A Randomized Trial Testing a Contingency-Based Weight Loss Intervention Involving Social Reinforcement
A Randomized Trial Testing a Contingency-Based Weight Loss Intervention Involving Social Reinforcement
复制标题
DOI：
10.1038/oby.2011.124
复制
发表时间：
2012-02-01
期刊：
影响因子：
6.9
通讯作者：
Wing, Rena R.
中科院分区：
文献类型：
--
作者：
Leahey, Tricia M.;Thomas, John G.;Wing, Rena R.
尽管行为减肥干预是在群体中进行的，但利用减肥群体的社会强化潜力的社会应急（SC）范式从未被测试过。我们测试了一种减肥干预措施，其中减肥组的参与取决于是否达到定期的体重目标。我们假设，使访问组依赖于体重减轻将改善体重的结果。参与者（N = 62; 84%女性; 94%白色;年龄= 51.9 +/- 9.0; BMI = 34.7 +/- 4.5）被随机分配至6个月的标准行为减肥（SBWL）或包括SC范例的行为计划。这两个团体都参与了社会凝聚力活动。没有达到体重目标的SC参与者没有参加小组会议;相反，他们接受了新干预者的单独治疗，一旦达到体重目标，他们就返回小组。SC未改善总体体重减轻结局（SC：-10.0 +/- 4.9 kg，SBWL：-10.8 +/- 6.4 kg，P = 0.63）。同样，在SC和SBWL条件下未达到定期减肥目标的参与者亚组中，总体体重减轻没有显着差异（-7.3 +/- 4.1 kg vs.-7.1 +/- 3.5 kg，P = 0.90）。令人惊讶的是，“成功的”SC参与者（达到他们的体重目标）实际上比“成功的”SBWL参与者减轻了更少的体重（-12.4 +/- 3.2 kg vs. -14.5 +/- 4.7 kg，P = 0.02）。然而，基于偶然性的治疗已经被测试用于其他健康行为（例如，药物滥用），这是第一项测试SC干预减肥的研究。这种方法并没有改善整体减肥效果。我们试图通过在需要时为SC参与者提供个体化治疗来提供适当的临床护理，这可能减轻了SC范式的影响。
Even though behavioral weight loss interventions are conducted in groups, a social contingency (SC) paradigm that capitalizes on the social reinforcement potential of the weight loss group has never been tested. We tested a weight loss intervention in which participation in the weight loss group was contingent upon meeting periodic weight goals. We hypothesized that making access to the group dependent upon weight loss would improve weight outcomes. Participants (N = 62; 84% female; 94% white; age = 51.9 +/- 9.0; BMI = 34.7 +/- 4.5) were randomized to 6-months of standard behavioral weight loss (SBWL) or to a behavioral program that included a SC paradigm. Both groups engaged in social cohesion activities. Participants in SC who did not meet weight goals did not attend group meetings; instead, they received individual treatment with a new interventionist and returned to group once their weight goals were met. SC did not improve overall weight loss outcomes (SC: -10.0 +/- 4.9 kg, SBWL: -10.8 +/- 6.4 kg, P = 0.63). Similarly, overall weight loss was not significantly different in the subgroup of participants in the SC and SBWL conditions who did not meet periodic weight loss goals (-7.3 +/- 4.1 kg vs. -7.1 +/- 3.5 kg, P = 0.90). Surprisingly, "successful" SC participants (who met their weight goals) actually lost less weight than "successful" SBWL participants (-12.4 +/- 3.2 kg vs. -14.5 +/- 4.7 kg, P = 0.02). Whereas contingency-based treatments have been tested for other health behaviors (e.g., substance abuse), this is the first study to test a SC intervention for weight loss. This approach did not improve overall weight loss outcomes. Our attempt to offer appropriate clinical care by providing individual treatment to SC participants when needed may have mitigated the effects of the SC paradigm.