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体重歧视与减肥手术:预期改善、心理健康与体重

Weight stigma and bariatric surgery: Prospective improvements, psychological health, and weight.

作者信息

McGarrity Larissa A, Farnsworth Hannah R, Aspinwall Lisa G, Ibele Anna R, Terrill Alexandra L

机构信息

Department of Physical Medicine and Rehabilitation, University of Utah.

Department of Psychology, University of Utah.

出版信息

Health Psychol. 2025 Jun 5. doi: 10.1037/hea0001517.

DOI:10.1037/hea0001517
PMID:40471820
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12353973/
Abstract

OBJECTIVE

Weight stigma among patients with obesity is a major risk factor for psychological and physical health comorbidities. Little is known, however, about experienced weight stigma (EWS) among metabolic bariatric surgery (MBS) patients in terms of pre- to post-MBS changes and correlates in the setting of significant weight loss. The current study utilized psychometrically validated measures to examine change in weight stigma from pre- to post-MBS and prospective associations with mental health, eating behaviors, and body mass index.

METHOD

Patients ( = 148) completed both pre-MBS psychological evaluation and follow-up assessment 1.5-3 years post-MBS, including measures of EWS, depressive symptoms, anxiety, binge eating, and disordered eating.

RESULTS

EWS improved significantly pre- to post-MBS (by both statistical and clinically meaningful standards), and this change was associated with improvements in mental health, dysregulated eating, and reduced BMI. In regression models controlling demographic covariates and each outcome at baseline, both changes in and post-MBS EWS predicted mental health, dysregulated eating, and body mass index.

CONCLUSIONS

EWS improves significantly from pre- to post-MBS, and this is associated with improvements in mental health, decreases in dysregulated eating, and reduced weight. However, patients who continue to experience stigma are at elevated risk for ongoing psychological, eating, and weight challenges. Interventions must be designed to buffer the impacts of weight stigma to optimize the quality of life and long-term outcomes following MBS. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

摘要

目的

肥胖患者中的体重歧视是心理和身体健康合并症的主要危险因素。然而,对于代谢性减肥手术(MBS)患者在术前到术后体重变化以及在显著体重减轻情况下的相关因素方面所经历的体重歧视(EWS),我们知之甚少。当前研究采用经过心理测量学验证的方法,来检验MBS术前到术后体重歧视的变化,以及与心理健康、饮食行为和体重指数的前瞻性关联。

方法

患者(n = 148)完成了MBS术前的心理评估以及MBS术后1.5至3年的随访评估,包括EWS、抑郁症状、焦虑、暴饮暴食和饮食失调的测量。

结果

MBS术前到术后EWS有显著改善(从统计学和临床意义标准来看都是如此),并且这种变化与心理健康改善、饮食失调改善以及BMI降低相关。在控制人口统计学协变量和基线时的每个结果的回归模型中,MBS术前和术后EWS的变化都预测了心理健康、饮食失调和体重指数。

结论

MBS术前到术后EWS有显著改善,这与心理健康改善、饮食失调减少以及体重减轻相关。然而,持续经历歧视的患者面临持续的心理、饮食和体重挑战的风险更高。必须设计干预措施来缓冲体重歧视的影响,以优化MBS后的生活质量和长期结果。(PsycInfo数据库记录(c)2025美国心理学会,保留所有权利)