An observed variable path and mediation analysis of psychological and behavioral factors promoting short-term weight loss outcomes

Li Jingran; Gong Faping; Zeng Menghua; Ran Pan; Li Ruishen; Duan Liqi; Wang Wo

doi:10.13406/j.cnki.cyxb.004094

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An observed variable path and mediation analysis of psychological and behavioral factors promoting short-term weight loss outcomes

Clinical research | 更新时间：2026-05-13

- An observed variable path and mediation analysis of psychological and behavioral factors promoting short-term weight loss outcomes
- Journal of Chongqing Medical University Vol. 51, Issue 5, Pages: 703-708(2026)
- 作者机构：
  
  1.重庆医科大学附属大学城医院精神科，重庆 401331
  2.重庆医科大学附属第一医院胃肠外科，重庆 400000
  3.重庆医科大学附属第一医院精神科，重庆 400000
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.004094
  CLC： R589.2
- Received：24 January 2026，
  
  Revised：2026-03-19，
  
  Accepted：20 March 2026，
  
  Published：28 May 2026
- 稿件说明：
移动端阅览
李静然，龚发平，曾梦华，等.心理与行为因素促进短期减重效果的显变量路径与中介分析[J].重庆医科大学学报，2026，51（5）：703-708.

Li Jingran,Gong Faping,Zeng Menghua,et al.An observed variable path and mediation analysis of psychological and behavioral factors promoting short-term weight loss outcomes[J].Journal of Chongqing Medical University,2026,51(5):703-708.
李静然，龚发平，曾梦华，等.心理与行为因素促进短期减重效果的显变量路径与中介分析[J].重庆医科大学学报，2026，51（5）：703-708. DOI： 10.13406/j.cnki.cyxb.004094.

Li Jingran,Gong Faping,Zeng Menghua,et al.An observed variable path and mediation analysis of psychological and behavioral factors promoting short-term weight loss outcomes[J].Journal of Chongqing Medical University,2026,51(5):703-708. DOI： 10.13406/j.cnki.cyxb.004094.

摘要

目的

探讨腹腔镜袖状胃切除术（laparoscopic sleeve gastrectomy，LSG）后患者抑郁与睡眠质量的改善，以及是否通过减少暴食行为影响短期减重效果。

方法

对133例接受LSG的肥胖患者进行术前及术后3个月随访，评估抑郁（patient health questionnaire-9，PHQ-9）、焦虑（generalized anxiety disorder-7，GAD-7）、睡眠质量（pittsburgh sleep quality index，PSQI）、暴食行为（binge eating scale，BES）及体质量指标，以百分比总减重（percentage of total weight loss，%TWL）为主要结局。采用配对样本

检验比较术前术后差异，独立样本检验比较减重达标组（%TWL≥20%）与未达标组的改善幅度，并基于Δ分数构建显变量路径与中介模型（饱和模型），分析各变量之间的关系。

结果

术后3个月，患者抑郁、焦虑、睡眠质量及暴食行为均明显改善（

0.01）。减重达标组在抑郁、睡眠及暴食行为的改善幅度上均优于未达标组（

0.01）。路径分析显示，抑郁与睡眠改善能直接预测%TWL，也通过促进暴食行为改善间接影响%TWL。中介分析表明，暴食行为改善在抑郁、睡眠改善与%TWL之间起到部分中介作用。

结论

LSG术后心理与行为因素的改善与短期减重效果相关，暴食行为的改善是抑郁和睡眠改善影响减重结局的中介路径。

Abstract

Objective

To investigate the improvements in depression and sleep quality after laparoscopic sleeve gastrectomy（LSG） and whether such improvements promotes short-term weight loss by reducing binge eating behavior.

Methods

A total of 133 obese patients who underwent LSG were assessed before surgery and were followed up for 3 months after surgery. Related indicators were evaluated，including depression（Patient Health Questionnaire-9），anxiety（Generalized Anxiety Disorder-7），sleep qua

lity （Pittsburgh Sleep Quality Index），binge eating behavior（Binge Eating Scale），and body weight，with percentage of total weight loss（%TWL） as the primary outcome measure. The paired samples

-test was used for comparison before and after surgery，and the independent samples

-test was used to compare the degree of improvement between the weight loss achievement group（%TWL≥20%） and the non-achievement group. An observed variable path and mediation model（saturated model） based on change scores was constructed to examine the association between variables.

Results

At 3 months after surgery，the patients showed significant improvements in depression，anxiety，sleep quality，and binge eating behavior（

0.01）. Compared with the non-achievement group，the weight loss achievement group had significantly greater improvements in depression，sleep quality，and binge eating behavior（

0.01）. The path analysis showed that improvement in depression and sleep quality could not only directly predict %TWL but also indirectly affect %TWL by promoting the improvement in binge eating behavior. The mediation analysis showed that the improvement in binge eating behavior played a partial mediating role in the association between the improvement in depression，sleep quality and %TWL.

Conclusion

The improvement in psychological and behavioral factors after LSG is associated with short-term weight loss outcomes，and the improvement in binge eating behavior is a mediating pathway through which the improvements in depression and sleep quality affect weight loss outcomes.

关键词

Keywords

references

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