Department of Research, Innlandet Hospital Trust, N-2381 Brumunddal, Norway.
Nutrients. 2020 Jul 5;12(7):1997. doi: 10.3390/nu12071997.
Treatment of subjects with morbid obesity (Body Mass Index (BMI) > 40 kg/m or > 35 kg/m with obesity-related complications) often fails. This study explored the biopsychosocial predictors of dropout and weight loss during a combined behavioural and surgical weight-reduction program. Behavioural treatment for six months was followed by bariatric surgery and a visit six months after surgery. The success criterion was the loss of ≥50% of excess BMI above 25 kg/m (%EBMIL). Thirty-one men and 113 women with BMI 43.5 kg/m (SD 4.3) and 41.8 kg/m (SD 3.6), respectively, were included; 115 underwent bariatric surgery (Gastric sleeve: 23; Roux-en-Y gastric bypass: 92), and 98 had a follow-up visit six months after surgery. The mean %EBMIL at follow-up was 71.2% (SD 18.5). Treatment success was achieved in 86 subjects. Assuming success in 17 subjects who did not attend the follow-up visit (best possible outcome), 103 out of 144 subjects (72%) achieved successful weight reduction. Cohabitation was the only predictor of accomplishing surgery. Neither weight loss during behavioural therapy nor biopsychosocial factors were found to be clinically significant predictors of weight loss after surgery. The success rate of less than three in four subjects was unsatisfactory. There is a need to improve the regimen and to determine effective alternative interventions.
治疗病态肥胖患者（身体质量指数（BMI）>40kg/m2 或>35kg/m2 且伴有肥胖相关并发症）往往会失败。本研究探讨了综合行为和手术减肥计划中脱落和减肥的生物心理社会预测因素。行为治疗持续六个月，随后进行减肥手术，并在手术后六个月进行访问。成功标准是超过 25kg/m2 的多余 BMI 减轻≥50%（%EBMIL）。纳入了 31 名男性和 113 名女性，BMI 分别为 43.5kg/m2（SD 4.3）和 41.8kg/m2（SD 3.6），其中 115 名接受了减肥手术（胃袖状切除术：23 例；Roux-en-Y 胃旁路术：92 例），98 名在手术后六个月进行了随访。随访时的平均%EBMIL 为 71.2%（SD 18.5）。治疗成功 86 例。假设 17 名未参加随访的患者（最佳可能结果）成功，144 名患者中有 103 名（72%）成功减轻体重。同居是完成手术的唯一预测因素。行为治疗期间的体重减轻或生物心理社会因素均未被发现是手术后体重减轻的临床显著预测因素。不到四分之三的患者的成功率不理想。需要改进方案并确定有效的替代干预措施。
