Early treatment response as a predictor of ongoing weight loss in obesity treatment
Early treatment response as a predictor of ongoing weight loss in obesity treatment
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DOI：
10.1348/135910705x43750
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发表时间：
2005-11-01
影响因子：
7.9
通讯作者：
Larocque, M
中科院分区：
文献类型：
--
作者：
Stotland, SC;Larocque, M
目标.本研究检查了肥胖治疗中的早期治疗反应，定义为体重指数（BMI）的早期变化和饮食行为的早期变化，作为肥胖患者体重持续减轻的预测因子。我们在9个月的时间里对饮食行为、情感因素（抑郁、压力、完美主义）和BMI进行了重复测量分析。受试者为344名女性，年龄18-65岁（平均= 41.8），BMI至少为25（平均BMI = 33.7），从事极低热量（VLCD）或低热量（LCD）饮食。多水平建模确定了持续体重减轻的四个重要预测因素（体重减轻发生在治疗开始后5周至9个月之间）。这些包括：饮食类型，早期BMI变化（开始至5周），称重次数和不受控制饮食的早期变化（开始至5周）。基于多水平模型的估计表明，早期治疗反应较强与较弱的患者在持续体重减轻方面预计会显示出较大的差异。饮食行为和体重的早期改善似乎在预测持续的体重变化方面具有累加效应。未来的研究需要确定减肥的最佳速度，是否有行为改变的关键时期，以及影响早期行为改变可能性的因素。
Objectives. This study examined early treatment response in obesity treatment, defined as early change in body mass index (BMI) and early change in eating behaviour, as a predictor of ongoing weight loss in obese patients.Methods. We conducted a repeated measures analysis of eating behaviour, emotional factors (depression, stress, perfectionism) and BMI, over a 9 month period. Subjects were 344 females, aged 18-65 (mean = 41.8), with a BMI of at least 25 (mean BMI = 33.7), engaged in very-low calorie (VLCD) or low-calorie (LCD) diets.Results. Multi-level modelling identified four significant predictors of ongoing weight loss (weight loss occurring between 5 weeks and 9 months after the start of treatment). These included: type of diet, early BMI change (start to 5 weeks), number of weigh-ins and the early change in uncontrolled eating (start to 5 weeks). Estimates based on multi-level modelling indicate that patients with strong versus weak early treatment responses would be expected to show large differences in ongoing weight loss.Conclusions. Early improvements in eating behaviour and weight appear to have additive effects in the prediction of ongoing weight change. Future research is required to identify the optimal rate of weight loss, whether there are critical periods for behaviour change, and factors which influence the likelihood of early behaviour change.