Motivation, Readiness to Change, and Weight Loss Following Adjustable Gastric Band Surgery
Motivation, Readiness to Change, and Weight Loss Following Adjustable Gastric Band Surgery
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DOI：
10.1038/oby.2008.609
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发表时间：
2009-04-01
期刊：
影响因子：
6.9
通讯作者：
O'Brien, Paul E.
中科院分区：
文献类型：
--
作者：
Dixon, John B.;Laurie, Cheryl P.;O'Brien, Paul E.
高水平的准备改变（RTC）被认为是至关重要的长期成功的体重管理计划，包括减肥手术。然而，没有数据支持这一说法。我们假设RTC水平不会影响手术后的体重结果。在227例接受可调节胃束带手术的连续患者中，我们记录了寻求手术的原因，并使用罗得岛大学变化评估测量RTC。在研究完成前对评分设盲。主要结局指标为2年时BMI过度降低的百分比（%EBMIL-2）;其他指标包括依从性和手术并发症。在227例受试者中，204例（90%）在2年时进行了体重测量。RTC评分与% EBMIL-2无显著相关性（r = 0.047，P = 0.5）。使用RTC评分的中位数分割，最低102例受试者的平均% EBMIL-2为52.9 +/- 26.9%，最高为52.2 +/-28.3%，P = 0.869。最高和最低四分位数之间没有体重减轻差异，体重减轻和RTC评分之间也没有非线性关系。RCT评分与依从性或并发症的可能性之间没有显著关系。那些以外表为动机的人更有可能是年轻的女性，她们在2岁时减掉了更多的体重。随访时出勤率低与体重减轻有关，尤其是男性。RTC的测量不能预测体重减轻、依从性或手术并发症。当使用RTC评估来预测减肥手术的结果时，建议谨慎。
High levels of readiness to change (RTC) are considered critical to the long-term success of weight management programs including bariatric surgery. However, there are no data to support this assertion. We hypothesize that RTC level will not influence weight outcomes following surgery. In 227 consecutive patients undergoing adjustable gastric banding surgery, we recorded reasons for seeking surgery, and RTC measured with the University of Rhode Island Change Assessment. Scores were blinded until study completion. The primary outcome measure was percentage of excess BMI loss at 2 years (%EBMIL-2); others included compliance and surgical complications. Of 227 subjects, 204 (90%) had weight measurement at 2 years. There was no significant correlation between RTC score and % EBMIL-2 (r = 0.047, P = 0.5). Using the median split for RTC score the lowest 102 subjects mean % EBMIL-2 was 52.9 +/- 26.9% and the highest 52.2 +/- 28.3%, P = 0.869. There was no weight loss difference between highest and lowest quartiles, or a nonlinear relationship between weight loss and RTC score. There was no significant relationship between RCT score and compliance, or likelihood of complications. Those motivated by appearance were more likely to be younger women who lost more weight at 2 years. Poor attendance at follow-up visits was associated with less weight loss, especially in men. Measures of RTC did not predict weight loss, compliance, or surgical complications. Caution is advised when using assessments of RTC to predict outcomes of bariatric surgery.