在代谢和减重手术背景下，以每日体重管理为重点的社会支持与体重减轻、活动行为及饮食调节之间的关联。
Associations of daily weight management-focused social support with weight loss, activity behaviors, and eating regulation in the context of metabolic and bariatric surgery.
作者信息
Bond Dale S, Smith Kathryn E, Schumacher Leah M, Vithiananthan Sivamainthan, Jones Daniel B, Papasavas Pavlos, Webster Jennifer, Thomas J Graham
机构信息
Department of Surgery Hartford Hospital Hartford Connecticut USA.
Department of Research Hartford Hospital Hartford Connecticut USA.
出版信息
Obes Sci Pract. 2023 Nov 10;10(1):e717. doi: 10.1002/osp4.717. eCollection 2024 Feb.
OBJECTIVE
Greater perceived social support (PSS) is associated with more favorable changes in weight loss, activity behaviors, and eating regulation after metabolic and bariatric surgery (MBS). However, studies have relied on generic, retrospective PSS measures, and stability of PSS levels and relations with weight loss and weight-related behaviors over time is unknown. Using smartphone-based Ecological Momentary Assessment, this study evaluated pre-to 1-year post-MBS changes in daily weight management-focused PSS and associations with weight loss, device-measured activity behaviors, and eating regulation before and during the initial year after MBS.
METHOD
Adult MBS patients ( = 71) received (1) an accelerometer to measure daily moderate-to-vigorous intensity physical activity (MVPA) and sedentary time (ST) minutes/day, and (2) a smartphone to complete morning weight-focused PSS ratings and eating regulation (dietary restraint/disinhibition) ratings at four semi-random times daily for 10 days at pre- and 3, 6, and 12-month postoperative. Generalized linear mixed models analyzed the associations of PSS with total weight loss (%TWL) and activity/eating outcomes.
RESULTS
Participants on average reported relatively stable moderate-to-high PSS (3.98 on one to five scale) across assessments. Perceived social support was not related to %TWL, MVPA, or ST. Participants with higher PSS reported lower disinhibition and higher restraint than those with lower PSS (ps < 0.05); however, participants reported higher restraint on days that PSS was lower than their usual levels ( = 0.009).
CONCLUSIONS
MBS patients on average had stable PSS levels across time. Higher PSS levels were associated with greater resistance to overeating cues (disinhibition) and cognitive control to restrict food intake (restraint) over time. Additionally, participants reported higher restraint when PSS levels were lower than usual. Overall, weight-focused PSS appeared to hold greater importance in relation to regulating eating behavior than engaging in activity behaviors or weight loss among MBS patients during the initial postoperative year.
CLINICAL TRIAL REGISTRATION
NCT02777177.
目的
更高的感知社会支持（PSS）与代谢和减重手术后（MBS）体重减轻、活动行为及饮食调节方面更有利的变化相关。然而，此前研究依赖的是通用的、回顾性的PSS测量方法，且PSS水平的稳定性以及其与体重减轻及体重相关行为随时间的关系尚不清楚。本研究采用基于智能手机的生态瞬时评估，评估了MBS术前至术后1年以日常体重管理为重点的PSS变化，以及与体重减轻、设备测量的活动行为和MBS术后第一年及期间的饮食调节之间的关联。
方法
成年MBS患者（n = 71）接受了：（1）一个加速度计，用于测量每日中度至剧烈强度身体活动（MVPA）和久坐时间（ST，分钟/天）；（2）一部智能手机，在术前以及术后3、6和12个月，连续10天每天四个半随机时间完成以早晨体重为重点的PSS评分和饮食调节（饮食抑制/去抑制）评分。广义线性混合模型分析了PSS与总体重减轻（%TWL）以及活动/饮食结果之间的关联。
结果
参与者在各次评估中平均报告了相对稳定的中度至高PSS（1至5分制下为3.98）。感知社会支持与%TWL、MVPA或ST无关。PSS较高的参与者比PSS较低的参与者报告的去抑制更低且抑制更高（p < 0.05）；然而，参与者在PSS低于其通常水平的日子里报告的抑制更高（p = 0.009）。
结论
MBS患者的PSS水平随时间平均保持稳定。随着时间推移，较高的PSS水平与对暴饮暴食线索（去抑制）的更强抵抗力以及限制食物摄入的认知控制（抑制）相关。此外，当PSS水平低于平时时，参与者报告的抑制更高。总体而言，在术后第一年，以体重为重点的PSS在调节MBS患者的饮食行为方面似乎比参与活动行为或体重减轻更为重要。
临床试验注册
NCT02777177。
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