据10月刊《外科学文献》发表的一项前瞻性纵向研究结果，减肥手术似乎对患者的家属也会产生有利影响：可使与之共同生活的成人和儿童体重减轻、饮食习惯更为健康以及活动水平提高。
既往研究表明，肥胖具有社会传染性，与肥胖者交往的人员更有可能变得肥胖。为证明减肥手术是否可使得患者周围人群体重降低和行为更为健康，斯坦福大学的Gavitt A. Woodard博士及其同事评估了与Roux-en-Y胃旁路术(RYGBP)患者术后共同生活1年的配偶、父母和子女的体重和生活方式改变情况。
研究者在2年内入组35个家庭，包括35例患者、26例配偶、3例祖父母、6例成年子女和15例年龄<18岁的子女，要求患者及其家庭成员参加有关生活方式改变的3次术前培训和5次术后访视，推荐患者食用高蛋白、高纤维、低糖饮食，并建议每日6次食用含有200~300卡路里和4~6盎司蛋白的少量饮食。生活方式改变包括实现每日增加体力活动(10,000步/d)、8 h睡眠、适量饮酒以及观看电视时间不超过2 h的目标。1年后，通过体检以及系列问卷调查评估受试者的总体健康、体力活动、睡眠、风险行为、看电视、饮酒量及生活质量等情况。
结果显示，患者如期达到减肥效果。家庭成员平均体重由100 kg下降至90 kg，无显著差异。但家庭成员如果按照基线体重进行分类，则其体重减轻具有显著差异。肥胖成年家庭成员平均体重由106 kg降至102.5 kg，体重下降显著；非肥胖成年家庭成员平均体重由81.6 kg降至79.8 kg，未见显著差异。体重指数(BMI)和腰围下降情况亦是如此。肥胖的成年家庭成员1年总体重下降3%，而此前报告Atkins、Zone、 Ornish或 LEARN饮食人群体重下降2%~5%，表明家庭成员与胃旁路术患者共同生活并且一起遵从有组织的饮食计划，则可达到与特殊饮食类似的降低体重效果。
鉴于儿童体重和腰围随自然成长而有所增加，故对儿童进行单独分析。考虑到病历确认的生长轨迹，肥胖儿童BMI增加(29.6 kg/m2)略小于预期(31.2 kg/m2)，非肥胖儿童BMI增加(19.8 kg/m2)稍大于预期(18.8 kg/m2)。肥胖儿童腰围由119 cm显著降至111 cm，但非肥胖儿童腰围未见任何变化。
患者及其成年家庭成员饮食习惯呈现明显变化，“不节制饮食”和“情绪化饮食”均有所减少。此外，患者但不包括其亲属的“饮食认知控制”明显增强。然而，儿童未见上述变化。儿童和成年家庭成员在食物选择或减少碳水化合物及垃圾食品摄入方面未见变化，但患者的确实现了这些目标。儿童报告“控制饮食”的比例显著增加，从基线时的25%增加至1年时的50%。患者及其成年家庭成员酒精消费明显减少，患者从每月5杯减少至0.2杯，成年家庭成员从每月11杯减少至0.8杯。此外，患者及家庭成员的每日活动水平均显著增加，儿童每日观看电视或使用计算机的时间有所减少，但未达到显著差异水平。
总之，该研究发现表明，减肥手术也为患者之外的家庭成员提供了干预机会。
该研究由斯坦福大学医学学者项目资助，研究者无利益冲突报告。
相关英文论文摘要：
Halo Effect for Bariatric Surgery: Collateral Weight Loss in Patients' Family Members
Context Bariatric surgery is an effective treatment for morbid obesity, which is increasingly recognized as a familial disease. Healthy behavior transmission may be enhanced by family relationships.
Objective To determine changes in weight and healthy behavior in patients who underwent Roux-en-Y gastric bypass surgery and their family members.
Design Prospective, longitudinal, and multidimensional health assessment before and 1 year after index Roux-en-Y gastric bypass surgery.
Setting An academic bariatric center of excellence, from January 1, 2007, through December 31, 2009.
Participants Eighty-five participants (35 patients, 35 adult family members, and 15 children <18 years old).
Intervention Roux-en-Y gastric bypass surgery and associated dietary and lifestyle counseling.
Main Outcome Measures Weight and expected body mass index (calculated as weight in kilograms divided by height in meters squared). Secondary outcomes were waist circumference, quality of life (36-Item Short Form or Pediatric Quality of Life Inventory), healthy behaviors, eating behaviors, and activity levels.
Results Participants were grouped by relationship to patient for analysis with paired 2-sample t tests. Before the operation, 60% of adult family members and 73% of children of patients undergoing Roux-en-Y gastric bypass surgery were obese. At 12 months after the operation, significant weight loss was observed in obese adult family members (from 234 to 226 lb; P = .01). There was a trend for obese children to have a lower body mass index than expected for their growth curve (31.2 expected vs 29.6 observed; P = .07). Family members increased their daily activity levels (adults, from 8 to 17 metabolic equivalent task–hours, P = .005; and children, from 13 to 22, P = .04). Adult family members also had improved eating habits with less uncontrollable eating (from 35 to 28; P = .01), emotional eating (from 36 to 28; P = .04), and alcohol consumption (from 11 drinks per month to 1 drink per month; P = .009).
Conclusion Gastric bypass surgery may render an additional benefit of weight loss and improved healthy behavior for bariatric patients' family members.
