Behavioral Health, Henry Ford Health, 1 Ford Place, Detroit, MI, 48202, USA.
Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S Maryland Ave MC3077, Chicago, IL, 60637, USA.
Obes Surg. 2024 Jul;34(7):2580-2586. doi: 10.1007/s11695-024-07326-x. Epub 2024 Jun 6.
Depressive and anxious symptoms and maladaptive eating behaviors fluctuate with stressful events for patients seeking bariatric surgery. These associations are less clear for patients postoperatively. Using the COVID-19 pandemic as a frame, we examined associations between changes in depressive and anxious symptoms and maladaptive eating behaviors between up to four years postoperatively.
Participants (N = 703) who underwent surgery between 2018 and 2021 completed web-based questionnaires between 2021 and 2022. Demographic and surgical data were obtained from electronic health records. Participants reported whether depressive and anxious symptoms increased or were stable/decreased during the COVID-19 pandemic, and completed eating behavior measures.
Many participants reported increased depressive (27.5%) and anxious (33.7%) symptoms during the COVID-19 pandemic. Compared to those who reported stable or decreased symptoms, these participants were as follows: (1) more likely to endorse presence of binge, loss-of-control, graze, and night eating; (2) reported higher emotional eating in response to anger and frustration, depression, and anxiety; and (3) reported higher driven and compulsive eating behaviors. Frequency of binge, loss-of-control, graze, and night eating episodes did not differ between groups (e.g., increased vs. stable/decreased anxious symptoms) among participants who endorsed any episodes.
A large portion of the sample reported increased depressive and anxious symptoms during the COVID-19 pandemic, and these increases were associated with maladaptive eating behaviors. Depressive and anxious symptoms and eating behaviors should be assessed postoperatively as significant stressors may be associated with increased distress and maladaptive eating behaviors that can affect postoperative outcomes. Postoperative interventions may be useful at simultaneously targeting these concerns.
寻求减肥手术的患者，其抑郁和焦虑症状以及适应不良的进食行为会随压力事件而波动。这些关联在术后患者中不太明确。我们以 COVID-19 大流行作为框架，研究了术后最多四年内抑郁和焦虑症状变化与适应不良进食行为之间的关系。
2018 年至 2021 年间接受手术的参与者（N=703）于 2021 年至 2022 年期间完成了在线问卷。人口统计学和手术数据从电子健康记录中获得。参与者报告了 COVID-19 大流行期间抑郁和焦虑症状是否增加或保持稳定/减少，以及完成进食行为的测量。
许多参与者报告在 COVID-19 大流行期间抑郁（27.5%）和焦虑（33.7%）症状增加。与报告症状稳定或减少的参与者相比，这些参与者：（1）更有可能出现暴食、失控、随意进食和夜间进食；（2）在愤怒和沮丧、抑郁和焦虑时报告更高的情绪化进食；（3）报告更高的强迫和冲动进食行为。在报告有任何进食发作的参与者中，暴食、失控、随意进食和夜间进食发作的频率在两组之间没有差异（例如，焦虑症状增加与稳定/减少）。
很大一部分样本报告在 COVID-19 大流行期间抑郁和焦虑症状增加，这些增加与适应不良的进食行为有关。术后应评估抑郁和焦虑症状以及进食行为，因为重大压力源可能与增加的痛苦和适应不良的进食行为有关，这些行为可能会影响术后结果。术后干预措施可能同时针对这些问题很有用。
