Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods.
Weight-loss maintenance in successful weight losers: surgical vs non-surgical methods.
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DOI：
10.1038/ijo.2008.256
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发表时间：
2009-01
影响因子：
4.9
通讯作者：
Wing, R. R.
中科院分区：
文献类型：
--
作者：
Bond, D. S.;Phelan, S.;Leahey, T. M.;Hill, J. O.;Wing, R. R.
由于除减肥手术外，很少能通过任何方法实现大幅减肥，因此目前还没有研究比较最初通过减肥手术或非手术方式大幅减肥的个体。国家体重控制登记处 (NWCR) 提供了进行此类独特比较的资源。这项研究比较了 NWCR 参与者的体重恢复量、行为和心理特征，这些参与者通过减肥手术或非手术方法同样成功地减轻和维持大量体重。将手术参与者 (n = 105) 与两名非手术参与者 (n = 210) 在性别、初始体重、最大体重减轻和体重维持持续时间方面进行匹配，并进行为期 1 年的前瞻性比较。手术组和非手术组的参与者报告称减重约 56 公斤，并在 5.5 ± 7.1 年内减重 ≥ 13.6 公斤。从登记到 1 年，两组患者的体重都增加了少量但显着（p = 0.034），但体重恢复幅度没有显着差异（手术组和非手术组分别为 1.8 ± 7.5 kg 和 1.7 ± 7.0 kg；p = 0.369）。手术参与者报告称，在入院时和一年内，体力活动较少，快餐和脂肪消耗较多，饮食限制较少，抑郁和压力较高。两组患者在开始时的较高水平的去抑制以及一年内增加的去抑制都与体重恢复有关。尽管各组之间存在显着的行为差异，但没有观察到体重恢复的显着差异。研究结果表明，通过非手术方法和更强化的行为努力，可以实现与减肥手术后相当的减肥维持效果。无论最初的减肥方法如何，对引发暴饮暴食的线索的敏感性增加可能会增加体重反弹的风险。
Since large weight losses are rarely achieved through any method except bariatric surgery, there have been no studies comparing individuals who initially lost large amounts of weight through bariatric surgery or non-surgical means. The National Weight Control Registry (NWCR) provides a resource for making such unique comparisons. This study compared amount of weight regain, behaviors, and psychological characteristics in NWCR participants who were equally successful in losing and maintaining large amounts of weight via either bariatric surgery or non-surgical methods. Surgical participants (n = 105) were matched with two non-surgical participants (n = 210) on gender, entry weight, maximum weight loss, and weight maintenance duration and compared prospectively over 1 year. Participants in the surgical and non-surgical groups reported having lost approximately 56 kg and keeping ≥ 13.6 kg off for 5.5 ± 7.1 years. Both groups gained small but significant amounts of weight from registry entry to 1 year (p = 0.034), but did not significantly differ in magnitude of weight regain (1.8 ± 7.5 kg and 1.7 ± 7.0 kg for surgical and non-surgical groups, respectively; p = 0.369). Surgical participants reported less physical activity, more fast food and fat consumption, less dietary restraint, and higher depression and stress at entry and 1 year. Higher levels of disinhibition at entry and increased disinhibition over 1 year were related to weight regain in both groups. Despite marked behavioral differences between the groups, significant differences in weight regain were not observed. The findings suggest that weight loss maintenance comparable to that after bariatric surgery can be accomplished through non-surgical methods with more intensive behavioral efforts. Increased susceptibility to cues that trigger overeating may increase risk of weight regain regardless of initial weight loss method.
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