Maintenance of Weight Loss After Initiation of Nutrition Training: A Randomized Trial.
Maintenance of Weight Loss After Initiation of Nutrition Training: A Randomized Trial.
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DOI：
10.7326/m16-2160
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发表时间：
2017-04-04
影响因子：
39.2
通讯作者：
Yancy WS Jr
中科院分区：
文献类型：
--
作者：
Voils CI;Olsen MK;Gierisch JM;McVay MA;Grubber JM;Gaillard L;Bolton J;Maciejewski ML;Strawbridge E;Yancy WS Jr
成功减肥干预后体重反弹是常见的。在肥胖成年人中建立与常规护理相比的减肥维持计划的疗效。2012年8月20日至2015年12月18日进行的按初始体重减轻（<10 kg vs. ≥10 kg）分层的2组、平行、随机试验。结果评估者对治疗分配不知情。（ClinicalTrials.gov：NCT 01357551）北卡罗来纳州达勒姆和罗利退伍军人事务医疗中心的3个初级保健诊所。肥胖门诊患者（体重指数≥30 kg/m2），在16周的分组减肥计划中体重减轻4 kg或以上。主要通过电话提供的维持干预，解决了对结果的满意度，复发预防计划，自我监测和社会支持。除研究测量外，患者护理不涉及任何接触。主要结局为第56周时的平均体重恢复。次要结局包括自我报告的热量摄入、步行和中度体力活动。在初始项目的504名患者中，222名体重减轻至少4公斤，并被随机分配到维持治疗组（n = 110）或常规治疗组（n = 112）。保留率为85%。大多数患者为中年白色男性。开始时的平均体重减轻为7.2 kg（SD，3.1）;随机化时的平均体重为103.6 kg（SD，20.4）。干预组的估计平均体重恢复（0.75 kg）在统计学上显著低于常规治疗组（2.36 kg）（估计平均差异，1.60 kg [95% CI，0.07 - 3.13 kg]; P = 0.040）。第56周时，次要结局无统计学显著差异。未观察到直接归因于干预的不良事件。结果可能无法推广到其他环境或人群。饮食摄入量和体力活动是自我报告的。持续时间限制为56周。一项针对特定维持策略的干预措施，以节约资源的方式进行，适度减缓了肥胖成年人的体重反弹速度。
Weight regain after successful weight loss interventions is common. To establish the efficacy of a weight loss maintenance program compared with usual care in obese adults. 2-group, parallel, randomized trial stratified by initial weight loss (<10 kg vs. ≥10 kg), conducted from 20 August 2012 to 18 December 2015. Outcome assessors were blinded to treatment assignment. (ClinicalTrials.gov: NCT01357551) 3 primary care clinics at the Veterans Affairs Medical Center in Durham and Raleigh, North Carolina. Obese outpatients (body mass index ≥30 kg/m2) who lost 4 kg or more of body weight during a 16-week, group-based weight loss program. The maintenance intervention, delivered primarily by telephone, addressed satisfaction with outcomes, relapse-prevention planning, self-monitoring, and social support. Usual care involved no contact except for study measurements. Primary outcome was mean weight regain at week 56. Secondary outcomes included self-reported caloric intake, walking, and moderate physical activity. Of 504 patients in the initial program, 222 lost at least 4 kg of body weight and were randomly assigned to maintenance (n = 110) or usual care (n = 112). Retention was 85%. Most patients were middle-aged white men. Mean weight loss during initiation was 7.2 kg (SD, 3.1); mean weight at randomization was 103.6 kg (SD, 20.4). Estimated mean weight regain was statistically significantly lower in the intervention (0.75 kg) than the usual care (2.36 kg) group (estimated mean difference, 1.60 kg [95% CI, 0.07 to 3.13 kg]; P = 0.040). No statistically significant differences in secondary outcomes were seen at 56 weeks. No adverse events directly attributable to the intervention were observed. Results may not generalize to other settings or populations. Dietary intake and physical activity were self-reported. Duration was limited to 56 weeks. An intervention focused on maintenance-specific strategies and delivered in a resource-conserving way modestly slowed the rate of weight regain in obese adults.