代谢与减重手术中术前饮食模式及其对术后结局的影响：一项对1550例患者的队列研究

Preoperative Eating Patterns and Their Effect on Post-operative Outcomes in Metabolic and Bariatric Surgery: A Cohort Study of 1550 Patients.

作者信息

Poljo Adisa, Wangnick Annika, Reichl Jakob J, Schneider Romano, Appel Meret, Dirnberger Amanda S, Billeter Adrian T, Kraljević Marko, Klasen Jennifer M, Peterli Ralph

机构信息

Department of Visceral Surgery, Clarunis, University Digestive Health Care Center Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland.

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel, Switzerland.

出版信息

Obes Surg. 2025 Aug 7. doi: 10.1007/s11695-025-08094-y.

DOI:10.1007/s11695-025-08094-y

PMID:40775573

Abstract

BACKGROUND

Postoperative outcomes after metabolic and bariatric (MBS) can vary due to preoperative behaviors and psychological factors, with several eating patterns (EPs), including eating disorders (EDs), often associated with suboptimal weight loss. Some guidelines even consider EDs a contraindication for MBS. This study examined the impact of EPs on long-term outcomes after MBS.

METHODS

A retrospective analysis was conducted on prospectively collected data from 1550 patients who underwent primary Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) between 2010 and 2018. Patients were categorized based on preoperative EPs, including binge eating disorder (BED), snacking behavior (SB), sweet eating habit (SEH), fat eating habit (FEH), night eating syndrome (NES), excessive eating habit (EEH), or no present EP. Demographics, morbidity, weight loss, comorbidities, and complications were assessed over 5 years. Outcomes were measured using the SF-BARI score.

RESULTS

EPs were common (67.6%), with many patients exhibiting multiple patterns. Patients with EPs were younger (40.8 vs. 43.3 years; p < 0.01) and had higher baseline BMI (44.5 vs. 43.8 kg/m; p = 0.046) compared to patients with no EP. They showed slightly higher % total weight loss (%TWL) in the first year (31.9% vs. 30.6%; p < 0.01), but differences diminished over time. At 5 years, SF-BARI scores remained slightly higher in the EP group (84.2 vs. 79.1; p = 0.046). RYGB was performed more frequently (69.9%) and yielded better outcomes than SG.

CONCLUSION

Preoperative EPs, including EDs, do not significantly impact postoperative outcomes after MBS, suggesting a need to reassess guidelines on EDs as contraindications.

摘要

背景

代谢与减重手术（MBS）后的术后结果可能因术前行为和心理因素而异，几种饮食模式（EPs），包括饮食失调（EDs），通常与不理想的体重减轻相关。一些指南甚至将饮食失调视为MBS的禁忌症。本研究探讨了饮食模式对MBS术后长期结果的影响。

方法

对2010年至2018年间接受初次 Roux-en-Y 胃旁路手术（RYGB）或袖状胃切除术（SG）的1550例患者的前瞻性收集数据进行回顾性分析。患者根据术前饮食模式进行分类，包括暴饮暴食症（BED）、吃零食行为（SB）、嗜甜食习惯（SEH）、嗜脂肪饮食习惯（FEH）、夜间饮食综合征（NES）、过度饮食习惯（EEH）或无特定饮食模式。在5年时间里评估人口统计学、发病率、体重减轻、合并症和并发症。使用SF-BARI评分来衡量结果。

结果

饮食模式很常见（67.6%），许多患者表现出多种模式。与无特定饮食模式的患者相比，有特定饮食模式的患者更年轻（40.8岁对43.3岁；p < 0.01），基线BMI更高（44.5对43.8kg/m²；p = 0.046）。他们在第一年的总体重减轻百分比（%TWL）略高（31.9%对30.6%；p < 0.01），但随着时间的推移差异逐渐减小。在5年时，特定饮食模式组的SF-BARI评分仍略高（84.2对79.1；p = 0.046）。RYGB的实施频率更高（69.9%），且比SG产生更好的结果。