Excess weight gain prevention in adolescents: Three-year outcome following a randomized controlled trial.
Excess weight gain prevention in adolescents: Three-year outcome following a randomized controlled trial.
复制标题
DOI：
10.1037/ccp0000153
复制
发表时间：
2017-03
影响因子：
5.9
通讯作者：
Yanovski JA
中科院分区：
文献类型：
--
作者：
Tanofsky-Kraff M;Shomaker LB;Wilfley DE;Young JF;Sbrocco T;Stephens M;Brady SM;Galescu O;Demidowich A;Olsen CH;Kozlosky M;Reynolds JC;Yanovski JA
人际心理治疗（IPT）可以预防患有肥胖和暴饮暴食症的成年人体重增加，对于心理社会问题增加的人尤其有效。然而，IPT并不上级健康教育（HE），以防止在1年的随访113个青春期女孩在过度体重增加的高风险，因为失控（NBS）-饮食和高BMI（kg/m2）的过度体重增加。最初试验的参与者在3年后重新联系进行评估。在基线，青少年和父母报告的社会适应问题和特质焦虑进行了评估。在基线和随访时，通过双能X线吸收法获得BMIz和肥胖。近60%的患者在3年时接受了重新评估，参与率无组间差异（ps≥.70）。与1年一致，各组对BMIz/肥胖的变化无主要影响（ps≥.18）。在探索性分析中，基线社会适应问题和特质焦虑调节结果（ps<.01）。在自我报告的基线社会适应问题或焦虑较高的女孩中，与HE相比，IPT与BMIz下降最快相关（p<0.001）。对于肥胖，HE中具有高或低焦虑的女孩，以及IPT中具有低焦虑的女孩经历了增益（ps≤.03），而IPT中具有高焦虑的女孩稳定。父母的报告产生了互补的结果。在有肥胖倾向的青春期女孩中，IPT在预防3年时体重过度增加方面并不上级于HE。与理论一致，探索性分析表明，在具有高度社会适应问题或特质焦虑的青年中，IPT与3年以上的BMIz改善相关。未来的研究应该测试IPT在有社会适应问题和/或焦虑的高危女孩中预防肥胖的有效性。
Interpersonal psychotherapy (IPT) prevents weight gain in adults with obesity and binge-eating-disorder, and is especially effective among those with increased psychosocial problems. However, IPT was not superior to health-education (HE) to prevent excess weight gain at 1-year follow-up in 113 adolescent girls at high-risk for excess weight gain because of loss-of-control (LOC)-eating and high BMI (kg/m2). Participants from the original trial were re-contacted 3-years later for assessment. At baseline, adolescent- and parent-reported social-adjustment problems and trait-anxiety were evaluated. At baseline and follow-ups, BMIz and adiposity by dual-energy X-ray absorptiometry were obtained. Nearly 60% were re-assessed at 3-years, with no group differences in participation (ps≥.70). Consistent with 1-year, there was no main effect of group on change in BMIz/adiposity (ps≥.18). In exploratory analyses, baseline social-adjustment problems and trait-anxiety moderated outcome (ps<.01). Among girls with high self-reported baseline social-adjustment problems or anxiety, IPT, compared to HE, was associated with the steepest declines in BMIz (p<.001). For adiposity, girls with high- or low-anxiety in HE, and girls with low-anxiety in IPT experienced gains (ps≤.03), while girls in IPT with high-anxiety stabilized. Parent-reports yielded complementary findings. In obesity-prone adolescent girls, IPT was not superior to HE in preventing excess weight gain at 3-years. Consistent with theory, exploratory analyses suggested that IPT was associated with improvements in BMIz over 3-years among youth with high social-adjustment problems or trait-anxiety. Future studies should test the efficacy of IPT for obesity prevention among at-risk girls with social-adjustment problems and/or anxiety.