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代谢与减重手术背景下的饮食失调:现状与未来方向

Eating Disorders in the Context of Metabolic and Bariatric Surgery: Current Status and Future Directions.

作者信息

Kerver Gail A, Murray Matthew F, Dougherty Elizabeth N

机构信息

Sanford Research, Center for Biobehavioral Research, 4840 23rd Ave S, Fargo, ND, 58104, USA.

Department of Psychiatry and Behavioral Science, School of Medicine and Health Sciences, University of North Dakota, 1919 Elm St. N, Fargo, ND, 58102-2416, USA.

出版信息

Curr Obes Rep. 2025 Apr 10;14(1):31. doi: 10.1007/s13679-025-00620-4.

Abstract

PURPOSE OF REVIEW

Eating disorders (EDs) are a relatively uncommon yet salient concern for patients undergoing metabolic and bariatric surgery (MBS). This report aims to advance understanding of the complex relationship between EDs and MBS by highlighting recent empirical evidence and identifying areas for future research.

RECENT FINDINGS

Little-to-no empirical evidence suggests that EDs be considered an absolute contraindication for MBS. However, a small subset of patients experience recurrent or emergent ED symptoms following surgery, invariably resulting in poorer postsurgical outcomes. Plausibly, a confluence of psychosocial and neurobiological mechanisms explains post-MBS ED symptoms. Accurate identification of MBS-related ED concerns is essential, with growing evidence suggesting structured postsurgical treatment may be optimal. Despite recent advances, more research on EDs in the context of MBS is needed, including rigorous mechanistic studies with long-term follow-up that clarify how predisposing factors interact to precipitate postsurgical ED symptoms. More work is also required to inform design and dissemination of targeted ED interventions for patients pursuing MBS.

摘要

综述目的

饮食失调(EDs)对于接受代谢和减重手术(MBS)的患者而言,是一个相对不常见但却十分突出的问题。本报告旨在通过强调近期的实证证据并确定未来研究领域,增进对EDs与MBS之间复杂关系的理解。

最新发现

几乎没有实证证据表明EDs应被视为MBS的绝对禁忌证。然而,一小部分患者在术后会出现反复或新发的ED症状,这 invariably 导致术后结局较差。心理社会和神经生物学机制的共同作用可能解释了MBS术后的ED症状。准确识别与MBS相关的ED问题至关重要,越来越多的证据表明结构化的术后治疗可能是最佳选择。尽管最近取得了进展,但在MBS背景下对EDs仍需要更多研究,包括进行严格的长期随访机制研究,以阐明易感因素如何相互作用导致术后ED症状。还需要开展更多工作,为针对寻求MBS的患者设计和推广有针对性的ED干预措施提供信息。 (注:原文中“invariably”未准确翻译出意思,这里保留英文以便更准确理解原文含义,在实际翻译中应根据语境准确翻译,比如“总是”等)

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