Aouad Phillip, Stedal Kristin, Walø-Syversen Gro, Hay Phillipa, Lindvall Dahlgren Camilla
InsideOut Institute, University of Sydney, Sydney, Australia.
School of Medicine, Western Sydney University, Penrith, NSW, Australia.
J Eat Disord. 2021 Jul 21;9(1):89. doi: 10.1186/s40337-021-00441-5.
BACKGROUND: Studies into the disordered eating behaviour of chew and spit have alluded to several cohorts more likely to engage in the behaviour, one such group being bariatric surgery candidates and patients. Weight-loss surgery candidates have received little to no attention regarding engaging in chew and spit behaviour. Changes in pre- and post- surgery eating pathology related to chew and spit behaviour has yet to be explored and described in academic literature. CASE PRESENTATION: The current study reports on three cases of individual women, aged 30, 35, and 62 respectively, who indicated engagement in chew and spit. All three cases underwent bariatric surgery (two underwent gastric bypass, one underwent vertical sleeve gastrectomy). Eating pathology-including chew and spit behaviour, anxiety and depression, and adherence to the Norwegian nutritional guidelines were examined pre-operatively and post-operatively (one and two-year follow-up). At baseline (pre-surgery), two participants reported that they engaged in chew and spit, compared to one patient post-surgery. All three cases reported that they, to at least some extent, adhered to dietary guidelines post-surgery. Subjective bingeing frequency appeared to be relatively low for all three cases, further declining in frequency at one-year follow-up. At baseline, one participant reported clinically significant depression and anxiety, with no clinically significant depression or anxiety reported at follow-ups in participants that chew and spit. CONCLUSIONS: The current study provides a starting point for the exploration of chew and spit as a pathological symptom of disordered eating in bariatric patients. It highlights the need to further explore chew and spit before and after weight-loss surgery.
背景:关于咀嚼并吐出食物这种紊乱饮食行为的研究提到了几个更有可能出现这种行为的人群,肥胖症手术候选者和患者就是其中之一。减肥手术候选者在咀嚼并吐出食物行为方面几乎没有受到关注。术前和术后与咀嚼并吐出食物行为相关的饮食病理学变化尚未在学术文献中得到探索和描述。 病例报告:本研究报告了三例分别为30岁、35岁和62岁的女性个体病例,她们均表示有咀嚼并吐出食物的行为。所有三例均接受了减肥手术(两例接受胃旁路手术,一例接受垂直袖状胃切除术)。对饮食病理学进行了术前和术后(一年和两年随访)检查,包括咀嚼并吐出食物行为、焦虑和抑郁以及对挪威营养指南的遵守情况。在基线期(术前),两名参与者报告有咀嚼并吐出食物的行为,术后只有一名患者有此行为。所有三例均报告术后至少在一定程度上遵守了饮食指南。所有三例的主观暴饮暴食频率似乎相对较低,在一年随访时频率进一步下降。在基线期,一名参与者报告有临床显著的抑郁和焦虑,而有咀嚼并吐出食物行为的参与者在随访时未报告有临床显著的抑郁或焦虑。 结论:本研究为探索咀嚼并吐出食物作为肥胖症患者饮食紊乱的一种病理症状提供了一个起点。它强调了在减肥手术前后进一步探索咀嚼并吐出食物行为的必要性。
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