Torres-Landa Samuel, Petcka Nicole L, Wu Jessica, Hechenbleikner Elizabeth M, Oyefule Mobola, Stetler Jamil L, Reddy Sheethal, Lin Edward, Scott S Davis, Mou Danny
Department of Gastrointestinal Surgery, Emory University, Atlanta, USA.
Department of Gastrointestinal Surgery, Washington University, Missouri, USA.
Surg Endosc. 2025 Sep 12. doi: 10.1007/s00464-025-12187-1.
Food insecurity (FI) places patients seeking metabolic and bariatric surgery (MBS) evaluation at a disadvantage, as it is associated with worse patient-reported outcome measures (PROMs). However, of the further granularity impact of FI levels on PROMs is needed. We sought to investigate the impact of food insecurity levels on BODY-Q ER (eating-related) behavior, distress, symptoms, and physical function in preoperative MBS patients.
Patients who underwent preoperative assessment for MBS (Feb 2024-2025) and completed the validated 6-item FI questionnaire and BODY-Q ER modules (scale of 0-100; 0 being worse health and 100 being optimal health) were included. Patients were divided into food security levels (high, low, and very low). Median Rasch scores (0-100, higher signifies better health) of BODY-Q ER behavior, distress, symptoms, and physical function were compared between food security levels using the Kruskal-Wallis test (p < 0.05).
From the 614 patients, 76% had high food security, 14.7% had low food security, and 9.9% had very low food security. Median Rasch scores from all four BODY-Q surveys (eating-related behavior, eating-related distress, eating-related symptoms, and physical function) were statistically different by food security level (p < 0.001). Higher median Rasch scores were seen in patients with high food security in all BODY-Q surveys compared to low food security and very low food security.
Food security levels directly correlate with BODY-Q PROMs scores: lower food security is associated with worse eating-related behavior, distress, symptoms, and physical function. The 6-item FI questionnaire helped identify individuals at highest risk. Presurgical planning should involve goal-directed interventions to optimize these patients and correlate with surgical outcomes.
粮食不安全（FI）使寻求代谢和减重手术（MBS）评估的患者处于不利地位，因为它与患者报告的结局指标（PROMs）较差有关。然而，需要进一步了解FI水平对PROMs的具体影响。我们试图研究粮食不安全水平对术前MBS患者的BODY-Q ER（饮食相关）行为、痛苦、症状和身体功能的影响。
纳入2024年2月至2025年接受MBS术前评估并完成经过验证的6项FI问卷和BODY-Q ER模块（0-100分；0分表示健康状况最差，100分表示健康状况最佳）的患者。患者被分为粮食安全水平（高、低和极低）。使用Kruskal-Wallis检验（p < 0.05）比较不同粮食安全水平下BODY-Q ER行为、痛苦、症状和身体功能的中位数Rasch分数（0-100分，分数越高表示健康状况越好）。
在614名患者中，76%的患者粮食安全状况高，14.7%的患者粮食安全状况低，9.9%的患者粮食安全状况极低。所有四项BODY-Q调查（饮食相关行为、饮食相关痛苦、饮食相关症状和身体功能）的中位数Rasch分数在不同粮食安全水平之间存在统计学差异（p < 0.001）。与粮食安全状况低和极低的患者相比，在所有BODY-Q调查中，粮食安全状况高的患者中位数Rasch分数更高。
粮食安全水平与BODY-Q PROMs分数直接相关：粮食安全水平较低与较差的饮食相关行为（饮食相关痛苦、饮食相关症状和身体功能）相关。6项FI问卷有助于识别风险最高的个体。术前规划应包括目标导向的干预措施，以优化这些患者的状况并与手术结果相关联。
