Bariatric Medicine Service, Centre for Diabetes, Endocrinology and Metabolism, HRB Clinical Research Facility, Galway University Hospital, H91 YR71 Galway, Ireland.
Heart and Stroke Center, Croi, The West of Ireland Cardiac Foundation, Moyola Lane, Newcastle, H91 FF68 Galway, Ireland.
Nutrients. 2021 Nov 21;13(11):4172. doi: 10.3390/nu13114172.
Lifestyle modification is the cornerstone of management for patients with severe and complicated obesity, but the effects of structured lifestyle programmes on quality of life, anxiety and depression scores and cardiovascular risk factors are not well-described. We sought to describe changes in self-reported quality of life and mental health-related outcomes as well as cardiovascular risk factors in patients completing a 10-week multidisciplinary lifestyle-modification programme.
We conducted a prospective cohort study of all patients referred from our bariatric service who completed the programme between 2013 and 2019. In addition to weight, body mass index (BMI), blood pressure, HbA1c, lipid profile and functional capacity, we quantified health-related quality of life using the Dartmouth COOP Questionnaire and the European Quality of Life Questionnaire Visual Analogue Scale (EQVAS) and mental health using the Hospital Anxiety and Depression Scale (HADS).
Of 1122 patients who started the programme, 877 (78.2%) completed it and were included in per protocol analyses. Mean age was 47.3 ± 11.9 years, 66.9% were female, 34.8% were in full- or part-time employment and 69.4% were entitled to state-provided medical care. BMI decreased from 47.0 ± 7.8 to 46.2 ± 7.8 kg m and weight decreased from 131.6 ± 25.5 to 129.5 ± 25.4 kg (both < 0.001). There were significant reductions in anxiety and depression scores and improvements in all Dartmouth COOP domains. The EQVAS score increased from 52 ± 22 to 63 ± 19 ( < 0.001). Small but statistically significant reductions in LDL cholesterol, systolic blood pressure and HBA1c were also observed.
Adults with severe and complicated obesity completing a specialised bariatric lifestyle-modification programme showed significant improvements in self-reported mental health and quality of life, in addition to reductions in cardiovascular risk factors.
生活方式的改变是严重和复杂肥胖患者管理的基石，但结构化的生活方式方案对生活质量、焦虑和抑郁评分以及心血管风险因素的影响还没有很好地描述。我们旨在描述完成 10 周多学科生活方式改变方案的患者自我报告的生活质量和与心理健康相关的结果以及心血管风险因素的变化。
我们对 2013 年至 2019 年间从我们的减重服务中转诊并完成该方案的所有患者进行了前瞻性队列研究。除体重、体重指数（BMI）、血压、HbA1c、血脂谱和功能能力外，我们还使用 Dartmouth COOP 问卷和欧洲生活质量问卷视觉模拟量表（EQVAS）量化了与健康相关的生活质量，使用医院焦虑和抑郁量表（HADS）评估了心理健康。
在开始该方案的 1122 名患者中，有 877 名（78.2%）完成了该方案，并纳入了方案分析。平均年龄为 47.3 ± 11.9 岁，66.9%为女性，34.8%全职或兼职工作，69.4%有资格享受国家提供的医疗保健。BMI 从 47.0 ± 7.8 降至 46.2 ± 7.8 kg/m2，体重从 131.6 ± 25.5 降至 129.5 ± 25.4 kg（均<0.001）。焦虑和抑郁评分显著降低，Dartmouth COOP 所有领域均有所改善。EQVAS 评分从 52 ± 22 增加到 63 ± 19（<0.001）。LDL 胆固醇、收缩压和 HBA1c 也略有但统计学上显著降低。
完成专门的减重生活方式改变方案的严重和复杂肥胖成年人除了降低心血管风险因素外，还显示出自我报告的心理健康和生活质量的显著改善。
