Hadipour Lakmehsari Abed, Mento Carmela, Scaramuzzino Claudia, Arena Federica, Turiaco Fabrizio, Muscatello Maria Rosaria Anna, Navarra Giuseppe, Pandolfo Gianluca, Lombardo Clara
Department of Cognitive, Psychological, Pedagogical Sciences and Cultural Studies, University of Messina, 98122 Messina, Italy.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy.
J Pers Med. 2025 May 26;15(6):215. doi: 10.3390/jpm15060215.
Obesity is associated with a reduced life expectancy of 5 to 20 years, depending on the severity of the condition and the presence of comorbidities. Beyond first- and second-line interventions such as lifestyle changes, pharmacotherapy, which includes appetite suppressants, drugs that reduce fat absorption or regulate neurohormonal pathways, and endoscopic procedures, bariatric surgery is currently considered one of the most effective long-term interventions for severe obesity. This exploratory study investigates the psychological functioning of bariatric surgery candidates in the preoperative phase, aiming to identify risk factors and potential predictors of response to surgery in an Italian sample. This is a retrospective, observational study with follow-up. Participants, evaluated between September 2021 and September 2022 at Messina University Hospital, were recontacted approximately one year after surgery for re-evaluation. Of the 97 initial patients, 33 agreed to complete online questionnaires for follow-up. : The baseline data showed no significant differences between men and women in psychological assessments. In the subgroup that completed the follow-up, significant changes were observed, including a reduction in BMI and an increase in the discomfort index (Body Uneasiness Test) post-surgery, with large effect sizes in both cases. However, despite these changes, the regression analysis revealed that preoperative BMI values were not directly related to postoperative body image difficulties. These findings suggest a limited psychological impact of bariatric surgery, emphasizing the need for tailored psychological interventions to address these issues. : While the intervention confirmed its effectiveness in reducing BMI, improvements in psychological well-being were less pronounced. In particular, a significant increase in body image concerns (PSDI) emerged after surgery, suggesting the need to address body-related distress in post-surgical care. These findings may suggest multidisciplinary approaches that integrate physical and psychological interventions may be needed to maximise long-term benefits. Further research should explore strategies to enhance patient awareness of treatment options, body image issues, and potential complications. These results should be interpreted with caution considering the limitations associated with this study such as a small sample size, lack of a control group, and the use of self-report and online methods to gather data, among others.
肥胖与预期寿命缩短5至20年有关，具体取决于病情的严重程度和合并症的存在情况。除了一线和二线干预措施，如生活方式改变、药物治疗（包括食欲抑制剂、减少脂肪吸收或调节神经激素途径的药物）以及内镜手术外，减肥手术目前被认为是治疗重度肥胖最有效的长期干预措施之一。这项探索性研究调查了减肥手术候选人在术前阶段的心理功能，旨在识别意大利样本中手术反应的风险因素和潜在预测指标。这是一项有随访的回顾性观察研究。2021年9月至2022年9月在墨西拿大学医院接受评估的参与者，在术后约一年被再次联系进行重新评估。在最初的97名患者中，33名同意完成在线问卷进行随访。基线数据显示，男性和女性在心理评估方面没有显著差异。在完成随访的亚组中，观察到了显著变化，包括术后体重指数降低和不适指数（身体不安测试）增加，两种情况的效应量都很大。然而，尽管有这些变化，回归分析显示术前体重指数值与术后身体形象困难没有直接关系。这些发现表明减肥手术的心理影响有限，强调需要针对性的心理干预来解决这些问题。虽然该干预措施证实了其在降低体重指数方面的有效性，但心理健康的改善不太明显。特别是，术后身体形象担忧（PSDI）显著增加，表明在术后护理中需要解决与身体相关的困扰。这些发现可能表明，可能需要综合身体和心理干预的多学科方法来最大化长期益处。进一步的研究应该探索提高患者对治疗选择、身体形象问题和潜在并发症认识的策略。考虑到本研究的局限性，如样本量小、缺乏对照组以及使用自我报告和在线方法收集数据等，这些结果应谨慎解释。
