Department of Obesity and Metabolic Surgery, Ospedale Evangelico Betania, Naples, Italy,
Department of Obesity and Metabolic Surgery, Sana Klinikum Offenbach, Offenbach am Main, Germany,
Obes Facts. 2020;13(3):307-320. doi: 10.1159/000506838. Epub 2020 May 5.
The hypothesis of "cross-addiction" has never been validated, and numerous aspects speak against it.
To compare the differences between sleeve gastrectomy (SG) and gastric bypass (GB) procedures concerning cross-addiction.
Center for maximum care in Germany.
We performed a prospective analysis of patients undergoing SG or GB as the first surgical treatment for severe obesity. All patients completed validated questionnaires to evaluate food intake (Yale Food Addiction Scale, YFAS), alcohol intake (Alcohol Use Disorders Identification Test), nicotine use (Fagerstrom Test for Nicotine Dependence), exercise (Exercise Addiction Inventory), drug addiction (20-item Drug Abuse Screening Test), and Internet use disorder (Internet Addiction Test) before the operation (T0) and 6 (T6) and 24 (T24) months postoperatively (ClinicalTrials.gov identifier: NCT02757716).
One hundred thirteen patients underwent SG (n = 68) or GB (n = 45). At the follow-up, 61% completed the questionnaires at T6 and 44% at T24. In the YFAS, the percentage of patients diagnosed with food addiction decreased from 69 to 10%, and the mean symptom count decreased from 3.52 ± 1.95 to 1.26 ± 0.99 at T24 (p < 0.0001); these values did not differ between the surgical groups (p = 0.784). No significant evidence of cross-addiction was observed for use of alcohol, nicotine, drugs, the Internet, or exercise in either surgical group. The percentage of patients with moderate nicotine dependence increased in the SG group (+8.9%) at T24, but this was not significant.
In this single-center cohort study, surgery for obesity caused significant addiction remission regarding food but without inducing cross-addiction after 2 years. Importantly, no significant differences were seen between the SG and GB procedures.
“交叉成瘾”假说从未得到验证，并且有许多方面对此表示反对。
比较袖状胃切除术（SG）和胃旁路术（GB）在交叉成瘾方面的差异。
德国最大关怀中心。
我们对接受 SG 或 GB 作为严重肥胖症首次手术治疗的患者进行了前瞻性分析。所有患者在手术前（T0）和术后 6 个月（T6）和 24 个月（T24）完成了经过验证的问卷，以评估食物摄入（耶鲁食物成瘾量表，YFAS）、酒精摄入（酒精使用障碍识别测试）、尼古丁使用（尼古丁依赖 Fagerstrom 测试）、运动（运动成瘾量表）、药物滥用（20 项药物滥用筛查测试）和互联网使用障碍（互联网成瘾测试）（ClinicalTrials.gov 标识符：NCT02757716）。
113 名患者接受了 SG（n = 68）或 GB（n = 45）治疗。在随访中，61%的患者在 T6 完成了问卷，44%的患者在 T24 完成了问卷。在 YFAS 中，被诊断为食物成瘾的患者比例从 69%下降到 10%，平均症状数从 3.52 ± 1.95 下降到 1.26 ± 0.99（p < 0.0001）；两组之间没有差异（p = 0.784）。在任何一组手术中，都没有观察到酒精、尼古丁、药物、互联网或运动使用的交叉成瘾的显著证据。SG 组在 T24 时中度尼古丁依赖的患者比例增加了（+8.9%），但这并不显著。
在这项单中心队列研究中，肥胖症手术导致食物成瘾显著缓解，但在 2 年后没有引起交叉成瘾。重要的是，SG 和 GB 手术之间没有明显差异。
