Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Utrecht, The Netherlands.
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Obes Rev. 2024 Jun;25(6):e13729. doi: 10.1111/obr.13729. Epub 2024 Mar 7.
Multiple factors are related to lower weight loss after bariatric surgery. This review and meta-analysis evaluates the influence of several mental and behavioral factors on weight loss.
Six electronic databases were searched. Percentage excess weight loss (%EWL) was calculated for all moderator and non-moderator groups of the variables: symptoms of depression, anxiety and binge eating, compliance, physical activity, quality of life, and body image. All moderators, surgery types, and follow-up moments were analyzed separately.
In total, 75 articles were included in the review; 12 meta-analyses were conducted. Higher postoperative compliance to follow-up was associated with 6.86%-13.68% higher EWL. Preoperative binge eating was related to more weight loss at 24- and 36-month follow-up (7.97% and 11.79%EWL, respectively). Patients with postoperative binge eating symptoms had an 11.92% lower EWL. Patients with preoperative depressive symptoms lost equal weight compared to patients without symptoms.
Despite the high heterogeneity between studies, a trend emerges suggesting that the presence of postoperative binge eating symptoms and lower postoperative compliance may be associated with less weight loss after bariatric-metabolic surgery. Additionally, preoperative depressive symptoms and binge eating do not seem to significantly impact weight loss.
多种因素与减重手术后体重减轻较少有关。本综述和荟萃分析评估了几种心理和行为因素对体重减轻的影响。
检索了六个电子数据库。对于抑郁、焦虑和暴食症状、依从性、身体活动、生活质量和身体形象等变量的所有调节因素和非调节因素组，计算了超重损失百分比（%EWL）。单独分析了所有调节因素、手术类型和随访时间点。
共纳入 75 篇综述文章；进行了 12 项荟萃分析。术后随访依从性较高与 EWL 增加 6.86%-13.68%相关。术前暴食与 24 个月和 36 个月随访时的体重减轻更多相关（分别为 7.97%和 11.79%EWL）。术后有暴食症状的患者 EWL 降低 11.92%。与无症状患者相比，术前有抑郁症状的患者减轻的体重相同。
尽管研究之间存在高度异质性，但出现了一种趋势，表明术后暴食症状和较低的术后依从性可能与减重代谢手术后体重减轻较少有关。此外，术前抑郁症状和暴食似乎不会显著影响体重减轻。
