A Randomized Controlled Trial of a Theory-Based Weight-Loss Program for Couples
A Randomized Controlled Trial of a Theory-Based Weight-Loss Program for Couples
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DOI：
10.1037/hea0000808
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发表时间：
2020-02-01
影响因子：
4.2
通讯作者：
Huedo-Medina, Tania B.
中科院分区：
文献类型：
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作者：
Gorin, Amy A.;Powers, Theodore A.;Huedo-Medina, Tania B.
目的：体重增加发生在婚姻期间，但肥胖治疗的重点是个人。结果可能会改善针对联合减肥和人际环境，促进配偶的相互依赖。自我决定理论（SDT）认为，支持自我决定的环境（例如，促进有意义的选择，最大限度地减少控制）产生更好的健康结果。这项试验测试了SDT知情的减肥干预，旨在促进夫妇的自主权支持。方法：64对夫妇被随机分配到标准行为减肥（BWL），夫妇一起参加或SDT知情减肥干预（SDT-WL），旨在加强自主支持（AS）。各组每周会面一次，持续6个月，并在0、3、6和12个月进行评估。结果：6个月和12个月时的体重减轻百分比分别为10.4% +/- 6.5%和9.2% +/-8.2%。在BWL和SDT-WL条件下，未观察到体重减轻百分比或AS变化的差异。在各种情况下，较高的基线AS预测6个月和12个月时的体重减轻更大（ps < .001）。随着时间的推移，AS的增加预示着6个月和12个月时体重减轻更大（ps < .02）。事后适度分析表明，只有低（但不高）基线AS的参与者在SDT-WL中12个月时的AS比BWL条件下获得更大的收益（p <0.02）。结论：虽然没有发现差异的条件之间的减肥或自主支持行为的变化，自主支持从一个人的配偶预测减肥在这两个夫妇为基础的减肥方法。对于AS水平较低的夫妇，SDT知情的方法可以有效地增加这种理想的人际行为。
Objective: Weight gain occurs during marriage, yet obesity treatment is focused on individuals. Outcomes may be improved by targeting joint weight loss and the interpersonal milieu that fosters spousal interdependence. Self-determination theory (SDT) posits that autonomy-supportive environments (e.g., promote meaningful choice, minimize control) produce better health outcomes. This trial tested an SDT-informed weight-loss intervention intended to facilitate autonomy support in couples. Method: Sixty-four couples were randomized to standard behavioral weight loss (BWL) that couples attended together or to a SDT-informed weight-loss intervention (SDT-WL) that aimed to bolster autonomy support (AS). Groups met weekly for 6 months with assessments at 0, 3, 6, and 12 months. Results: Percent weight loss at 6 and 12 months was 10.4% +/- 6.5% and 9.2% +/- 8.2%. No differences were observed between the BWL and SDT-WL conditions in percent weight loss or changes in AS. Across conditions, higher baseline AS predicted greater weight loss at 6 and 12 months (ps < .001). Increases in AS over time predicted greater weight loss at 6 and 12 months (ps < .02). Post hoc moderation analysis indicated that only participants with low (but not high) baseline AS achieved greater gains in AS at 12 months in SDT-WL than in the BWL conditions (p < .02). Conclusions: Although no differences were found between conditions on weight loss or changes in autonomy support behavior, autonomy support from one's spouse predicted weight loss in both couples-based weight-loss approaches. For couples with low levels of AS, an SDT-informed approach was effective at increasing this desirable interpersonal behavior.