Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Maria Aspmans gata 30A, Stockholm, SE-171 64, Sweden.
Center for Obesity, Academic Specialist Center, Stockholm, Sweden.
Obes Surg. 2023 Aug;33(8):2517-2526. doi: 10.1007/s11695-023-06718-9. Epub 2023 Jul 5.
Food quality, energy intake, and various eating-related problems have been highlighted as some of the components influencing weight after bariatric surgery. This study aimed to increase our knowledge of patients' perspectives on dietary patterns and eating behaviors during weight regain after bariatric surgery.
We recruited 4 men and 12 women with obesity and the experience of weight regain after bariatric surgery at an obesity clinic in Stockholm, Sweden. Data were collected during 2018-2019. We conducted a qualitative study, carried out individual semi-structured interviews, and analyzed the recorded and transcribed interview data with thematic analysis.
Participants had regained 12 to 71% from their lowest weight after gastric bypass surgery performed 3 to 15 years before. They perceived their dietary challenges as overwhelming and had not expected weight management, meal patterns, increasing portion sizes, and appealing energy-dense foods to be problematic after surgery. In addition, difficulties with disordered eating patterns, emotional eating, and increased alcohol intake further contributed to the weight management hurdles. Insufficient nutritional knowledge and lack of support limited participants' ability to avoid weight regain, leading to restrictive eating and dieting without sustained weight loss.
Eating behavior and dietary factors such as lack of nutritional knowledge, emotional eating, or disorganized meal patterns contribute to difficulties with weight management after gastric bypass surgery. Improved counseling may help patients prepare for possible weight regain and remaining challenges with food and eating. The results highlight the importance of regular medical nutrition therapy after gastric bypass surgery.
食物质量、能量摄入以及各种与饮食相关的问题已被强调为影响减重手术后体重的因素之一。本研究旨在增进我们对患者在减重手术后体重反弹期间饮食模式和饮食习惯的看法。
我们在瑞典斯德哥尔摩的一家肥胖诊所招募了 4 名男性和 12 名女性肥胖患者，他们均经历过减重手术后的体重反弹。数据收集于 2018 年至 2019 年期间。我们进行了一项定性研究，开展了个体半结构化访谈，并通过主题分析对记录和转录的访谈数据进行了分析。
参与者在胃旁路手术后的 3 至 15 年前体重最低时已反弹了 12%至 71%。他们认为自己面临的饮食挑战令人难以承受，且没有预料到术后的饮食管理、膳食模式、不断增加的食物份量以及诱人的高热量食物会成为问题。此外，饮食失调模式、情绪性进食和饮酒量增加也进一步增加了体重管理的障碍。营养知识不足和缺乏支持限制了参与者避免体重反弹的能力，导致他们限制饮食和节食，但无法持续减重。
饮食行为和饮食因素，如缺乏营养知识、情绪性进食或不规律的膳食模式，会导致胃旁路手术后体重管理困难。改善咨询可能有助于患者为可能的体重反弹和剩余的食物及进食相关挑战做好准备。结果强调了胃旁路手术后定期进行医学营养治疗的重要性。
