Mechanisms that Predict Weight Trajectory after Bariatric Surgery: The Interactive Roles of Behavior and Biology

减肥手术后预测体重轨迹的机制：行为和生物学的相互作用

• 批准号: 9769016
• 负责人: Leslie J. Heinberg
• 金额: $ 95.6万
• 依托单位: NORTH DAKOTA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-15 至 2021-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9769016
• 关键词: Affect; Anatomy; Bariatrics; Behavior; Behavioral; Biological; Biology; Body Weight; Body Weight Changes; Body Weight decreased; Cognition; Comorbidity; Complex; Data; Data Collection; Development; Diabetes Mellitus; Disease remission; Eating; Eating Behavior; Enrollment; Etiology; Gastrectomy; Gastric Bypass; Health; Hypertension; Intervention; Knowledge; Lead; Literature; Longitudinal Studies; Measurement; Mediating; Moods; Morbid Obesity; Morbidity - disease rate; Obesity; Operative Surgical Procedures; Outcome; Participant; Patients; Pattern; Physical activity; Physiological; Play; Procedures; Protocols documentation; Recurrence; Reporting; Resolution; Risk; Role; Sample Size; Sampling; Time; Variant; Weight; bariatric surgery; base; biobehavior; cognitive function; design; diet and exercise; effective therapy; exercise regimen; experience; follow-up; gut microbiome; gut microbiota; gut-brain axis; individual patient; microbiome; mood symptom; novel; patient subsets; prospective; recidivism; response; surgery outcome; therapy development

Abstract Bariatric surgery is currently the most efficacious and durable intervention for severe obesity. Many comorbid conditions (e.g., diabetes, hypertension) generally remit or resolve following bariatric surgery. Yet, some patients experience suboptimal weight outcomes following surgery, often resulting from substantial weight regain following successful weight loss. Unfortunately, weight recidivism is also often associated with reemergence of obesity-associated comorbidities. The most commonly performed procedures in the U.S. are the Roux-en-Y Gastric Bypass (RYGB) and the laparoscopic Sleeve Gastrectomy (SG). Both procedures involve significant anatomical and physiological changes that lead to changes in behavior and biology. The etiological contributors to weight loss following surgery are not well understood, and it is therefore difficult to predict which patients may experience suboptimal post-surgical weight outcomes. Changes in eating and physical activity behaviors, mood, and the microbiome have all been reported to occur following bariatric surgery and have an association with weight change. Weight change likely involves complex interactions between behavioral and biological variables. The longitudinal relationship between changes in the gut microbiome and post-surgery weight trajectory has not been explored thoroughly, and the associations between the microbiome and other variables that impact weight have been similarly understudied. Therefore, we propose to conduct a prospective, 24-month longitudinal study of patients planning to undergo RYGB or SG and aim to identify correlates and predictors of observed weight loss trajectories over 24 months following bariatric surgery. In particular, this application is designed to examine the relationships between empirically supported behavioral and biological variables following surgery and their combined impact on weight outcome. These data will extend the current literature by collecting behavioral and biological data, by carrying out longer term follow-up of participants enrolled, and by studying a larger sample size. Novel data collection in this protocol will include intensive measurement of problematic eating behaviors and compliance with diet and exercise regimens post-surgically, which may be altered in parallel with, or in response to, changes observed in the gut microbiota. Identifying post-surgical predictors of weight loss and comorbidity resolution will allow for the development of interventions that can be tailored to individual patients based upon his/her risk profile which can then be implemented early to optimize surgery-related outcomes.

抽象的 减肥手术是目前治疗严重肥胖症最有效、最持久的干预措施。 许多合并症（例如糖尿病、高血压）通常会在以下情况下缓解或解决： 减肥手术。然而，一些患者在手术后体重结果不理想， 通常是由于成功减肥后体重大幅反弹所致。很遗憾， 体重累犯也常常与肥胖相关疾病的再次出现有关 合并症。在美国最常进行的手术是 Roux-en-Y 胃绕道术（RYGB）和腹腔镜袖状胃切除术（SG）。两个程序 涉及显着的解剖学和生理学变化，导致行为和行为的变化 生物学。手术后体重减轻的病因尚不清楚， 因此很难预测哪些患者可能会经历次优的术后情况 体重结果。饮食和身体活动行为、情绪和行为的变化 据报道，微生物群均在减肥手术后出现，并且存在关联 随着体重的变化。体重变化可能涉及行为之间复杂的相互作用 和生物变量。肠道微生物组变化之间的纵向关系 和术后体重轨迹尚未得到彻底探索，并且这些关联 微生物组和影响体重的其他变量之间的关系也类似 待研究。因此，我们建议开展一项为期 24 个月的前瞻性纵向研究 计划接受 RYGB 或 SG 的患者，旨在确定相关因素和预测因素 观察减肥手术后 24 个月内的体重减轻轨迹。特别是，这 应用程序旨在检查经验支持的行为之间的关系 手术后的生物变量及其对体重结果的综合影响。这些 数据将通过收集行为和生物数据、通过执行 对登记的参与者进行长期随访，并研究更大的样本量。新颖的数据 该协议中的收集将包括对有问题的饮食行为的深入测量 以及术后遵守饮食和运动方案，这些方案可能会同时改变 伴随或响应肠道微生物群中观察到的变化。识别术后 体重减轻和合并症解决的预测因素将允许发展 可以根据患者的风险状况为个体患者量身定制干预措施， 然后尽早实施以优化手术相关的结果。