Department of Psychology, Catholic University of Milan, Milan, Italy,
Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Milan, Italy,
Obes Facts. 2022;15(1):1-18. doi: 10.1159/000518200. Epub 2021 Nov 23.
Optimizing maintenance of weight loss for people with obesity following intragastric balloon (IGB) therapy hinges on the degree to which health care providers can recognize both the impact of emotional problems and mood difficulties on their capacity to self-manage, and requirements for additional support. However, there is limited research on the psychological correlates of IGB therapy. This systematic review, for the first time, attempts to identify and synthesize the empirical evidence for the reciprocal influence between psychological variables and IGB outcomes.
A literature search was performed in the PubMed, SCOPUS, MEDLINE, and Google Scholar databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed using rigorous inclusion criteria and screening by at least 2 reviewers. The selected articles were assessed for quality using the Strengthening the Reporting of Observational Studies Epidemiology (STROBE) checklist. Data were extracted to address the review aims and presented as a narrative synthesis. The review protocol was preregistered (Prospero CRD42019121291).
A total of 16,179 titles, 14,369 abstracts, and 51 full-text articles were screened, of which 16 studies were included. Findings suggest that female gender, older age, basic educational level, and single/divorced civil status, together with lower levels of depression, binge eating, higher perceived quality of life, and motivation to change were predictors of enhanced IGB treatment outcomes. Dissatisfaction with treatment was higher in those with impaired obesity-related social-life difficulties. The IGB treatment was effective in reducing weight and improving depression, anxiety, eating disorder symptoms, and the overall life quality of patients with obesity - mainly within 6 months from the device positioning and in conjunction with conventional therapies.
DISCUSSION/CONCLUSION: In line with the available literature on obesity and bariatric surgery interventions, poor mental health appears to be an important barrier for successful weight loss among patients with obesity undergoing IGB treatment. In order to improve the efficacy and effectiveness of the IGB therapy, more comprehensive and standardized studies are needed to provide insight into the psychological mechanisms maintaining weight management issues.
对于接受胃内球囊（IGB）治疗的肥胖患者，维持减肥效果的关键在于医疗保健提供者能够认识到情绪问题和情绪困难对其自我管理能力的影响程度，以及对额外支持的需求。然而，关于 IGB 治疗的心理相关性的研究有限。本系统评价首次尝试确定和综合心理变量与 IGB 结果之间相互影响的实证证据。
在 PubMed、SCOPUS、MEDLINE 和 Google Scholar 数据库中进行文献检索。使用严格的纳入标准和至少由 2 名评审员进行筛选，遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南。使用加强观察性研究的流行病学报告（STROBE）清单评估选定文章的质量。提取数据以解决综述目的，并以叙述性综合形式呈现。审查方案已预先注册（Prospéro CRD42019121291）。
共筛选了 16179 个标题、14369 个摘要和 51 篇全文文章，其中纳入了 16 项研究。研究结果表明，女性、年龄较大、基本教育水平、单身/离异的公民身份，以及较低的抑郁水平、暴食、更高的感知生活质量和改变的动机是增强 IGB 治疗效果的预测因素。治疗满意度在肥胖相关社会生活困难的患者中较低。IGB 治疗在减轻体重和改善抑郁、焦虑、饮食障碍症状以及肥胖患者的整体生活质量方面是有效的-主要在从设备定位后 6 个月内，并与常规治疗相结合。
讨论/结论：与肥胖和减肥手术干预的现有文献一致，不良心理健康似乎是肥胖患者接受 IGB 治疗成功减肥的重要障碍。为了提高 IGB 治疗的疗效和有效性，需要进行更全面和标准化的研究，以深入了解维持体重管理问题的心理机制。
