Weight cycling in treatment-seeking obese persons: data from the QUOVADIS study
Weight cycling in treatment-seeking obese persons: data from the QUOVADIS study
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DOI：
10.1038/sj.ijo.0802741
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发表时间：
2004-11-01
影响因子：
4.9
通讯作者：
Melchionda, N
中科院分区：
文献类型：
--
作者：
Marchesini, G;Cuzzolaro, M;Melchionda, N
目的：确定用于评估体重循环的体重史参数及其与心理困扰和暴饮暴食的关系。设计：横断面研究对象：共有1889名寻求治疗的肥胖受试者，来自25个意大利中心（78%女性受试者），年龄20 - 65岁（中位数45）; 1691人报告了先前的减肥努力（第一次节食的平均年龄，30岁）。测量：通过预定义的结构化访谈检查每年尝试减肥的次数、自20岁以来的体重增加、累积的体重减轻和增加。采用症状自评量表（SCL-90）、暴食量表（BES）和饮食三因素问卷（TFEQ）对患者进行心理困扰测试。体重史参数处于上四分位数的患者被认为是体重循环者。在多变量逻辑回归分析中，校正年龄、性别和BMI后，高BES评分是唯一与高频率节食系统相关的因素（OR，1.70; 95%置信区间，1.22 - 2.36; P = 0.022），累积体重减轻较高（1.42; 1.12 - 1.80; P = 0.003）和累积体重增加（1.38; 1.06 - 1.79; P = 0.017）。然而，高BES评分检测周期者的敏感性、特异性和阳性预测值非常低。体重循环并没有携带更高的风险并发症diseases.CONCLUSIONS：体重循环与心理困扰，暴饮暴食独立增加的风险，但不能用来预测循环。此外，肥胖患者谁不经历暴饮暴食作为失去控制停止治疗或恢复体重治疗后。
OBJECTIVE: To determine parameters of weight history useful for the assessment of weight cycling and their association with psychological distress and binge eating.DESIGN: Cross-sectional.SUBJECTS: A total of 1889 treatment-seeking obese subjects, enrolled by 25 Italian centers (78% female subject), aged 20 - 65 y ( median 45); 1691 reported previous efforts to lose weight ( median age of first dieting, 30 y).MEASUREMENTS: The number of yearly attempts to lose weight, weight gain since age 20 y, cumulative weight loss and gain were checked by a predefined structured interview. Psychological distress was tested by means of Symptom Check-List 90 (SCL-90), Binge Eating Scale (BES) and Three Factor Eating Questionnaire (TFEQ).RESULTS: Differences in anthropometric, clinical and psychological parameters were observed in relation to previous attempts to lose weight. Patients in the upper quartile of parameters of weight history were considered weight cyclers. In multivariate logistic regression analysis, after correction for age, sex and BMI, a high BES score was the only factor systematically associated with a high frequency of dieting ( OR, 1.70; 95% confidence interval, 1.22 - 2.36; P = 0.022), with higher cumulative weight loss (1.42; 1.12 - 1.80; P = 0.003) and cumulative weight gain (1.38; 1.06 - 1.79; P = 0.017). However, the sensitivity, specificity and positive predictive value of a high BES score were very low to detect cyclers. Weight cycling did not carry a higher risk of complicating diseases.CONCLUSIONS: Weight cycling is associated with psychological distress, and binge eating independently increases the risk, but cannot be used to predict cycling. Also, obese patients who do not experience overeating as a loss of control discontinue treatment or regain weight following therapy.