Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification - a 2-y follow-up study
Health-related quality of life in obese outpatients losing weight with very-low-energy diet and behaviour modification - a 2-y follow-up study
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DOI：
10.1038/sj.ijo.0802379
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发表时间：
2003-10-01
影响因子：
4.9
通讯作者：
Mustajoki, P
中科院分区：
文献类型：
--
作者：
Kaukua, J;Pekkarinen, T;Mustajoki, P
目的：研究健康相关的生活质量（HRQL）在临床选定的样本肥胖outpatients.Design：一个单链的研究前和后2年随访后，治疗包括10周的极低能量饮食（VLED）和4个月的行为修改组。d.）年龄48.2（11.1）y和体重指数42.8（6.2）kg/m（2）肥胖患者（63%的妇女）转介到肥胖症诊所治疗。测量：体重和HRQL使用问卷调查（兰德36项健康调查1.0和肥胖相关心理社会问题量表（OP量表））。共有100例患者（61%女性）完成了治疗，67例（71%女性）完成了2年随访。平均值（S）d.）治疗结束时体重减轻12.5（5.6）%，治疗1年后体重减轻6.0（7.1）%，治疗2年后体重减轻2.6（7.5）%。在基线时，平均值（s. d.）OP量表评分为61.9（24.6）。每兰德-36量表的平均得分明显低于芬兰人没有慢性疾病。治疗期间HRQL的所有量表均明显改善。在随访期间，所有量表开始恢复到基线水平，在2年时，只有肥胖相关的心理社会问题和身体功能相对于基线仍有改善。在2年时的体重变化类别中（体重减轻大于或等于10%、体重减轻0 - 9.9%、体重增加），肥胖相关的心理社会功能、身体功能和一般健康状况显示出随着体重减轻的增加而改善的剂量反应。治疗后2年体重减轻大于或等于10%与肥胖相关的心理社会问题、身体功能、身体角色功能、身体疼痛、一般健康、心理健康和活力的明显改善相关。0 - 9.9%的体重减轻与肥胖相关的心理社会问题和身体功能的改善有关。体重增加与肥胖相关的心理社会问题和社会功能的改善有关。研究人群太小，检查可能的性别差异。结论：VLED和行为矫正治疗产生显着的短期体重减轻和HRQL的各个方面的明显改善。在治疗后2年，平均保持体重减轻是适度的。然而，1/3的患者保持大于或等于5%的体重减轻。与肥胖相关的心理社会问题和身体功能的改善甚至与不到10%的持续减肥有关。由于HRQL变化模式仅部分遵循预期的体重变化模式，因此其他因素（如参与减肥计划的治疗效果或体力活动增加）可能会影响HRQL反应。
OBJECTIVE: To study health-related quality of life (HRQL) in a clinically selected sample of obese outpatients.DESIGN: A single-strand before and after study with 2-y follow-up after treatment comprising 10 weeks on very-low-energy diet (VLED) and 4 months of behaviour modification in groups.SUBJECTS: A total of 126 (mean (s. d.) age 48.2 (11.1) y and body mass index 42.8 (6.2) kg/m(2) obese patients (63% women) referred for treatment in an obesity clinic.MEASUREMENTS: Weight and HRQL using questionnaires (RAND 36-Item Health Survey 1.0 and Obesity-related Psychosocial problems scale (OP-scale)).RESULTS: A total of 100 patients (61% women) completed the treatment and 67 (71% women) completed the 2- y follow-up. The mean ( s. d.) weight loss was 12.5 (5.6)% at the end of group therapy, 6.0 (7.1)% at 1 y, and 2.6 (7.5)% at 2 y. At baseline, the mean ( s. d.) score for the OP-scale was 61.9 (24.6). The mean scores on every RAND-36 scale were markedly lower than in the Finns without chronic conditions. All the scales in HRQL improved markedly during the treatment. During the follow-up, all the scales started to return towards baseline levels, and at 2 y only obesity-related psychosocial problems and physical functioning were still improved relative to baseline. In categories of weight change at 2 y ( greater than or equal to10% weight loss, 0 - 9.9% weight loss, weight gain), obesity-related psychosocial functioning, physical functioning, and general health showed dose - response improvement with increasing weight loss. A greater than or equal to10% weight loss at 2 y after treatment was associated with clear improvement in obesity-related psychosocial problems, physical functioning, physical role functioning, bodily pain, general health, mental health, and vitality. A 0 - 9.9% weight loss was associated with improvement in obesity-related psychosocial problems and physical functioning. Weight gain was associated with improvement in obesity-related psychosocial problems and social functioning. The study population was too small to examine possible gender differences.CONCLUSIONS: Treatment with VLED and behaviour modification produces marked short-term weight loss and clear improvement in all aspects of HRQL. At 2 y after treatment, the average maintained weight loss is modest. However, 1/3 of patients maintained a greater than or equal to5% weight loss. Improvement in obesity-related psychosocial problems and physical functioning is associated even with less than 10% of maintained weight loss. Since the pattern of HRQL changes only partly followed the pattern of weight change as expected, other factors, such as the therapeutic effect of participating in the weight loss programme or increase in physical activity, may affect HRQL responses.