Powers P S, Rosemurgy A, Boyd F, Perez A
Department of Psychiatry and Behavioral Medicine, College of Medicine, Health Sciences Center, University of South Florida, Tampa 33613, USA.
Obes Surg. 1997 Dec;7(6):471-7. doi: 10.1381/096089297765555197.
Weight losses following bariatric surgery have varied widely, depending on length of follow-up and various pre-surgical characteristics of patients undergoing surgery.
One hundred thirty one patients had a detailed presurgical psychiatric evaluation. Patients were assessed clinically for 2 years after surgery and at follow-up a mean of 5.7 years after surgery.
Mean presurgical body mass index (BMI) was 52.9 kg/m2; therefore, many patients had 'super obesity'. Two-thirds of the patients were located a mean of 5.7 years after surgery. The mean change in BMI at follow-up was 25% and the mean weight loss was 27%. One-third had excellent or good weight outcomes using the Griffen criteria. Five patients had died by follow-up. There was no relationship between age, gender, or fat content presurgically and weight loss at follow-up, although presurgical weight was associated with greater weight loss at follow-up. Weight regain began 2 years after surgery. There was no relationship between the presence or absence of a presurgical psychiatric diagnosis and weight loss at follow-up. There was also no relationship between the presence of a presurgical psychiatric diagnosis and various mental health parameters at follow-up. Satisfaction with the surgery was marginally associated with weight loss but significantly associated with improved mental and physical health.
Mean weight losses were less than have been previously reported with gastric restriction procedures but the follow-up was longer than usually reported and many patients had 'super obesity' prior to surgery. The implications of 'super obesity' for weight loss are discussed.
减肥手术后的体重减轻差异很大，这取决于随访时间以及接受手术患者的各种术前特征。
131名患者接受了详细的术前精神科评估。术后对患者进行了2年的临床评估，并在术后平均5.7年进行随访。
术前平均体重指数（BMI）为52.9kg/m²；因此，许多患者患有“超级肥胖症”。三分之二的患者在术后平均5.7年接受随访。随访时BMI的平均变化为25%，平均体重减轻为27%。根据格里芬标准，三分之一的患者体重减轻效果极佳或良好。随访时有5名患者死亡。术前年龄、性别或脂肪含量与随访时的体重减轻之间没有关系，尽管术前体重与随访时更大的体重减轻有关。体重在术后2年开始反弹。术前是否存在精神科诊断与随访时的体重减轻之间没有关系。术前精神科诊断的存在与随访时的各种心理健康参数之间也没有关系。对手术的满意度与体重减轻略有相关，但与精神和身体健康的改善显著相关。
平均体重减轻低于先前报道的胃限制手术，但随访时间比通常报道的更长，且许多患者术前患有“超级肥胖症”。本文讨论了“超级肥胖症”对体重减轻的影响。
