Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, United States.
Department of Behavioral Health, Gundersen Health System, La Crosse, WI, United States.
Front Endocrinol (Lausanne). 2022 Jul 18;13:934680. doi: 10.3389/fendo.2022.934680. eCollection 2022.
Weight regain after bariatric surgery is associated with problematic eating behaviors that have either recurred after a period of improvement or are new-onset behaviors. Problematic eating behaviors after bariatric surgery have been conceptualized in different ways in the literature, such as having a food addiction and experiencing a loss of control of eating. The intersection of these constructs appears to be defined as patients' experiences of reduced control of their eating which results in overeating behavior. The purpose of this review is to define patient experiences of driven overeating through the behavioral expression of emotion-based eating, reward-based eating, and executive functioning deficits-namely impulsivity-which is associated with weight regain after having bariatric surgery. Delineating concepts in this way and determining treatment strategies accordingly may reduce distress related to the inevitable return of increased hunger, cravings, portion sizes, and tolerance for highly palatable foods after surgery. Along with standard behavioral weight maintenance strategies, topics including acceptance, motivation, emotion-based eating, reward-based/impulsive eating, physical activity, and self-compassion are discussed. These concepts have been adapted for patients experiencing weight regain after having bariatric surgery and may be particularly helpful in attenuating driven overeating and weight regain.
减重手术后的体重反弹与不良进食行为有关，这些行为要么在改善一段时间后再次出现，要么是新出现的行为。减重手术后的不良进食行为在文献中有不同的概念化方式，例如存在食物成瘾和进食失控。这些结构的交集似乎被定义为患者对进食控制能力下降的体验，导致暴饮暴食行为。本综述的目的是通过基于情绪的进食、基于奖励的进食和执行功能缺陷（即冲动）的行为表现来定义患者的驱动性过度进食体验，这些缺陷与减重手术后的体重反弹有关。以这种方式阐明概念，并相应地确定治疗策略，可能会减少与手术后继发的饥饿感、渴望感、食物份量增加以及对高可口食物的耐受性增加相关的痛苦。除了标准的行为体重维持策略外，还讨论了接受、动机、基于情绪的进食、基于奖励/冲动的进食、身体活动和自我同情等主题。这些概念已针对经历减重手术后体重反弹的患者进行了调整，可能特别有助于减轻驱动性过度进食和体重反弹。
