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初级保健中的综合策略:应对代谢和减肥手术后体重反复增加的问题

Integrative Strategies in Primary Care: Addressing Recurrent Weight Gain Post-Metabolic and Bariatric Surgery.

作者信息

Tolvanen Liisa, Mossberg Karin, Standen Erin C, Grace Lindsey M, Lebow Jocelyn R, Phelan Sean M, Andersson Daniel P, Koball Afton M

机构信息

Department of Medicine H7 Karolinska Institutet Stockholm Sweden.

Center for Obesity Academic Specialist Center Stockholm Health Services Stockholm Sweden.

出版信息

Obes Sci Pract. 2025 Aug 11;11(4):e70087. doi: 10.1002/osp4.70087. eCollection 2025 Aug.

Abstract

BACKGROUND

Metabolic and bariatric surgery (MBS) is the most effective and durable approach to treating obesity, yet recurrent weight gain occurs in a subset of patients. Primary care often serves as a routine point of contact for patients following MBS and is a potential gateway for addressing and/or preventing recurrent weight gain.

METHODS

Although guidelines for the management of recurrent weight gain after MBS exist, this narrative review was undertaken to clarify the role of the primary care providers in enhancing long-term outcomes and preventing weight gain after MBS.

FINDINGS

Regular follow-up in primary care provides an opportunity to identify challenges related to weight management and overall health outcomes, which may include concerns related to nutrition, mental or physical well-being, body image, motivation, and behavior change, for example. The availability of multidisciplinary providers within primary care settings, including behavioral health specialists, dietitians, and physical therapists, is an important strength of this setting in addressing potential post-MBS concerns such as recurrent weight gain.

CONCLUSION

This review outlines clinical considerations for managing recurrent weight gain post-MBS in primary care and includes recommendations for both primary care providers and specialty clinicians working in primary care to deliver care effectively and mitigate weight stigma post-MBS.

摘要

背景

代谢与减重手术(MBS)是治疗肥胖最有效且持久的方法,但仍有一部分患者体重会反复增加。初级保健通常是患者接受MBS治疗后的常规联系点,也是解决和/或预防体重反复增加的潜在途径。

方法

尽管存在MBS后体重反复增加的管理指南,但进行本叙述性综述是为了阐明初级保健提供者在改善长期预后及预防MBS后体重增加方面的作用。

研究结果

在初级保健中进行定期随访,为识别与体重管理及整体健康预后相关的挑战提供了机会,这些挑战可能包括例如与营养、心理或身体健康、身体形象、动机及行为改变等相关的问题。初级保健机构中多学科医疗服务提供者的存在,包括行为健康专家、营养师和物理治疗师,是该机构在解决MBS后潜在问题(如体重反复增加)方面的一项重要优势。

结论

本综述概述了初级保健中管理MBS后体重反复增加的临床注意事项,并包括对初级保健提供者及在初级保健机构工作的专科临床医生的建议,以便有效提供护理并减轻MBS后的体重歧视。

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