Clínica Opción Médica S.L., C. Calvet 24, 08021 Barcelona, Barcelona, Spain.
Departament d'Infermeria Fonamental i Medicoquirúrgica de la Facultat de Medicina, Universitat de Barcelona, Feixa Llarga, 08907 l'Hospitalet de Llobregat, Barcelona, Spain.
Nutrients. 2022 May 28;14(11):2261. doi: 10.3390/nu14112261.
Endoscopic bariatric therapies (EBTs) are promising strategies for the treatment of obesity. However, there is still great variability in its effectiveness in weight loss. Thus, we investigated whether adherence to healthy lifestyle habits is a significant determinant of weight loss effectiveness among patients undergoing EBTs. Additionally, the role of eating behaviors and psychological traits in the effectiveness of weight loss was studied. A cohort of 361 participants (81.4% women; age 41.8 ± 9.5 years; BMI 37.8 ± 4.3 kg/m2) was followed for 1 year after EBT. Anthropometric parameters, adherence to healthy lifestyle habits, emotional eating, and psychological traits (anxiety and depression) were evaluated. General linear models were used to compare outcome variables according to weight loss effectiveness groups (poor vs. good weight-loss-responders). Additionally, a hierarchical linear regression model was used to determine whether adherence to healthy lifestyle habits, emotional eating, or psychological traits were significant predictors of excess weight loss (%EWL). One year after EBT, weight loss differed significantly between good and poor weight-loss-responders (67.5% EWL [95% CI: 64.2, 70.8] vs. 28.2% EWL [95% CI: 25.5, 30.9], p < 0.001). Participants who adhered to good lifestyle habits had 4.37 more odds [95% CI: 2.19, 8.88] of being good weight-loss-responders. We also observed that eating four to five meals/day and practicing muscle-strengthening activities >2 times/week were the two lifestyle habits that most significantly determined weight loss response. Furthermore, our results revealed that while adherence to healthy lifestyle habits was a significant determinant of %EWL 3, 6, and 12 months after EBT (p < 0.001), emotional eating was a significant determinant of %EWL only 3 and 6 months after the intervention (p < 0.01 and p < 0.05, respectively). Regarding psychological traits, we observed that neither anxiety nor depression were significant determinants of %EWL. Our results revealed that adherence to healthy lifestyle habits is a significant determinant for weight loss effectiveness among patients with obesity undergoing EBT. These findings highlight the importance of implementing an adequate nutritional intervention program, especially since patients who adhere to good lifestyle habits are able to achieve a weight loss that would be comparable with bariatric surgery.
内镜减重治疗（EBT）是治疗肥胖的一种很有前景的策略。然而，它在减肥方面的效果仍然存在很大的差异。因此，我们研究了在接受 EBT 治疗的患者中，是否坚持健康的生活习惯是体重减轻效果的重要决定因素。此外，还研究了饮食行为和心理特征在减肥效果中的作用。对 361 名参与者（81.4%为女性；年龄 41.8±9.5 岁；BMI 37.8±4.3kg/m2）进行了 1 年的随访，以评估他们的体重减轻情况。评估了人体测量参数、健康生活习惯的依从性、情绪性进食和心理特征（焦虑和抑郁）。采用一般线性模型根据体重减轻效果组（不良体重减轻反应者与良好体重减轻反应者）比较结果变量。此外，还采用分层线性回归模型来确定健康生活习惯、情绪性进食或心理特征是否是超重减轻百分比（%EWL）的显著预测因子。在 EBT 治疗 1 年后，不良体重减轻反应者和良好体重减轻反应者之间的体重减轻差异有统计学意义（67.5% EWL [95%CI：64.2，70.8]与 28.2% EWL [95%CI：25.5，30.9]，p<0.001）。坚持良好生活习惯的参与者成为良好体重减轻反应者的可能性增加了 4.37 倍[95%CI：2.19，8.88]。我们还观察到，每天进食四到五餐和每周进行两次以上的肌肉强化活动是决定体重减轻反应的两个最重要的生活习惯。此外，我们的结果表明，坚持健康的生活习惯是 EBT 治疗后 3、6 和 12 个月%EWL 的重要决定因素（p<0.001），而情绪性进食仅在干预后 3 和 6 个月是%EWL 的重要决定因素（p<0.01 和 p<0.05）。关于心理特征，我们发现焦虑和抑郁都不是%EWL 的重要决定因素。我们的研究结果表明，坚持健康的生活习惯是肥胖患者接受 EBT 治疗时体重减轻效果的重要决定因素。这些发现强调了实施适当的营养干预计划的重要性，尤其是因为坚持良好生活习惯的患者能够实现与减重手术相当的体重减轻效果。
