Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA.
Department of Epidemiology and Biostatistics, College of Public Health, Temple University, Ritter Annex Building, 9th Floor, 1301 Cecil B Moore Avenue, Philadelphia, PA, 19122, USA.
Obes Surg. 2023 Mar;33(3):733-742. doi: 10.1007/s11695-022-06442-w. Epub 2023 Jan 24.
Identifying eating behaviors associated with suboptimal weight loss following bariatric surgery remains important. This study assessed the relationship between eating behaviors and weight loss following bariatric surgery in a racially diverse sample.
Participants were assessed before surgery and 6 and 12 months postoperatively, with the Structured Clinical Interview for DSM-5, the Eating Disorder Examination-Bariatric Surgery Version, and validated measures assessing a range of eating behaviors. Linear mixed effect models were used to test the impact of eating behaviors on percent weight loss (%WL) at 6 and 12 months.
We enrolled 300 participants (mean age 40.1 years; BMI 45.9 kg/m; 87% women; 62% Black and 30% White). The majority (82%) underwent sleeve gastrectomy (SG). Mean %WL was 23.0 ± 5.1% at 6 months and 26.2 ± 7.6% at 12 months. Subjective binge episodes prior to surgery predicted greater %WL over the first 12 postoperative months (p = 0.028). Postoperative disinhibition, hunger, night eating symptoms, objective binge episodes, global disordered eating attitudes and behaviors, and snacks per day were associated with smaller %WL over 12 months (all p's < 0.01). The presence of picking/nibbling and addictive-like eating behaviors was not associated with %WL at the end of the first postoperative year.
Among a diverse participant sample, problematic eating behaviors following surgery were associated with smaller %WL over 12 months. Postoperative assessment and treatment of eating behaviors are needed to address these issues as they arise and to prevent attenuation of early weight loss in some patients.
识别与减重手术后体重减轻不理想相关的饮食行为仍然很重要。本研究评估了在种族多样化的样本中，手术后饮食行为与体重减轻之间的关系。
参与者在手术前和手术后 6 个月和 12 个月进行评估，使用 DSM-5 结构化临床访谈、减重手术版饮食障碍检查和经过验证的评估各种饮食行为的措施。线性混合效应模型用于测试饮食行为对 6 个月和 12 个月体重减轻百分比（%WL）的影响。
我们纳入了 300 名参与者（平均年龄 40.1 岁；BMI 45.9 kg/m；87%为女性；62%为黑人，30%为白人）。大多数人（82%）接受了袖状胃切除术（SG）。6 个月时的平均%WL 为 23.0±5.1%，12 个月时为 26.2±7.6%。手术前的主观暴食发作预测术后 12 个月内体重减轻百分比更大（p=0.028）。术后的抑制破坏、饥饿、夜间进食症状、客观暴食发作、总体饮食失调态度和行为以及每日零食与 12 个月内的体重减轻百分比较小相关（所有 p 值均<0.01）。挑剔/啃咬和类似成瘾的进食行为的存在与术后第一年结束时的%WL 无关。
在一个多样化的参与者样本中，手术后出现的问题性饮食行为与 12 个月内体重减轻百分比较小有关。需要在术后评估和治疗饮食行为，以解决这些问题，并防止某些患者早期体重减轻的减弱。
