Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
J Behav Med. 2021 Jun;44(3):421-436. doi: 10.1007/s10865-021-00201-5. Epub 2021 Feb 12.
Bariatric surgery is the most effective treatment for severe obesity; however, a subset of patients experience suboptimal outcomes. Psychosocial interventions that address eating pathology may ameliorate negative consequences, although their efficacy has not been examined. Thus, a systematic review to evaluate the impact of psychosocial randomized controlled trials (RCTs) on eating pathology in adults pre and post-bariatric surgery was conducted. Six scientific databases were searched for psychosocial trials assessing eating pathology as an outcome. Ten RCTs representing seven distinct interventions were identified (i.e., four preoperative and six postoperative). Trials utilized cognitive-behavioral therapy, mindfulness-based approaches, acceptance-based treatment, motivational interviewing, and psychoeducational interventions. Findings provide initial support for reducing eating pathology pre and postoperatively in the short-term (i.e., 6 months); however, the small number of RCTs and heterogeneity among postoperative trials made it difficult to draw conclusions. Additional longitudinal studies are needed to determine the long-term impact of psychosocial interventions that address eating pathology in bariatric surgery patients endorsing significant eating pathology.
减重手术是治疗重度肥胖症最有效的方法；然而，一部分患者的治疗效果并不理想。针对进食障碍的心理社会干预措施可能改善负面后果，尽管其疗效尚未得到检验。因此，我们进行了一项系统综述，以评估心理社会随机对照试验（RCT）对减重手术前后成年人进食障碍的影响。我们在六个科学数据库中搜索了评估进食障碍作为结果的心理社会试验。确定了 10 项 RCT，代表了 7 种不同的干预措施（即 4 项术前和 6 项术后）。试验采用了认知行为疗法、正念方法、基于接纳的治疗、动机性访谈和心理教育干预。研究结果初步支持在短期内（即 6 个月）减少减重手术前后的进食障碍；然而，由于术后试验的 RCT 数量较少且存在异质性，很难得出结论。需要进行更多的纵向研究，以确定针对减重手术患者进食障碍的心理社会干预措施对有明显进食障碍的患者的长期影响。
