Predictors of post-treatment weight reduction after in-patient behavioral therapy
Predictors of post-treatment weight reduction after in-patient behavioral therapy
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DOI：
10.1038/sj.ijo.0801710
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发表时间：
2001-05-01
影响因子：
4.9
通讯作者：
Fichter, MM
中科院分区：
文献类型：
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作者：
Cuntz, U;Leibbrand, R;Fichter, MM
目的：本研究的目的是确定治疗后体重减轻的协变量和预测因素。为了阐明个体因素的影响，我们比较了“胜利者”（在随访期间失去超过 2 个 BMI 点）和“失败者”（同时获得超过 2 个 BMI 点）。 设计：在一项基于问卷的研究中，我们在三个时间点评估了对饮食行为、一般精神病理学和抑郁症状的心理影响：入院前三个月（T0）、开始时（T1）和结束时。住院治疗 (T2) 以及治疗后 6、12 和 18 个月 (T3-T5)。 对象： 138 名肥胖患者 (BMI < 30 kg/m(2)) 被招募到该研究中。所有患者均参加了为期 10 周的多模式住院治疗计划。治疗内容包括认知行为疗法、运动疗法和营养咨询。治疗的目的是调节食物摄入量，尽量减少不良情绪对饮食行为的影响，加强体育锻炼并治疗共病精神疾病。初始样本中的 29 名患者 (13%) 在治疗期间和治疗后期间退出或被排除。 结果：在住院治疗期间，所有患者的饮食行为均得到改善，体重显着下降。后续期间体重持续小幅下降。此外，一般精神病理学、抑郁症状和饮食行为在随访期间得到改善并保持稳定。这些好处与减肥密切相关。 T0 和 T1 时测量的饮食行为、饮食相关认知或精神病理学都不能预测 T5 时的长期成功。在随访中，与“失败者”相比，“胜利者”表现出较少的精神病理学、较少的抑郁症状和较少的饮食行为紊乱。在出院时（T2），获胜者不太容易因外部刺激而进食，并且饥饿感也较少。这些差异预测了治疗后体重减轻（T3 -T5）。结论：报告的饥饿感和出院时测量的饮食行为抑制倾向能够预测我们样本中治疗后体重减轻。在住院治疗期间感到饥饿的患者在随访期间不太可能出现体重进一步减轻的情况。同样，治疗期间减少“去抑制”是治疗后减肥的先决条件。
OBJECTIVE: The goal of the present study was to identify covariates and predictors of post-treatment weight reduction. To clarify the impact of the individual factors, we compared 'winners' (losing more than 2 BMI-points in the follow-up period) with 'losers' (gaining more than 2 BMI-points in the same time).DESIGN: In a questionnaire based study, we evaluated the psychological impact on eating behavior, general psychopathology and depressive symptoms at three points in time: three months prior to admission (T0), at the beginning (T1) and at the end of in-patient treatment (T2) as well as 6, 12, and 18 months after treatment (T3-T5).SUBJECTS: One hundred and thirty eight obese patients (BMI < 30 kg/m(2)) were recruited to the study. All patients participated in a multimodal in-patient treatment program over a period of 10 weeks. Treatment elements were cognitive behavioral therapy, movement therapy, and nutritional counseling. The aim of treatment was to regulate food intake, to minimize dysfunctional emotional influences on eating behavior, to enhance physical exercise and to treat comorbid psychiatric disorders. Twenty nine patients (13%) of the initial sample dropped out or were excluded during the treatment and post-treatment period.RESULTS: During in-patient treatment eating behavior improved and body weight decreased considerably in all patients. The weight reduction continued slightly in the follow-up period. Moreover, general psychopathology, depressive symptoms and eating behavior improved and remained stable during follow-up. These benefits were closely related to weight reduction. Neither eating behavior, nor eating related cognition nor psychopathology measured at T0 and T1 predicted long term success at T5. 'Winners' as compared to 'losers' at follow-up showed less psychopathology, less depressive symptoms and a less disturbed eating behavior. Already at discharge (T2), winners were less prone to eating triggered by external stimuli and reported fewer feelings of hunger. These differences predicted post-treatment weight reduction (T3 -T5).CONCLUSION: Reported feelings of hunger and the tendency to disinhibited eating behavior measured at discharge were able to predict post-treatment weight reduction in our sample. Patients suffering from a feeling of hunger during in-patient treatment were less likely to show further weight reduction in the follow-up period. Similarly, reduction of 'disinhibition' during treatment is a precondition for post-treatment weight loss.