One hundred-pound weight losses with an intensive behavioral program: changes in risk factors in 118 patients with long-term follow-up
One hundred-pound weight losses with an intensive behavioral program: changes in risk factors in 118 patients with long-term follow-up
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DOI：
10.1093/ajcn/86.2.301
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发表时间：
2007-08-01
影响因子：
7.1
通讯作者：
Nicholas, Amy S.
中科院分区：
文献类型：
--
作者：
Anderson, James W.;Conley, Shannon B.;Nicholas, Amy S.
背景：严重肥胖症的治疗很困难；在过去，生活方式措施被证明并不有效。然而，最近，使用膳食替代和低能量饮食的密集行为干预使一些严重肥胖者实现了非肥胖体重。目的：我们评估了减重100磅(45.5公斤)的患者的减重率、风险因素和药物需求的变化以及长期体重维持。设计：在9年的时间里，我们前瞻性地确定了减重100磅(45.5公斤)的患者，并积极记录了随访体重。对图表进行系统回顾，以评估结果衡量标准和副作用。干预措施包括代餐(奶昔和主菜)、低能量饮食、每周课程以及记录保存和体力活动方面的培训。评估包括每周体重、实验室研究、药物使用、生活方式行为、副作用和随访体重。结果：63名男性和55名女性减掉了100磅。在基线水平，受试者的平均体重为160公斤，97%的受试者有1例与肥胖相关的共病，74%的受试者正在服用药物治疗。44wk体重平均下降61 kg。66%的患者停药，每月节省成本100美元。尽管停药，但低密度脂蛋白胆固醇(20%)、三酰甘油(36%)、血糖(17%)以及收缩压(13%)和舒张压(15%)的血压值显著下降。副作用轻微，只有2例患者有严重或严重的不良反应。在平均5年的随访中，患者的体重平均下降了30公斤。结论：强化行为干预对某些严重肥胖者来说是非常有效的，风险最小。
Background: Treatment of severe obesity is difficult; in the past, lifestyle measures did not prove effective. Recently, however, intensive behavioral interventions using meal replacements and low-energy diets have enabled some severely obese persons to achieve nonobese weights.Objective: We assessed rates of weight loss, changes in risk factors and medication requirements, and long-term weight maintenance in patients who lost >= 100 pounds (45.5 kg).Design: Over a 9-y period, we prospectively identified patients who lost 100 pounds (45.5 kg) and actively recorded follow-up weights. Charts were systematically reviewed to assess outcome measures and side effects. The intervention included meal replacements (shakes and entrees), low-energy diets, weekly classes, and training in record keeping and physical activity. Assessments included weekly weights, laboratory studies, medication use, lifestyle behaviors, side effects, and follow-up weights.Results: Sixty-three men and 55 women lost >= 100 pounds. At baseline, the subjects' average weight was 160 kg, 97% had >= 1 obesity-related comorbidity, and 74% were taking medications for comorbidities. Weight losses averaged 61 kg in 44 wk. Medications were discontinued in 66% of patients with a cost savings of $100/mo. Despite medication discontinuation, significant decreases in LDL cholesterol (20%), triacylglycerol (36%), glucose (17%), and systolic (13%) and diastolic (15%) blood pressure values were seen. Side effects were mild, and only 2 patients had severe or serious adverse events. At an average of 5 y of follow-up, patients were maintaining an average weight loss of 30 kg.Conclusion: Intensive behavioral intervention can be very effective with minimal risk for certain severely obese persons.