Behavioral Health, Henry Ford Health, Detroit, USA.
Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Place, 5E, Detroit, MI, 48202, USA.
J Racial Ethn Health Disparities. 2024 Dec;11(6):3838-3845. doi: 10.1007/s40615-023-01835-8. Epub 2023 Oct 24.
There are several psychological and behavioral factors associated with poorer outcomes following bariatric surgery, yet it is unknown whether and how these factors may differ by race. In this cross-sectional study, individuals who underwent bariatric surgery from 2018 to 2021 and up to 4 years post-surgery were invited to complete an online survey. Psychiatric symptoms, maladaptive eating patterns, self-monitoring behaviors, and exercise frequency were examined. Participants (N = 733) were 87% women, 63% White, with a mean age of 44 years. Analyses of covariance demonstrated that White individuals endorsed greater anxiety symptoms (p =.01) and emotional eating due to depression (p = .01), whereas Black individuals endorsed greater depression severity (p = .02). Logistic regression analyses demonstrated that White individuals were more likely to experience loss of control eating (OR= 1.7, p = .002), grazing (OR= 2.53, p <.001), and regular self-weighing (OR= 1.41, p <.001) than Black individuals, and were less likely to skip meals (OR= .61, p = .04), or partake in nighttime eating (OR= .40, p <.001). There were no racial differences in binge eating, emotional eating due to anxiety or frustration, use of a food diary, or exercise. Thus, depressive symptoms, skipping meals, and nighttime eating may be important, modifiable intervention targets to optimize the benefits of bariatric surgery and promote equitable outcomes.
有一些与减重手术后结果较差相关的心理和行为因素,但尚不清楚这些因素是否以及如何因种族而异。在这项横断面研究中,邀请了 2018 年至 2021 年期间接受减重手术并在手术后 4 年内的患者完成在线调查。检查了精神症状、适应不良的饮食模式、自我监测行为和运动频率。参与者(N=733)中 87%为女性,63%为白人,平均年龄为 44 岁。协方差分析表明,白人个体报告了更多的焦虑症状(p=.01)和因抑郁而导致的情绪化进食(p=.01),而黑人个体报告了更严重的抑郁症状(p=.02)。逻辑回归分析表明,白人个体更有可能经历失控性进食(OR=1.7,p=.002)、随意进食(OR=2.53,p<.001)和定期自我称重(OR=1.41,p<.001),而不太可能错过餐食(OR=.61,p=.04)或进行夜间进食(OR=.40,p<.001)。在暴饮暴食、因焦虑或沮丧而情绪化进食、使用饮食日记或运动方面,没有种族差异。因此,抑郁症状、错过餐食和夜间进食可能是优化减重手术效果和促进公平结果的重要、可改变的干预目标。