Department of Psychology, Royal Holloway, University of London, London, UK.
Bariatric Surgery Psychology Department, Chelsea and Westminster NHS Foundation Trust, Fulham, London, UK.
Obes Surg. 2020 Jun;30(6):2131-2139. doi: 10.1007/s11695-020-04424-4.
This study aimed to explore the experiences of women who had developed excessively restrictive eating behaviours following bariatric surgery.
Five female participants, who were at least nine months post-bariatric surgery and exhibiting restrictive eating behaviours, were recruited from Bariatric Surgery Psychology Services and asked to complete qualitative face-to-face semi-structured interviews. The data was analysed using interpretative phenomenological analysis (IPA).
Three super-ordinate themes emerged: (1) experiences of weight stigma and weight history on self, (2) the impact of loose skin, (3) thoughts about food and disordered eating patterns. These captured the impact of past weight-related experiences-including weight stigma, intense fears of weight gain, negative cognitions about the self, the impact of excess skin, changes in the way the women thought about food and restrictive eating behaviours.
This study is one of the first to specifically explore restrictive eating disorders after bariatric surgery using a qualitative approach. The findings of this study may offer helpful aspects for professionals to hold in mind when identifying individuals with problematic restrictive eating behaviours following bariatric surgery. Body contouring surgery, internalised weight bias and weight stigma are explored in relation to the post-bariatric surgery treatment pathway. The current diagnostic criterion for anorexia nervosa are discussed to highlight difficulties in diagnosing this presentation in the post-bariatric surgery population, where people can have BMIs over 25 kg/m but are severely restricting energy intake.
本研究旨在探讨经历过减重手术后出现过度限制进食行为的女性的体验。
从减重手术心理服务中招募了 5 名至少术后 9 个月且表现出限制进食行为的女性参与者，并要求她们完成定性面对面半结构化访谈。使用解释现象学分析（IPA）对数据进行分析。
出现了三个超主题：（1）与自我相关的体重耻辱感和体重史的体验，（2）皮肤松弛的影响，（3）对食物的想法和饮食失调模式。这些主题捕捉到了过去与体重相关的经历的影响，包括体重耻辱感、对体重增加的强烈恐惧、对自我的消极认知、多余皮肤的影响、女性对食物的看法和限制进食行为的变化。
这是首次使用定性方法专门探讨减重手术后限制进食障碍的研究之一。本研究的结果可能为专业人员在识别减重手术后出现问题性限制进食行为的个体时提供有帮助的方面。本文探讨了身体塑形手术、内化的体重偏见和体重耻辱感与减重手术后的治疗途径之间的关系。讨论了神经性厌食症的现行诊断标准，以突出在 BMI 超过 25kg/m2 但严重限制能量摄入的减重手术后人群中诊断这种表现的困难。
