“走自己的路，让别人说去吧”：青少年在接受减重手术后生活的感悟。
"Your own pace, your own path": perspectives of adolescents navigating life after bariatric surgery.
机构信息
Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Department of Psychology, The Hospital for Sick Children, Toronto, ON, Canada.
出版信息
Int J Obes (Lond). 2021 Dec;45(12):2546-2553. doi: 10.1038/s41366-021-00928-w. Epub 2021 Aug 12.
INTRODUCTION
Bariatric surgery, an established weight-loss tool, may be offered to some adolescents with severe obesity. However, few studies explore adolescents' postoperative experiences beyond physical and metabolic outcomes and quality-of-life measures.
METHODS
Between 2016 and 2021, 45 semi-structured interviews were conducted with adolescents (16-20 years) at 6 months (N = 15), 12 months (N = 15), and 24 months (N = 15) following bariatric surgery. A deductive thematic analysis framework was applied by two independent coders (Cronbach's α = 0.84). Themes were identified and refined iteratively, and discrepancies were resolved through discussion.
RESULTS
Five major themes emerged related to: (1) weight-loss expectations vs. reality, (2) social landscape, (3) body image, (4) eating and moving, and (5) challenges for long-term success. The pace of and satisfaction with weight loss and side effects was heterogenous among participants, with most changes occurring early and stabilizing by 24 months. Adolescents adapted over time to their new social landscapes (e.g., relationships) and reported improved body image and confidence, yet persistently struggled to reconcile their internal identity with evolving external perceptions and discomfort with new attention. Participants experienced changes to lifestyle routines after surgery (e.g., eating, moving, habits), which introduced distress at 6 months but resolved over time. Life transitions in early adulthood (e.g., moving away, university/college, employment), concurrent with their evolving and increasing autonomy, physical, social, and financial independence, imposed unexpected challenges to postoperative routines and support systems. Participants unanimously reaffirmed that bariatric surgery is a lifelong journey and that they were committed to long-term success.
CONCLUSION
Our findings provide insight into optimizing adolescent selection for bariatric surgery and perioperative support. Specifically, important life transitions during this developmental period impact postoperative experiences and outcomes and adolescents may benefit from postoperative counseling focused on managing weight-loss expectations and adapting to evolving nutritional needs and changing social circumstances.
简介
减重手术作为一种已确立的减肥手段，可能会被用于一些严重肥胖的青少年。然而，很少有研究探讨青少年术后的体验，除了身体和代谢结果以及生活质量措施。
方法
在 2016 年至 2021 年间，对 45 名（16-20 岁）接受过减重手术的青少年在术后 6 个月（N=15）、12 个月（N=15）和 24 个月（N=15）时进行了 45 次半结构化访谈。两名独立编码员应用了一个演绎主题分析框架（Cronbach's α=0.84）。主题是通过反复识别和精炼确定的，分歧通过讨论解决。
结果
出现了五个主要主题，涉及：（1）减肥预期与现实，（2）社会环境，（3）身体形象，（4）饮食和运动，以及（5）长期成功的挑战。参与者之间减肥速度和满意度以及副作用存在差异，大多数变化发生在早期，并在 24 个月时稳定下来。青少年随着时间的推移适应了他们的新社会环境（例如关系），并报告说他们的身体形象和信心得到了改善，但仍在努力调和他们的内在身份与不断变化的外部认知以及对新关注的不适应。手术后，参与者的生活方式（如饮食、运动、习惯）发生了变化，这在 6 个月时引起了困扰，但随着时间的推移得到了解决。成年早期的生活过渡（如搬离、上大学/学院、就业），伴随着他们不断增强的自主性、身体、社会和经济独立，给术后常规和支持系统带来了意想不到的挑战。参与者一致重申，减重手术是一个终身的旅程，他们致力于长期成功。
结论
我们的研究结果提供了优化青少年减重手术选择和围手术期支持的见解。具体来说，在这个发展阶段的重要生活过渡会影响术后的体验和结果，青少年可能受益于术后咨询，重点是管理减肥预期和适应不断变化的营养需求和变化的社会环境。
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