Guerrero-Pérez Fernando, Vega Rojas Natalia, Sánchez Isabel, Munguía Lucero, Jiménez-Murcia Susana, Artero Cristina, Sobrino Lucía, Lazzara Claudio, Monseny Rosa, Montserrat Mónica, Rodríguez Silvia, Fernández-Aranda Fernando, Vilarrasa Nuria
Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, 08907 Barcelona, Spain.
Biomedical Research Institute of Bellvitge (IDIBELL), L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
Nutrients. 2025 Jun 26;17(13):2114. doi: 10.3390/nu17132114.
: Food addiction (FA) is prevalent among individuals with severe obesity and has been associated with poorer weight loss (WL) outcomes after dietary interventions. However, its long-term impact after bariatric surgery (BS) remains unclear. : This study aimed to evaluate the effect of preoperative FA on WL and weight regain (WR) three years after different BS techniques. : An ambispective study was conducted in 165 patients undergoing BS (41.1% sleeve gastrectomy [SG], 13.3% Roux-en-Y gastric bypass [RYGB], and 45.6% hypoabsorptive procedures [HA]). FA was assessed preoperatively using the Yale Food Addiction Scale 2.0. WL outcomes were evaluated at 1 and 3 years postoperatively. Mixed-effects models were used to assess longitudinal changes, adjusted for baseline weight, sex, type 2 diabetes (T2D), and height. : FA was present in 17.6% of patients. At 3 years, total WL was lower in FA patients compared to those without FA (-27.1% vs. -31.0%; = 0.023), driven by greater WR from nadir (+8.3% vs. +1.7%; = 0.03). The effect was particularly pronounced after RYGB and HA, but not after SG. Nevertheless, a substantial proportion of FA patients (58%) were no longer classified as having obesity at 3 years. The presence of FA was not associated with insufficient WL or lower T2D remission rates. Mixed models confirmed a significant interaction between FA and time, indicating a trend toward reduced WL over time in FA patients. : Preoperative FA was not associated with a reduced likelihood of achieving satisfactory WL following BS. Our data does not support the use of preoperative FA as a decisive factor in guiding the choice of BS type. Although FA was associated with increased WR over time, clinically meaningful WL was achieved in most patients. Long-term multidisciplinary follow-up remains essential in this subgroup.
食物成瘾（FA）在重度肥胖个体中普遍存在，并且与饮食干预后的体重减轻（WL）效果较差有关。然而，其在减肥手术后（BS）的长期影响仍不清楚。本研究旨在评估术前FA对不同BS技术三年后的WL和体重反弹（WR）的影响。对165例接受BS的患者进行了一项前瞻性研究（41.1%为袖状胃切除术[SG]，13.3%为Roux-en-Y胃旁路术[RYGB]，45.6%为低吸收手术[HA]）。术前使用耶鲁食物成瘾量表2.0评估FA。术后1年和3年评估WL结果。使用混合效应模型评估纵向变化，并根据基线体重、性别、2型糖尿病（T2D）和身高进行调整。17.6%的患者存在FA。在3年时，FA患者的总WL低于无FA的患者（-27.1%对-31.0%；P = 0.023），这是由于最低点后的WR更大（+8.3%对+1.7%；P = 0.03）。这种影响在RYGB和HA后尤为明显，但在SG后不明显。尽管如此，相当一部分FA患者（58%）在3年时不再被归类为肥胖。FA的存在与WL不足或较低的T2D缓解率无关。混合模型证实了FA与时间之间存在显著交互作用，表明FA患者的WL随时间有下降趋势。术前FA与BS后获得满意WL的可能性降低无关。我们的数据不支持将术前FA作为指导BS类型选择的决定性因素。虽然FA与随时间增加的WR有关，但大多数患者实现了具有临床意义的WL。对该亚组进行长期多学科随访仍然至关重要。
