Binge Eating and Weight Loss Outcomes in Individuals with Type 2 Diabetes: 4-Year Results from the Look AHEAD Study.

Binge Eating and Weight Loss Outcomes in Individuals with Type 2 Diabetes: 4-Year Results from the Look AHEAD Study.
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DOI:
10.1002/oby.21975
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发表时间:
2017-11
期刊:
Obesity (Silver Spring, Md.)
影响因子:
--
通讯作者:
Berkowitz RI
Berkowitz RI
中科院分区:
其他
文献类型:
--
作者:
Chao AM;Wadden TA;Gorin AA;Shaw Tronieri J;Pearl RL;Bakizada ZM;Yanovski SZ;Berkowitz RI

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评估以减肥为目的的强化生活方式干预(ILI)是否会促进暴饮暴食(BE),以及BE是否会减缓2型糖尿病和超重/肥胖患者4年的体重减轻。参与者(n=4,901)来自Look AHEAD,这是一项比较ILI与糖尿病支持和教育(DSE)的随机对照试验。我们使用年度体重评估和自我报告的BE。根据每年的时间点,一个人认可BE,参与者分为:没有BE;汇出;事件;不一致的BE(2-3年,包括基线);持续BE(≥4年,包括基线)。我们使用Cox回归和混合效应模型进行分析。ILI参与者在第4年报告BE事件的可能性略高于DSE参与者(p=0.06)。在第4年,BE缓解的ILI参与者体重减轻(4.7±0.8%)比BE持续的患者(1.9±1.0%;p=0.03)更多。未发生BE的ILI参与者比偶发BE(3.1±0.6%,p=0.02)和持续BE (p=0.01)的ILI参与者体重减轻(4.6±0.2%)。与突发性和持续性脑损伤患者相比,脑损伤缓解的DSE参与者体重减轻更多。先前存在的BE似乎不是ILI的禁忌症,尽管持续的BE会减轻体重。报告新的或正在进行的BE患者需要额外的治疗。
To assess whether an intensive lifestyle intervention (ILI) for weight reduction precipitates binge eating (BE) and whether BE attenuates 4-year weight loss among participants with type 2 diabetes and overweight/obesity. Participants (n=4,901) were from Look AHEAD, an RCT that compared ILI to diabetes support and education (DSE). We used annual assessments of measured weight and self-reported BE. Using yearly time points a person endorsed BE, participants were classified as: no BE; remitted BE; incident BE; inconsistent BE (2–3 years including baseline); and consistent BE (≥4 years including baseline). We used Cox regression and mixed-effects models for analyses. ILI participants were marginally more likely to report incident BE at year 4 than those in DSE (p=0.06). At year 4, ILI participants with remitted BE lost more weight (4.7±0.8%) than those with consistent BE (1.9 ±1.0%; p=0.03). ILI participants with no BE lost more weight (4.6 ±0.2%) than those with incident BE (3.1 ±0.6%; p=0.02) and consistent BE (p=0.01). DSE participants with remitted BE lost more weight than those with incident and consistent BE. Preexisting BE does not seem to be a contraindication for ILI, although persistent BE attenuates weight loss. Patients who report new or ongoing BE need additional treatment.
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