Department of Psychiatry, Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, New Haven, Connecticut.
Department of Psychiatry, Yale University School of Medicine, Program for Obesity, Weight, and Eating Research, New Haven, Connecticut.
Surg Obes Relat Dis. 2024 Mar;20(3):291-296. doi: 10.1016/j.soard.2023.09.028. Epub 2023 Oct 2.
Postoperative loss-of-control (LOC) eating is associated with eating-disorder psychopathology, poorer weight loss, and mental health outcomes following bariatric surgery. The nature and significance of shape discrepancy has not been examined in patients with LOC eating following bariatric surgery.
To examine shape discrepancy, WBI (weight bias internalization) and ED (eating-disorder) psychopathology in patients with LOC eating after bariatric surgery.
Yale University School of Medicine, United States.
Participants (N = 148, 84.5% female) seeking treatment for eating and weight concerns and with recurrent LOC eating approximately 6 months after bariatric surgery were assessed with the Eating Disorder Examination-Bariatric Surgery Version Interview and completed questionnaires measuring WBI and depression. Participants selected body shapes representing their current and ideal shapes, and a shape discrepancy score was calculated.
Most participants (N = 142/148) reported an ideal shape smaller than their current shape; shape discrepancy scores ranged from 0 to 5 (M = 1.89, SD = .82). Greater shape discrepancy was significantly correlated with greater current body mass index (BMI; r = .271, p=<.001) and percent weight loss (%WL) since surgery (r = -.19, p = .023). After adjusting for %WL, shape discrepancy was significantly correlated with greater WBI (r = .37, p < .001), depression (r = .27, p < .001), and ED psychopathology (r = .25, p = .002).
Nearly all participants preferred a significantly smaller shape than their current shape. Greater discrepancy between current and ideal shape was associated with higher levels of a range of behavioral (ED psychopathology), cognitive (WBI), and psychological/somatic (depression) concerns. These findings, which persisted after adjusting for %WL, highlight the importance of addressing body image in postoperative interventions.
术后失控性进食与饮食障碍病理、减重手术后体重减轻效果较差以及心理健康结局有关。在接受减重手术后出现失控性进食的患者中，尚未对体型差异的性质和意义进行研究。
检查减重手术后出现失控性进食的患者的体型差异、体重偏见内化（WBI）和饮食障碍（ED）病理。
美国耶鲁大学医学院。
研究对象为（N=148，84.5%为女性）因饮食和体重问题寻求治疗，并在接受减重手术后约 6 个月出现反复发作的失控性进食。使用饮食障碍检查-减重手术版本访谈（Eating Disorder Examination-Bariatric Surgery Version Interview）和 WBI 及抑郁问卷对参与者进行评估。参与者选择代表当前和理想体型的身体形状，并计算体型差异评分。
大多数参与者（N=142/148）报告理想体型小于当前体型；体型差异评分范围为 0 至 5（M=1.89，SD=0.82）。体型差异与当前体重指数（BMI）更大（r=0.271，p<0.001）和手术以来体重减轻百分比（%WL；r=-0.19，p=0.023）显著相关。在调整了%WL 后，体型差异与 WBI 更高（r=0.37，p<0.001）、抑郁（r=0.27，p<0.001）和 ED 病理更严重（r=0.25，p=0.002）显著相关。
几乎所有参与者都更喜欢比当前体型小很多的体型。当前和理想体型之间的差异越大，与一系列行为（ED 病理）、认知（WBI）和心理/躯体（抑郁）问题的严重程度越高。这些发现，在调整了%WL 后仍然存在，突出了在术后干预中解决身体形象问题的重要性。
