Novarum, Center for Eating Disorders and Obesity, Jacob Obrechtstraat 92, 1071 KR, Amsterdam, The Netherlands.
Arkin, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands.
Eat Weight Disord. 2021 Apr;26(3):963-972. doi: 10.1007/s40519-020-00930-7. Epub 2020 May 29.
Bariatric surgery is the most effective long-term treatment for sustained weight loss in obesity. Studies have shown that not all patients lose the expected amount of weight. The aim of this study was to develop a better understanding of which behavioral and psychological factors are associated with suboptimal weight loss.
The present paper describes a cross-sectional study that included 140 participants. The mean follow-up period after bariatric surgery was 3.16 years. Eating disorder pathology (Eating Disorder Examination-Questionnaire), impulsivity (Barratt Impulsiveness scale-II) and depressive symptoms (Beck Depression Inventory) were compared with successful and suboptimal participants. A weight loss of more than or equal to 50% of excess weight, was considered to be successful.
More than 81% of the participants met the criterion for successful weight loss. The suboptimal weight loss group reported more symptoms of eating disorder pathology (p = .001), more loss of control over eating (p = .001), and more avoidant behavior due to poor body image (p < .001). The suboptimal weight loss group scored higher on impulsivity (p = .007) and on depression (p < .001). More early weight loss was associated with better weight outcome later on (r = .491). Reporting more eating disorder pathology, a longer follow-up period and pre-operative super-obesity (body mass index ≥ 50 kg/m) at the time of surgery were associated with poorer weight loss (p < .001).
Eating disorder pathology, loss of control over eating and avoidant behavior due to poor body image, as well as depressive symptoms and impulsivity, (as reported postoperatively) are associated with suboptimal weight loss. Level III: Case-control analytic study.
减重手术是肥胖症患者长期有效减轻体重的最有效方法。研究表明，并非所有患者都能达到预期的减重效果。本研究旨在更好地了解哪些行为和心理因素与减重效果不佳有关。
本研究为横断面研究，共纳入 140 名参与者。术后平均随访时间为 3.16 年。比较了饮食障碍病理学（饮食障碍检查问卷）、冲动性（巴雷特冲动量表-II）和抑郁症状（贝克抑郁量表）与成功和效果不佳的参与者。体重减轻超过或等于多余体重的 50%被认为是成功的。
超过 81%的参与者符合成功减重的标准。效果不佳的体重减轻组报告了更多的饮食障碍病理学症状（p = .001）、更多的饮食失控（p = .001）以及更多的因不良身体形象而回避行为（p < .001）。效果不佳的体重减轻组冲动性得分更高（p = .007）和抑郁得分更高（p < .001）。早期体重减轻与后期更好的体重结果相关（r = .491）。报告更多的饮食障碍病理学、更长的随访时间以及术前超肥胖（体重指数≥50 kg/m）与较差的减重效果相关（p < .001）。
术后报告的饮食障碍病理学、饮食失控和因不良身体形象而回避行为以及抑郁症状和冲动性与减重效果不佳有关。三级：病例对照分析研究。
