Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: The ENACT trial
Efficacy of environmental and acceptance-based enhancements to behavioral weight loss treatment: The ENACT trial
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DOI：
10.1002/oby.21813
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发表时间：
2017-05-01
期刊：
影响因子：
6.9
通讯作者：
Schaumberg, Katherine
中科院分区：
文献类型：
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作者：
Butryn, Meghan L.;Forman, Evan M.;Schaumberg, Katherine
目的本研究旨在比较传统行为治疗（BT）方法的减肥效果，该方法整合了管理肥胖食物环境的技能（BT+E）与整合环境和接受技能的方法（BT+EA）。作为探索性目标，对主持人进行了检查。方法成人 (N=283) 被随机分配到不同的治疗条件，并在 12 个月的时间内接受 26 次分组治疗。在第 0、6 和 12 个月时在诊所测量体重。结果随着时间的推移，体重变化并没有因病情而出现显着差异。然而，种族显着减轻了条件对体重减轻的影响（P=0.04），例如，在 BT（6.2% vs. 11.5%）和 BT+E 条件（6.6% vs. 12.2%）中，非洲裔美国参与者比非西班牙裔白人参与者减轻的体重更少，但在 BT+EA 条件下，这两组的体重减轻相似（9.4% vs. 11.5%）。在非裔美国人中，BT+EA (80%) 在 12 个月时实现临床显着体重减轻（即> 5%）的比率高于 BT（57%）或 BT+E（48%）（P=0.04）。结论这种创新的行为方法显示出治疗非裔美国人的希望，鉴于迄今为止在解决肥胖干预效果方面的种族差异方面缺乏进展，这一点值得注意。
ObjectiveThis study was designed to compare weight loss through a traditional behavioral treatment (BT) approach that integrated skills for managing the obesogenic food environment (BT+E) with an approach that integrated environmental and acceptance-based skills (BT+EA). Moderators were examined as an exploratory aim.MethodsAdults (N=283) were randomly assigned to treatment condition and provided with 26 group-based sessions over the course of 12 months. Weight was measured in the clinic at months 0, 6, and 12.ResultsChange in weight over time did not significantly differ by condition. However, race significantly moderated the effect of condition on weight loss (P=0.04), such that African-American participants lost less weight than non-Hispanic white participants in the BT (6.2% vs. 11.5%) and BT+E conditions (6.6% vs. 12.2%), but weight loss in these two groups was similar in the BT+EA condition (9.4% vs. 11.5%). Among African Americans, rates of achieving a clinically significant weight loss (i.e.,>5%) at 12 months were higher in BT+EA (80%) than BT (57%) or BT+E (48%) (P=0.04).ConclusionsThis innovative behavioral approach shows promise for treatment of African Americans, which is notable given the lack of progress to date addressing racial disparities in obesity intervention efficacy.