpatient Clinic of the Universidade Federal São Paulo completed the Questionnaire on Eating and Weight Patterns-Revised, the Beck Depression Inventory and an anxiety inventory to assess the occurrence of binge eating, depressive symptoms (DS) and anxious symptoms (AS) before and after short-term and long-term BS.
Twenty-four months after BS, the prevalence of binge eating, depression and anxiety decreased from 100 to 13%, 100 to 15% and 43 to 4%, respectively. The mean WR of 35.2 ± 17.3% of weight loss occurred in nine patients after 24 months and was associated with binge eating (p = 0.002) but not with DS or AS. At long-term follow-up (12 ± 1.5 years), 67% had a mean WR of 50.3 ± 24.9%. The prevalence of binge eating, DS and AS were 48%, 46% and 63%, respectively, in this group, and significant associations were observed between WR and binge eating (p = 0.001), DS (p = 0.029) and AS (p = 0.001). Furthermore, the number of psychiatric disorders was inversely associated with the percentage of weight loss (p < 0.05) and positively associated with WR (p < 0.05).
Weight regain was associated with the occurrence of binge eating in the short and long term after BS, whereas the occurrence of depressive and anxious symptoms was associated with WR only in the long term.
Evidence obtained from well-designed cohort or case-control analytic studies.
减重手术后体重反弹（WR）很常见。
本研究旨在评估精神障碍的发生是否与 BS 后的短期和长期 WR 相关。
来自圣保罗联邦大学肥胖与减重外科门诊的 96 名患者（77.6%为女性，年龄 40.2±10.1 岁，BMI 为 50±8.2kg/m）完成了饮食和体重模式修订问卷、贝克抑郁量表和焦虑量表，以评估 BS 前后短期和长期暴食、抑郁症状（DS）和焦虑症状（AS）的发生情况。
BS 后 24 个月，暴食、抑郁和焦虑的患病率从 100%分别下降至 13%、100%至 15%和 43%至 4%。9 例患者在 24 个月后体重减轻 35.2±17.3%，体重出现 WR，与暴食行为相关（p=0.002），但与 DS 或 AS 无关。在长期随访（12±1.5 年）中，67%的患者 WR 为 50.3±24.9%。在该组中，暴食、DS 和 AS 的患病率分别为 48%、46%和 63%，WR 与暴食行为（p=0.001）、DS（p=0.029）和 AS（p=0.001）均显著相关。此外，精神障碍的数量与体重减轻百分比呈负相关（p<0.05），与 WR 呈正相关（p<0.05）。
BS 后短期和长期 WR 与暴食行为的发生相关，而抑郁和焦虑症状的发生仅与长期 WR 相关。
级别 III：来源于精心设计的队列或病例对照分析研究的证据。
