Bariatric and Upper GI Department, Royal Shrewsbury Hospital, Shrewsbury, UK.
Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
J Hum Nutr Diet. 2023 Aug;36(4):1438-1450. doi: 10.1111/jhn.13121. Epub 2022 Dec 19.
An estimated 26% of men and 29% of women in the UK are living with obesity according to recent statistics. Bariatric surgery can induce significant weight loss and improve comorbidity status. However, previous studies highlight challenges in maintaining dietary changes and weight loss. This systematic review aimed to investigate patient experiences of weight loss and eating in the first 2 years following surgery, as well as provide clinical recommendations to support this group.
Ethical approval was granted by the University. A systematic search was conducted in four databases. Studies were selected according to the predefined eligibility criteria and methodological quality, assessed via the Critical Appraisal Skills Program (CASP) tool. Data were extracted and analysed using a thematic synthesis method. Rigour was enhanced via use of a data extraction tool, a validated method for data synthesis, peer review and transparent reporting.
In total, 507 records were screened; nine studies met the inclusion criteria. The thematic synthesis yielded four, interlinked analytical themes based on the experiences of 154 patients: relationship with food, relationship with oneself, relationship with others and unfinished journey. Positive experiences were reported including development of healthy eating behaviours and significant weight loss, improving physical and psychosocial wellbeing. On the other hand, challenges in adjusting to life after surgery were also reported.
The present study highlights the need for personalised dietary advice, addressing the psychological aspects of eating. Support should be extended to the family. Ongoing psychological support must be incorporated in the postsurgery care pathway to help patients deal with the negative outcomes of surgery such as excess skin.
根据最近的统计数据，英国约有 26%的男性和 29%的女性患有肥胖症。减重手术可以显著减轻体重并改善合并症状况。然而，先前的研究强调了维持饮食改变和减肥的挑战。本系统评价旨在调查手术后 2 年内患者的减肥和饮食体验，并提供临床建议以支持这一群体。
大学获得了伦理批准。在四个数据库中进行了系统搜索。根据预设的合格标准和通过关键评估技能计划（CASP）工具评估的方法学质量选择了研究。使用主题综合方法提取和分析数据。通过使用数据提取工具、数据综合的验证方法、同行评审和透明报告来提高严谨性。
总共筛选了 507 条记录；符合纳入标准的有九项研究。主题综合产生了四个相互关联的分析主题，基于 154 名患者的经验：与食物的关系、与自己的关系、与他人的关系和未完成的旅程。报告了积极的体验，包括发展健康的饮食习惯和显著减轻体重，改善身体和心理健康。另一方面，也报告了手术后生活调整方面的挑战。
本研究强调了个性化饮食建议的必要性，解决饮食的心理方面。应向家庭提供支持。必须在手术后护理途径中纳入持续的心理支持，以帮助患者应对手术的负面后果，如多余的皮肤。
