BACKGROUND Weight maintenance remains to be a challenge for patients in a reduced obese state and it has been recommended to provide them more individualized support. For this purpose it is crucial to understand the barriers patients are experiencing after weight loss. Many have been identified by qualitative studies. We evaluated if a quantitative assessment of patient perspective during weight maintenance can help identify major barriers that refer to actual regain. METHODS Follow-up data were analyzed from patients attempting weight maintenances after successful completion of a nonsurgical weight loss and lifestyle intervention for morbid obesity. The data were acquired at mandatory follow-up assessments and included rating of 26 probable difficulties. A principal component analysis was carried out to explore whether these difficulties could be grouped into meaningful factors. Associations with socio-demographics, follow-up time, and weight changes were evaluated. RESULTS Data from 88 out of 102 patients were available (baseline BMI 49.5 ± 7.4 kg/m2; 12-month weight loss 24.3 ± 9.6%; follow-up time 1.48 ± 0.6 years). Four solid factors, composed of 21 items and explaining 56% of the variance were extracted and interpreted as 'Hedonic Hunger', 'Mental Distress', 'Binge Eating', and 'Demoralization'. Weight regain (12.4 ± 12%) was correlated with each factor, most closely with 'Mental Distress' (r = 0.38). When controlling for age and follow-up time, 'Binge Eating' was the most important predictor (adj. R2 = 0.297). CONCLUSIONS A quantitative assessment of patient perspective during the first years after weight loss can help identify valid barriers to weight loss maintenance.

中文翻译：

---

维持减肥的四个主要障碍？肥胖患者成功减轻体重后所遇到的困难的定量分析。

背景技术对于维持肥胖状态的患者而言，维持体重仍然是一项挑战，因此建议为他们提供更多的个性化支持。为此，至关重要的是要了解患者减肥后遇到的障碍。通过定性研究已经确定了许多。我们评估了维持体重期间对患者观点的定量评估是否可以帮助确定与实际恢复有关的主要障碍。方法从成功完成非手术减肥和生活方式干预的病态肥胖患者中尝试维持体重的患者的随访数据进行分析。这些数据是通过强制性后续评估获得的，其中包括对26种可能困难的评分。进行了主成分分析，以探讨是否可以将这些困难归为有意义的因素。评估与社会人口统计学，随访时间和体重变化的关系。结果从102名患者中的88名患者获得了数据（基线BMI 49.5±7.4 kg / m2； 12个月体重减轻24.3±9.6％；随访时间1.48±0.6年）。提取了由21个项目组成并解释了56％的方差的四个坚实因素，并将其解释为“享乐主义饥饿”，“精神困扰”，“暴饮暴食”和“不道德化”。体重恢复（12.4±12％）与每个因素相关，与“精神困扰”最为相关（r = 0.38）。当控制年龄和随访时间时，“ Binge Eating”是最重要的预测因子（R2 = 0.297）。