Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, UK.
Diabetes Complications Research Centre, University College Dublin, Dublin, Ireland.
Obes Rev. 2021 Jun;22(6):e13202. doi: 10.1111/obr.13202. Epub 2021 Feb 1.
Gastric bypass surgery is an effective long-term treatment for individuals with severe obesity. Changes in appetite, dietary intake, and food preferences have all been postulated to contribute to postoperative body weight regulation, however, findings are inconsistent. The aim of this systematic review was to evaluate the current literature on changes in dietary intake and appetite following gastric bypass surgery, in the context of the methodology used and the analysis, interpretation, and presentation of results. Four databases were systematically searched with terms related to "gastric bypass surgery," "appetite," and "dietary intake," and 49 papers (n = 2384 patients after gastric bypass) were eligible for inclusion. The evidence indicated that only a reduction in overall energy intake and an increase in postprandial satiety are maintained beyond 6-month post-surgery, whereas relative macronutrient intake and premeal hunger remain unchanged. However, available data were limited by inconsistencies in the methods, analysis, presentation, and interpretation of results. In particular, there was a reliance on data collected by subjective methods with minimal acknowledgment of the limitations, such as misreporting of food intake. There is a need for further work employing objective measurement of appetite and dietary intake following gastric bypass surgery to determine how these mechanisms may contribute to weight regulation in the longer term.
胃旁路手术是治疗严重肥胖症患者的有效长期治疗方法。食欲、饮食摄入和食物偏好的变化都被认为有助于术后体重调节，但研究结果不一致。本系统评价的目的是评估胃旁路手术后饮食摄入和食欲变化的现有文献，同时考虑使用的方法以及结果的分析、解释和呈现。通过与“胃旁路手术”、“食欲”和“饮食摄入”相关的术语对四个数据库进行了系统搜索，共有 49 篇论文（n = 2384 例胃旁路手术后患者）符合纳入标准。证据表明，只有在手术后 6 个月以上，才能维持总能量摄入的减少和餐后饱腹感的增加，而相对宏量营养素的摄入和餐前饥饿感则保持不变。然而，现有数据受到方法、分析、呈现和结果解释方面不一致的限制。特别是，人们依赖于通过主观方法收集数据，几乎没有认识到这些方法的局限性，例如食物摄入量的错误报告。需要进一步的工作，采用客观测量胃旁路手术后的食欲和饮食摄入，以确定这些机制如何有助于长期的体重调节。
